TWiV 1114: Clinical update with Dr. Daniel Griffin

In his weekly clinical update, Dr. Griffin discusses expanded use of the RSV vaccine by GSK, how the youngest member of the MicrobeTV family was hospitalized with RSV, why we are seeing more RSV infections than before the pandemic and how administration of monoclonal antibody therapy does not prevent infection but disease, before reviewing the weekly US COVID update, how SARS-CoV-2 affects neurodevelopment of the fetus and probability of preeclampsia, if giving Paxlovid prevents long COVID, and FDA recommends switching from the XBB.1.5 variant to JN.1 for fall COVID-19 vaccine formulations. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Young “Immune” co-host with RSV (YouTube) RSV on Immune (MicrobeTV) More children hospitalized with RSV after pandemic than before (Pediatrics) France supports Nirsevimab for RSV (Influenza and other respiratory viruses) Protects against disease not infection Nirsevimab (CIDRAP) TWiV tells it likes it is: protects against disease NOT infection (TWiV 695) RSV vaccine access expanded 50-59 (CIDRAP) GSK RSV vaccine expanded use for high risk 50-year olds (GSK) COVID-19 deaths COVID-19 national trend Neurodevelopmental delay in children whose mothers exposed to SARS-CoV-2 (Scientific Reports) Preeclampsia associated with SARS-CoV-2 infection (Journal of Maternal-Fetal & Neonatal Medicine) Effectiveness of nirmatelvir/ritonavir in children and adolescents (Nat Comm) JN.1 for fall COVID-19 boosters (FDA) COVID-19 vaccine booster switch (CIDRAP) EUA for pemgarda (FDA) Infusion centers near you! (pemgarda.com) CDC quarantine guidelines (CDC) Early phase of SARS-CoV-2 infection (COVID.gov) NIH COVID-19 treatment guidelines (NIH) Infectious Disease Society guidelines for treatment and management (IDSociety) Drug interaction checker (University of Liverpool) Molnupiravir safety and efficiacy (JMV) Convalescent plasma recommendations for immunocompromised (ID Society) Updated respiratory virus guidelines (CDC) What to do when your healthcare provider is infected with SARS-CoV-2 (CDC) Managing healthcare staff shortages (CDC) Steroids, dexamethasone at the right time (OFID) Anticoagulation guidelines (hematology.org) Long COVID evidence based review TWiV shout out (TWiV 1088) Nirmatrelvir-ritonavir prevents long COVID-19? (JAMA Medicine) Contribute to our Floating Doctors fundraiser Letters read on TWiV 1122 Dr. Griffin’s COVID treatment summary (pdf) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to [email protected]

TWiV rebuts a recent opinion piece which falsely claims that the COVID-19 pandemic began in a lab (it began in Nature). This material has been extracted from TWiV 1121. Hosts: Vincent Racaniello, Alan Dove, Rich Condit, Brianne Barker, and Jolene Ramsey Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode MicrobeTV Discord Server SARS-CoV-2 origin discussions previously on TWiV: TWiV 1019: Eddie Holmes on SARS-CoV-2 origins TWiV 1017: From Nature, not a lab TWiV 995: Viral origin stories TWiV 940: Eddie Holmes in on viral origins TWiV 876: Spillover market with Michael Worobey TWiV 762: SARS-CoV-2 origins with Robert Garry TWiV 760: SARS-CoV-2 origins with Peter Daszak, Thea Kølsen Fischer, Marion Koopmans TWiV 774: Kristian Andersen, Robert Garry, and the deleted SARS-CoV-2 sequences Why the Pandemic Probably Started in a Lab, in 5 Key Points (NY Times) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your virology questions and comments to [email protected] Content in this podcast should not be construed as medical advice.

TWiV rebuts a recent opinion piece which falsely claims that the COVID-19 pandemic began in a lab (it began in Nature), followed by a discussion of Paride bacteriophage, which has the unsual property of being able to kill dormant, antibiotic-tolerant cells by direct lytic replication. Hosts: Vincent Racaniello, Alan Dove, Rich Condit, Brianne Barker, and Jolene Ramsey Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode MicrobeTV Discord Server 2024 International HBV Meeting Register for ASV Annual Meeting SARS-CoV-2 origin discussions previously on TWiV: TWiV 1019: Eddie Holmes on SARS-CoV-2 origins TWiV 1017: From Nature, not a lab TWiV 995: Viral origin stories TWiV 940: Eddie Holmes in on viral origins TWiV 876: Spillover market with Michael Worobey TWiV 762: SARS-CoV-2 origins with Robert Garry TWiV 760: SARS-CoV-2 origins with Peter Daszak, Thea Kølsen Fischer, Marion Koopmans TWiV 774: Kristian Andersen, Robert Garry, and the deleted SARS-CoV-2 sequences Why the Pandemic Probably Started in a Lab, in 5 Key Points (NY Times) Phage Paride kills dormant, antibiotic-tolerant cells of Pseudomonas aeruginosa (Nat Comm) Interview with Enea Maffei (Spotify) Timestamps by Jolene. Thanks! Weekly Picks Brianne – How to build a nuclear warning for 10,000 years’ time Rich – Doctor My Eyes | Jackson Browne Alan – WHO Health for All Film Festival winners Jolene – El enemigo de mi enemigo es mi amigo Vincent – A Population Dotmap of New York City and Race and Ethnicity in New York City Listener Picks David – The greatest clock (and map) ever made Peter – The Mouse as a Microscope Intro music is by Ronald Jenkees Send your virology questions and comments to [email protected]

In his weekly clinical update, Dr. Griffin reports the third case of influenza H5N1 infection in a human, this time with respiratory symptoms, an H5 avian influenza virus wastewater dashboard, FDA approves Moderna’s mRNA vaccine for respiratory syncytial virus, vaccine advisors to FDA recommend switching from the XBB.1.5 variant to JN.1 for fall COVID-19 vaccine formulations, weekly US COVID update, a controlled human exhaled breath aerosol experimental study on the relative efficacy of masks and respirators as source control for viral aerosol shedding from people infected with SARS-CoV-2, systematic review of early use of oral antiviral drugs and the risk of post COVID-19 syndrome, long-COVID autonomic syndrome in working age and work ability impairment, Centers for Disease Control and Prevention estimates that 5.3% of Americans currently have long COVID, and the National Academies of Sciences, Engineering, and Medicine presented a report with  a number of conclusions about long-COVID diagnosis, symptoms, and impact on daily function. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode More cattle and dairy workers infected with highly pathogenic H5N1 in Michigan (CDC Newsroom) Not eye but respiratory human H5N1 in Michigan (CIDRAP) Emory and Stanford’sH5N1 dashboard (Emory and Stanford) FDA approval for MRESVIA(FDA) Moderna RSV vaccine for the elderly (CIDRAP) Moderna announces approval of MRESVIA (moderna) FDA VRBPAC meeting for fall COVID boosters (FDA) JN.1 variant for fall booster (CIDRAP) COVID-19 national trend (CDC) COVID-19 deaths (CDC) Masks and respirators for source control from viral aerosol shedding (Lancet) Spring vaccine advice (CIDRAP) Older adult spring booster available (CDC) Advisory committee for immunization practices slides (CDC) EUA for pemgarda (FDA) Where to get pemgarda (Pemgarda) CDC Quarantine guidelines (CDC) Early phase of SARs-CoV-2 infection (COVID.gov) NIH COVID-19 treatment guidelines (NIH) Infectious Disease Society guidelines for treatment and management (ID Society) Drug interaction checker (University of Liverpool) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendations for immunocompromised (IDSociety) Updated respiratory virus guidances (CDC) What to do when your healthcare provider is infected with SARS-CoV-2 (CDC) Managing healthcare staffing shortages (CDC) Steroids, dexamethasone at the right time (OFID) Anticoagulation guidelines (hematology.org) Early use of oral antiviral drugs and risk of long COVID (Journal of Infection) Early antiviral use associates with low risk of long COVID (CIDRAP) Long-COVID autonomic syndrome impairment (Scientific reports) Autonomic nervous assessment tool (hATTR) Do you know percentage of population with long COVID? (CDC National Center for Health Statistics) How many symptoms are there to long COVID? (CIDRAP) Long-term health effects of long COVID (National Academies of Sciences Engineering Medicine) Long COVID evidence based review TWiV shout out Contribute to our Floating Doctors fundraiser Letters read on TWiV 1120 Dr. Griffin’s COVID treatment summary (pdf) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to [email protected]

TWiV reviews viral shedding and antibody responses of men with acute monkeypox virus infection, and gene editing for latent herpes simplex virus infection reduces viral load and shedding. Hosts: Vincent Racaniello, Rich Condit, Kathy Spindler, and Angela Mingarelli Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode MicrobeTV Discord Server MicrobeTV store at Cafepress 2024 International HBV Meeting Michelson Prizes: Next Generation Grants Register for ASV Annual Meeting Monkeypox virus shedding (Nat Commun) Gene editing of herpes simplex virus (Nat Commun) Letters read on TWiV 1119 Timestamps by Jolene. Thanks! Weekly Picks Angela – Unconventional Sex Let Anglerfish Conquer the Deep Ocean Kathy – Doonesbury from 5-26-24. And Publish or Perish game Rich – Sky: Giant Sunspot Region 3664 and Resulting Auroras APOD video Vincent – Mysterious sea urchin plague is spreading through the world’s oceans Listener Pick Abdulaziz – Biomedical Scientist Answers Pseudoscience Questions Intro music is by Ronald Jenkees Send your virology questions and comments to [email protected] Content in this podcast should not be construed as medical advice.

In his weekly clinical update, Dr. Griffin delves into highly pathogenic H5N1 infection of hunting dogs, dairy cattle, humans and alpacas before reviewing the recent statistics on SARS-CoV-2 infection, risks factors associated with the development of severe COVID-19 in pediatric patients, virus transmission on commercial airline flights, the guidelines for spring administration of COVID vaccines boosters, the emergency use application of a pre-exposure prophylactic, a drug interaction database, absence of durability of XBB.1.15 vaccine induced immunity and continues to dispel the myth of viral rebound, when to use steroids and the benefits of convalescent plasma, what do when healthcare workers succumb to SARS-CoV-2 infection, and discusses why development of long COVID should be included in the development of treatments for acute viral disease, if vaccination effects long COVID, structural impairment of brain during long COVID, how cognitive and respiratory function may be compromised in long COVID.  For more information about long COVID-19 listen to TWiV 1088 and for H5N1 in dairy cattle and unpasteurized milk TWiV 1117. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Bird dogs  infected with high pathogenic avian flu H5N1(AKC) Hunting dogs with antibodiesagainst influenza A (H5N1) (Emerging Infectious Diseases) Dairy cattle and 2 humans infected with highly pathogenic avian influenza A (H5N1) (MMWR) Daisy, are you reading NEJM: cow’s milk infected with highly pathogenic avian influenza A (H5N1)?  (NEJM) Better yet, listen TWiV 1117: pol dances with RNA to learn if mice can transmit H5N1 to each other Alpacasinfected with for highly pathogenic avian influenza A (H5N1) (CIDRAP) USDA is now inspecting for highly pathogenic avian influenza A (H5N1) in alpacas in Idaho (USDA APHIS) COVID-19 deaths COVID-19 national trend Risk factors for pediatric critical COVID-19 (JPIDS) Kids and their underlying conditions for increased risk for severe COVID-19 (CIDRAP) SARS-CoV-2 transmission during airline flights (Environmental Research and Public Health) Spring vaccine advice(CIDRAP) Older adult spring  booster available (CDC) Advisory committee for immunization practice slides(CDC) Really, durable immune response of XBB.1.5 vaccines against Omicron subvariants (NEJM) EUA for pemgarda(FDA) Infusion centers near you! (pemgarda.com) CDC quarantine guidelines (CDC) Early phase of SARS-CoV-2 infection (COVID.gov) NIHCOVID-19 treatment guidelines (NIH) Infectious Disease Society guidelinesfor treatment and management (IDSociety) Drug interaction checker (University of Liverpool) Molnupiravirsafety and efficiacy (JMV) Convalescent plasma recommendations for immunocompromised (IDSociety) Updated respiratory virus guidelines (CDC) What to do when your healthcare provider is infected with SARS-CoV-2 (CDC) Managing healthcare staff shortages (CDC) Steroids, dexamethasone at the right time (OFID) Anticoagulation guidelines (hematology.org) Long COVID evidence based review TWiV shout out (TWiV 1088) Post COVID-19 following virus vaccination (Nat Comm) Why include long COVID-19 when developing novel treatments for acute disease (JID) Cerebral microstructural alterations post COVID-19 cognitive, memory and fatigue (Nat Comm) Cognitive impairment prevalence and co-occurrence in children and young adults 12 months after Omicron infection (Brain) Persistent static lung hyperinflation and small airway dysfunction in long COVID (Respiratory Research) Long COVID evidence based review TWiV shout out Contribute to our Floating Doctors fundraiser Letters read on TWiV 1118 Dr. Griffin’s COVID treatment summary (pdf) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to [email protected]

TWiV discusses presence of infectious avian H5N1 influenza virus in raw milk from infected dairy cows. dynamics of measles immunity from birth and following vaccination, and a mechanism for cis-preferential reverse transcription revealed by deep mutational scanning of hepatitis B virus. Hosts: Vincent Racaniello, Dickson Despommier, Alan Dove, Rich Condit, Kathy Spindler, and Brianne Barker Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode MicrobeTV Discord Server MicrobeTV store at Cafepress 2024 International HBV Meeting Michelson Prizes: Next Generation Grants Register for ASV Annual Meeting H5N1 influenza virus in raw cow milk infects mice (NIAID News) Dynamics of measles virus immunity from birth (Nat Comm) Mechanism of cis-preferential HBV reverse transcription (Cell) Timestamps by Jolene. Thanks! Weekly Picks Dickson – Oldest virus in Neanderthal bones Brianne – Jeopardy! winner reveals entwined memory systems make a trivia champion Kathy – Bright future of intelligent fabrics primary article and Self-dyeing textiles (primary article) Rich – Farewell to HD Atlas; Boston Dynamics Retires HD Atlas Robot Alan – Why vaccinating cattle against H5N1 is hard Vincent – Singapore Airlines turbulence: why climate change is making flights rougher Intro music is by Ronald Jenkees Send your virology questions and comments to [email protected]

In his weekly clinical update, Dr. Griffin delves highly pathogenic H5N1 biology including its circulation in New York City, being able to infect cells within mammary glands and why testing is not supported before reviewing the recent statistics on SARS-CoV-2 infection, how vaccination reduced deaths and hospitalizations associated with COVID-19 and how to take off PPE to reduce virus transmission, discussing the guidelines for spring administration of COVID vaccines boosters, the emergency use application of a pre-exposure prophylactic, a drug interaction database and the global phase 3 trail of a novel antiviral, continues to dispel the myth of viral rebound, when to use steroids and the benefits of convalescent plasma, what do when healthcare workers succumb to SARS-CoV-2 infection, reminisces about when available monoclonal antibody therapies were effective, and discusses muscle training/exercise for treatment of PASC/long COVID and the use of RNase for its treatment. For more information about long COVID-19 listen to TWiV 1088. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Clade 2.3.4.4b of highly pathogenic H5N1 in NYC (J Vi) Avian and human influenza A receptors in bovine mammary glands (bioRxiv) Where livestock infected with HPAI live (USDA) Another dairy worker contracted bird flu (NY Times) Reluctance to test for H5N1 (STAT News) COVID-19 national trend (CDC) COVID-19 deaths (CDC) Estimates of hospitalization and deaths prevaccination era (Emerg Inf Dis) Slightly less than half of COVID-19 patients died prevaccination (CIDRAP) Spring vaccine advice (CIDRAP) Older adult spring booster available (CDC) Advisory committee for immunization practices slides (CDC) Advisory committee for immunization practices spring 2024 COVID-19 boosters (CDC) EUA for pemgarda (FDA) CDC Quarantine guidelines (CDC) Early phase of SARs-CoV-2 infection (COVID.gov) NIH COVID-19 treatment guidelines (NIH) Infectious Disease Society guidelines for treatment and management (IDSociety) Drug interaction checker (University of Liverpool) Global phase 3 study of ensitrelvir (Shionogi) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (IDSociety) Updated respiratory virus guidances (CDC) What do when your heathcare provider is infected with SARS-CoV-2 (CDC) Managing healthcare staffing shortages (CDC) Remember when monoclonal antibody therapies worked (JID) Steroids, dexamethasone at the right time (OFID) Anticoagulation guidelines (hematology.org) Global clinical study of long COVID-19 (International Journal of Infecitous Diseases) Cardiopulmonary exercises testing of children with long COVID-19 (Pediatric Infectious Disease Journal) Phase 2 trial of RSVL-132 for severe fatigue related to PASC (CID) Muscle training may improve diaphragm muscle weakness 2 years after COVID-19 (American Journal of Respiratory Critical Care Health) Long COVID evidence based review TWiV shout out (TWiV 1088) Contribute to our Floating Doctors fundraiser Letters read on TWiV 1116 Dr. Griffin’s COVID treatment summary (pdf) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to [email protected]

TWiV reviews results of a phase 3 trial of a self-amplifying mRNA COVID-19 vaccine, and the finding that baseline innate and T cell populations are correlates of protection against symptomatic influenza virus infection independent of serology. Hosts: Dickson Despommier, Alan Dove and Brianne Barker Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode MicrobeTV Discord Server MicrobeTV store at Cafepress Michelson Prizes: Next Generation Grants Immunogenicity and safety of self-amplifying mRNA COVID-19 vaccine (Lancet Inf Dis) First self-amplifying mRNA vaccine approved in Japan (Science) Rise of the RNA machines (Trends Biochem) Innate and T cell populations correlates of protection against influenza (Nat Immunol) Timestamps by Jolene. Thanks! Weekly Picks Dickson - Nitrogen-fixing organelle in a marine algaBrianne – Mapping a lost branch of the Nile Alan – Interactive version of the updated USDA gardening zone map on NPR. Intro music is by Ronald Jenkees Send your virology questions and comments to [email protected]

In his weekly clinical update, Dr. Griffin delves into discussing drinking “raw” milk possessing H5N1 influenza virus, if the virus can reproduce in the human gut, and the meaning of finding viral RNA in wastewater samples before reviewing the recent statistics on SARS-CoV-2 infection, the guidelines for spring administration of COVID vaccines boosters, withdrawal of AstraZeneca’s SARS-CoV-2 vaccine from the European market, discusses the emergency use application of a pre-exposure prophylactic, continues to dispel the myth of viral rebound, when to use steroids and the benefits of convalescent plasma, what do when healthcare workers succumb to SARS-CoV-2 infection, if administration of colchicine for the management of COVID-19, compares and provides information for the enrollment into the NIH clinical trials of long COVID and its effects on sleep, exercise intolerance and the cognitive profile in multiple sclerosis and post-COVID, exercise intolerance and post-exertional malaise. For more information about cow and milk infection by H5N1 listen to the discussion with Richard Webby on TWiV 1113 and for long COVID-19 listen to TWiV 1088. Dr. Griffin also provides a list of apps for monitoring one’s health including brain health. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Who demands milk infected with H5N1? (Futurism) Uncowed by milk possessing H5N1  (LA Times) Cow flu flying around for 4 months (CNN) The unpasteurized raw milk institute (Raw Milk Institute) Infection and reproduction of H5N1 in the human gut (JID) Wastewater samples identified H5N1 in 9 cities (medrxiv) Richard Webby, is H5N1 a concern? (TWiV 1113) COVID-19 national trend (CDC) COVID-19 deaths (CDC) Spring vaccineadvice (CIDRAP) Older adult spring booster available (CDC) Advisory committee for immunization practices slides (CDC) Advisory committee for immunization practices spring 2024 COVID-19 boosters (CDC) Withdrawal of Astra-Zeneca SARS-CoV-2 vaccine in Europe (European Medicines Agency) Astra-Zeneca withdraws SARS-CoV-2 vaccine from market (AP news) Global vaccine data/adverse event network (Vaccine) EUA for pemgarda (FDA) CDC Quarantine guidelines (CDC) Early phase of SARs-CoV-2 infection (COVID.gov) NIH COVID-19 treatment guidelines (NIH) Infectious Disease Society guidelines for treatment and management (IDSociety) Overuse ofantibiotics for COVID-19: a viral disease (European Society of Clinical Microbiology and Infectious Diseases) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (IDSociety) Outpatient treatment with concomitant vaccine-boosted convalescent plasma (mBio) Updated respiratory virus guidances (CDC) What do when your heathcare provider is infected with SARS-CoV-2 (CDC) Managing healthcare staffing shortages (CDC) Steroids,dexamethasone at the right time (OFID) Anticoagulation guidelines (hematology.org) Colchicine for managing COVID-19 (BMC Pulmonary Medicine) Colchicine guidelines (ID Society) Long COVID evidence based review TWiV shout out (TWiV 1088) NIH long COVID sleep disturbance, exercise intolerance and post exertional malaise clinical trials (NIH News) COVID-19 Yorkshire rehabilitation scale (BML Open Respiratory Research) Visible heart monitor (Makevisible) Bearable app (Bearable) Tracking your chronic illness using Flaredown (Flaredown) Improving your brain health (BrainHQ)Vanderbilt’s long COVID resources: podcasts and books (Vanderbilt University) Contribute to our Floating Doctors fundraiser Letters read on TWiV 1114 Dr. Griffin’s COVID treatment summary (pdf) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to [email protected]