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Featured topic and speakers
Is there a blood test for Alzheimer's? What causes colon cancer? How many measles cases in 2025? Is bird flu still an issue? What outbreaks are happening right now?
AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, covers the first measles cases of the year in new U.S. cities, and avian flu outbreaks in dairy cattle and poultry. Also discussing a recent survey on Alzheimer's disease and new research suggesting links between gut bacteria and colon cancer in younger adults. 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: Both Chicago and Dallas have reported their first measles cases for the year. Here, in Chicago, local public health departments are investigating two cases. One is a Chicago resident who traveled internationally through O'Hare Airport in early April. The other is a Cook County resident who sought care at a local hospital on April 28 and was quickly isolated.
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. Great to be here.
Unger: It feels like we haven't talked about bird flu in a long time, but bird flu was back in the news last week. And there have been a number of new cases, Andrea. Bring us up to speed.
Garcia: Well, the past few weeks, we've seen new H5N1 avian flu detections in both dairy cattle and poultry across multiple states. According to the USDA's Animal and Plant Health Inspection Service, last week, there were 15 new cases of bird flu in cattle in Idaho and one new case in California. Idaho is where we're seeing most of the new cases in dairy cattle, and that's according to the state's Department of Agriculture. Right now, there are 59 quarantined dairy cow facilities in four counties there.
As for new bird flu cases in poultry, there were three more detections in late April in three different states—New York, North Dakota and Minnesota. These new cases continue the steady drumbeat that we've been tracking over the last couple of months. Thankfully, we have not seen new human cases of H5N1 in the U.S. or evidence of human-to-human transmission. But it's still something that we need to be concerned about.
Unger: Yes, we do. And just last week, a group of leading health experts called for more action to address the threat of bird flu. Andrea, what did that have to say?
Garcia: Well, Todd, those comments appeared in The Lancet Regional Health Americas and came from the Global Virus Network, which is an international coalition of virologists. The commentary identified key areas of concern and 11 ways the global health community can help prevent a widespread outbreak of bird flu.
A few of those recommendations included enhanced surveillance and monitoring and faster genomic data sharing. Additionally, it recommended improving biosecurity and biocontainment on farms by providing PPE and support for culling operations. Other recommendations included establishing best practices, making rapid tests available on farms.
According to the CDC, the risk H5N1 poses to the general public remains low. We know that farmers and those who work with infected animals or their byproducts are at increased risk. We're definitely going to need to stay vigilant on this and take steps to mitigate the spread of H5N1.
Unger: All right. Thank you for bringing us up to speed on bird flu. Let's turn our attention now to measles, which is, of course, been in the news for many of the past few weeks, including last week right here in Chicago we had a development. Andrea, what's going on there?
Garcia: Yeah, Todd, so both Chicago and Dallas have reported their first measles cases for the year. Here in Chicago, local public health departments are investigating two cases. One is a Chicago resident who traveled internationally through O'Hare Airport in early April. The other is a Cook County resident who sought care at a local hospital on April 28 and was quickly isolated. In Dallas, there was a case involving a patient that has been linked to multiple exposures, including a Texas Rangers baseball game on April 19.
Now, the broader Dallas-Fort Worth area does now have four measles cases. Health officials have not officially tied any of those cases to the broader Texas outbreak. But as we've discussed before, the state of Texas has seen a large number of measles cases this year.
Unger: Yes, and speaking of that, we're still closely following the big outbreak that's happening in West Texas and the surrounding areas. How have cases changed since we talked last?
Garcia: Well, as of last Friday, there have now been 683 cases in Texas that are tied to this outbreak and 67 cases in New Mexico. Meanwhile, in Oklahoma, the total number of cases has increased to 16. As for Kansas, last Wednesday, there were 46 cases in total there. So week after week, we are still seeing a steady increase in new cases. And at the moment, this outbreak doesn't appear to be losing much momentum.
Unger: All right. And we'll be sure to check in next week for an update on those numbers. For now, let's shift gears and talk about something different, and that is Alzheimer's. It was back in the news because a new survey released by the Alzheimer's Association. Andrea, what were some of the key takeaways from that study?
Garcia: Well, this was a survey of 1,700 people age 45 and older, and it asked about a range of topics covering testing, diagnosis and treatment of Alzheimer's disease. Let's talk about a few of the highlights.
It found that nearly 80% of people surveyed said they would want to know if they had Alzheimer's before symptoms began to interfere with their daily activities. 91% said they would take a blood biomarker test or some other simple test if one were available. And then 92% said if they were diagnosed with Alzheimer's, they would probably or definitely want to take a drug that could slow its progression. These findings show a strong desire from patients to be knowledgeable about their health and take action when it comes to Alzheimer's.
Unger: And that makes a lot of sense. But Andrea, what are the options right now in terms of treating Alzheimer's?
Garcia: Well, Todd, there have been a lot of developments on both the testing and treatment fronts recently. In terms of testing, we talked about a month ago about two new blood tests for Alzheimer's. These tests are unique because they don't just help diagnose the condition, but they also give an indication of how far it's progressed.
Now, these tests are not yet widely available to patients, but they could be soon. Additionally, over the last couple of years, we've seen the FDA approved two new drugs, which can help slow the progression of Alzheimer's in the early stages of the disease. These two drugs are lecanemab and donanemab. When you take these developments together, it amounts to some pretty big changes in a short amount of time.
And I think that's going to lead to even more change because our health care system currently isn't prepared to diagnose, treat and monitor a large number of Alzheimer's patients. That's mostly because these opportunities just didn't exist a few years ago. So this is definitely an area we'll be keeping an eye on this year.
Unger: That's encouraging news. Andrea, another topic we've been discussing recently on the show is the rise of colon cancer in younger adults, those in their 40s, as opposed to the traditional 50 and up. A new study is shedding more light on that, Andrea. What do we need to know?
Garcia: Well, colon cancer is indeed on the rise in younger generations. And you talked about this trend last week with Dr. Corley from the Permanente Medical Group. In your conversation, he mentioned that changes in the gut biome could be one of the factors behind this increase.
There was a new study in Nature that is offering some support for that idea, and that study analyzed tissue samples from nearly 1,000 colorectal cancer patients from across four continents. It found a majority of patients had cancer-bearing mutations that signaled an encounter with colibactin, which is a toxin made by a certain strain of E. coli and other bacteria. Those under age 40 with early-onset colon cancer were three to five times more likely to have these mutations than those aged 70 and older. Todd, the thinking here is that colibactin can get directed at people's gut cells and cause mutations that then put them at increased risk of developing colorectal cancer.
Unger: Gosh, the microbiome, so much to explore and understand there. And I recall that Dr. Corley also mentioned that it was probably a combination of risk factors that are contributing to this overall increase. With this study in mind, is that the case?
Garcia: Absolutely. First, it's important to remember that this study doesn't prove that colibactin caused these patients to develop colon develop colon cancer. And researchers in general don't expect that any single microbe is going to be the main reason why colon cancer is on the rise in younger adults. What this study does is give us new insights and a new area for research to explore. And as Dr. Corley noted in his interview, there are many other risk factors that need to be explored further in this space.
Unger: And if you didn't have a chance to check that interview out with Dr. Corley, I encourage you to take a look. A lot to learn here. Andrea, thank you for all these insights, and as always, for keeping us up to date each week. If you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/joinnow.
Patients you too can get involved by joining the AMA's Patient Action Network at patientsactionnetwork.com. As always 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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