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Avian influenza, having victimized fifty-eight million poultry birds, hundreds of South American wild sea lions, and a European farm of minks, threatens humans as a catalyst and potential pandemic capable virus. Although the virus has yet to unlock a string of mutations and genetic changes that could result in spillover to mammals, the avian flu’s risk profile is being closely monitored.

Mississippi, our nation’s poorest state, crushed by a staggering 900% increase in newborns with syphilis. This horrifying finding, which is an avoidable public health crisis, supports the unfortunate Mississippi statistic of being home to the nation’s worst infant mortality rate.

Ohio’s abortion law highlights a fascinating and brutal case study of public health policy interfering with clinical judgement and common sense. In this story of a rare condition called limb body wall complex, government impeding clinical care is illuminated.

Measles outbreak in central Ohio has been neutralized after sickening 85 children who were not fully vaccinated. The outbreak, which hasn’t seen a new case in at least 42 days, resulted in 36 hospitalizations but zero deaths.

Sexual attacks and other traumatic experiences have led to an unprecedented level of hopelessness and suicidal thoughts among America's young women, as reported by the CDC. Our teenage girls are suffering a significant and heartbreaking decline in youth health and wellbeing overall, according to data published by the CDC.

The Ohio train derailment sets off alarms for health and environmental concerns amid contamination and toxicity threats

Earlier this month, 50 cars of a 150 car Norfolk Southern train derailed, which included about 20 cars carrying hazardous materials, and resulted in a days-long fire with major concern over a massive explosion to follow. The hazardous chemicals contained in the derailed and burning cars include vinyl chloride, butyl acrylate, ethylhexyl acrylate and ethylene glycol monobutyl ether, with the main concern on this list being vinyl chloride, which is a cancer-causing and explosive chemical ingredient used to make hard plastic such as PVC pipe.

Upon evacuating the residents in the immediate one-mile radius of East Palestine, Ohio where the derailment took place, the decision was made to drain the chemicals into a trench and conduct a controlled burn, which effectively converts vinyl chloride into phosgene gas, used as a lethal chemical weapon in World War I. In addition to the primary vinyl chloride threat, contact with ethylhexyl acrylate, a carcinogen, can cause burning and irritation of the skin and eyes, and inhalation can irritate the nose and throat, causing shortness of breath and coughing, according to the CDC. To round out our list of toxins introduced to East Palestine, inhalation of isobutylene can cause dizziness and drowsiness as well, while exposure to ethylene glycol monobutyl ether can cause irritation in the eyes, skin, nose, and throat, as well as hematuria, or blood in the urine, nervous system depression, headache, and vomiting, according to the CDC.

• Upon the evacuation lifting, and the area declared safe, serious skepticism, concerns, and precautions are still appropriate. The EPA has also screened over three hundred homes near the crash site and has not detected any levels of vinyl chloride or hydrogen chloride, the agency said.
  
  
• While the chemicals being burned off have in a perverted sense eliminated some immediate danger, nasty byproducts have been created via combustion and introduced to the air, soil, and water. While the Ohio Department of Natural Resources has already connected the deaths of 3,5000 small fish across nearly 8 miles of streams to the chemical spill, reports of far greater and wide reaching casualties continue to accumulate, adding to the growing fear of environmental backlash of this disaster of an accident.
  
  

What the author of the study is saying: "Now that we are entering into a longer-term phase of this, people are going to be concerned about the long-term chronic exposure that comes at lower levels," said Ohio State Professor Karen Dannemiller, who specializes in indoor air quality.

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While fungal threats will not lead to “The Last of Us,” fungal infections deserve fear, respect, and a closer look

While I do not anticipate a cataclysmic event depicted in HBO’s latest series “The Last of Us” in which a Ophiocordyceps fungal species variant infects humanity making Covid-19 appear as a delicate hors d’oeuvre offering, I do believe the fungus kingdom deserves our full attention and a dedicated post in this newsletter.

Key takeaways

• The threats imposed by fungal pathogens is increasing, and will grow much worse due to the warming climate, wetter environment, and sicker population of the world.
  
  
• An overarching theme of the fungus kingdom growing an increased resistance to antifungal treatments along with compromised immune systems and/or underlying conditions creates the highest risk. These underlying conditions include HIV, cancer, or diabetes, and suppressed immune systems due to age, disease, or drug use.
  
  
• Because of the environmental factors at play, along with a growing number of immune suppressed people highlighted by an aging population, fungal threats grow and fear around their potential pathogenic impact swells.
  
  
• There are four most critical species labeled by the WHO, none of which have an associated vaccine, and they are as follows: Cryptococcus neoformans, Candida auris, Aspergillus, and Candidiasis.
  
  

By the digits

• 75,000 hospitalizations due to fungal infections per year in the U.S.
  
  
• 9 million outpatient visits due to fungal infections per year in the U.S.
  
  
• 7,200 deaths from fungal diseases in the U.S. in 2021
  
  
• 1.5 million deaths from fungal treatments worldwide per year
  
  
• 300 fungal species of the 4 million species known have been identified as human pathogens that can cause disease.
  
  
• 19 fungal species identified as major threats to public health by the World Health Organization.
  
  
• 30 different countries (including the U.S.) host the Candida auris fungus, which is resistant to all the drugs used to treat it.
  
  

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A 24-year-old man and a 22-year-old woman come to the office for the first time for premarital evaluation and counseling. Neither of them has ever been sexually active because they "want to wait" until after marriage to have sexual intercourse. Other discussion reveals that they have never had blood transfusions, used illicit drugs, or drunk excessive amounts of alcohol. They have heard about the test for HIV antibody and wonder whether they should obtain this test before marriage.
Compared with persons who have multiple risk factors for HIV, which of the following statements best applies to this couple?

Climate change and antimicrobial resistance are two of the greatest threats to global health, according to a new report from the United Nations Environment Programme. The appropriately named “Bracing for Superbugs” report illuminates the compounding factors leading to the rise of antimicrobial resistance, headlined by climate change and environmental factors.

Protection against cognitive decline points towards education, income, and job type. A new study indicates that these factors potentially explain the near 40% difference in amount of cognitive ability lost by the age of fifty-four.

Enormous California based study of 2.5 million pregnant women found that those exposed to wildfire smoke for at least one day received a higher risk of preterm birth. The study also found that the odds of preterm birth increased by 0.3% with each passing day of smoke exposure.

Long-term exposure to polluted air linked to developing late-onset depression in relation to those who live in areas with cleaner air. These results are surprising considering that new diagnoses of depression are far more common in younger adults than older adults, highlighting the impact of the pollutants being studied.

Thank you for reading! More next week,

My best wishes for a productive and idea-filled week ahead. Thanks for your ongoing efforts to improve the lives of the patients we all serve. Please send any news, comments, suggestions and ideas to hello@morningmed.email.

Quiz answer: The correct answer is B) "The positive predictive value of the test would be lower"

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