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Featured topic and speakers
Can cats get bird flu? Is there a cure for measles? How many measles cases in the U.S.? Is the new COVID vaccine effective? Why are cancer screenings declining?
AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, discusses post-pandemic cancer screening rates, latest updates on the measles outbreak, bird flu in cattle, H5N1 in pets and the effectiveness of the COVID vaccine. 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: Cancer screening rates have had somewhat of an uneven recovery from the pandemic. So from 2019 to 2013, screening rates for breast cancer increased 7% while those for colorectal cancer increased 12%. However, screening rates for cervical cancer decreased 14% over that time.
Unger: Hello everyone 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 for having me. Good to be here.
Unger: Well, let's start with measles. There have been a number of new developments in the measles outbreak that we've been following. Andrea, why don't you start by bringing us up to speed on what's going on?
Garcia: Sure, Todd. And I'm sorry to say that there has now been a second death in this growing regional outbreak. This individual was an unvaccinated adult who lived in Lea County, New Mexico. He did not seek medical care before their death, and their official cause of death is still under investigation.
However, the state health department has confirmed the presence of the measles virus in that individual. It's noteworthy because it's the first measles death reported in the Lea County outbreak. We do know that over half of the cases there are in individuals over the age of 18. As we've discussed, this county is over the border from Gaines County, Texas, which has been the hardest hit by this outbreak.
Unger: Well, Andrea, the number of measles cases has been steadily rising as well. Where do the numbers stand now?
Garcia: Well, as of last Friday, there were 198 cases in Texas, which is up from 146 when we talked last week. In Lea County, New Mexico, as of last Thursday, there were 30 cases, which is up from nine the week before. The CDC has announced that it's now working with local health officials on the ground in Texas to help contain that outbreak.
The agency said this partnership is known as Epi-Aid. It involves epidemic intelligence service, or EIS, officers, who provide on site support for one to three weeks. As always, we will continue to monitor how cases rise over the next week and keep people posted on new developments.
Unger: Andrea, last Friday, the CDC also issued a HAN health advisory about the measles outbreak. What did that advisory have to say?
Garcia: Well, that's right, Todd. And as of March 6, there have been a total of 222 measles cases reported by 12 U.S. jurisdictions this year. So that advisory provided guidance for physicians, for public health agencies, as well as people with upcoming travel plans. In it, the CDC urged physicians to be vigilant for cases of febrile rash illnesses that meet the measles case definition, particularly in unvaccinated persons. It provided physicians with recommendations on talking to their patients about vaccination and what to do if they suspect a patient has measles.
The agency also urged travelers to ensure that they are vaccinated against measles, and this is especially important given the upcoming spring and summer travel season and the fact that we're already starting to see measles cases in other states due to travel, like those in Seattle, King County, Washington, Howard County, Maryland, and Montgomery County, Pennsylvania. For more information, people can find the link to the full advisory in the description of this episode.
Unger: All right. And we will continue to track this outbreak closely as things develop. Andrea, we recently put out a statement urging the public to get vaccinated. What were some of the highlights from that message?
Garcia: Well, Todd, the AMA wanted to remind the public that the measles, mumps and rubella vaccine is extraordinarily safe and effective. It's widely available and the surest way to protect yourself and those around you from measles. As you noted, we're urging people to talk to their physician or their children's pediatrician about getting vaccinated if they haven't already done so. There is no cure or specific antiviral treatment for measles. Vaccination remains the best defense against infection.
Unger: All right. Thank you so much for the measles outbreak update. And now let's shift gears and check in on bird flu. Andrea, any updates on cases that we should know about?
Garcia: Well, Todd, we have not seen any additional reported human cases of H5N1 in the U.S. That number of cases still stands at 70. But we are continuing to see H5N1 in dairy cattle. On March 4, we saw the USDA confirm that H5N1 had been detected in dairy cattle in Idaho.
This is the first case of bird flu in dairy cattle in that state since last October. So far, it's unclear if this virus is the B3.13 genotype, which has been spreading in dairy cattle, or the D1.1 genotype. That D1.1 genotype has been spreading in wild birds, but over the last several weeks it has made the jump to dairy cattle, both in Nevada and in Arizona. The agency has also reported that more cases of bird flu have been seen in poultry in two states, and we've seen seven more cases in domestic cats. And that's in Washington, in Oregon, Colorado and New Jersey.
Unger: Speaking of cats, pet owners out there have a lot of questions about what they can do to protect their pets from bird flu. This is an unusual topic for us, Andrea. Why don't you give the folks out there a high-level overview of what they might need to know?
Garcia: Well, the CDC outlined steps that pet owners should be taking, and many of them are good for everyone to be aware of. For example, the agency encourages people to avoid direct contact with wild birds and to observe wild birds only from a distance.
That goes for pets as well. Neither people nor pets should touch sick or dead birds, their feces or litter, or any surface or water source that might be contaminated with their bodily fluids. If people must come into direct contact with wild birds or contaminated areas, the CDC recommends wearing PPE and washing your hands with soap and water afterwards. And lastly, people should not let their pets consume raw pet food or unpasteurized milk.
Unger: All right. Well, thank you so much for that. For our next update, there's a new study on trends in cancer screenings. What can you tell us about that, Andrea?
Garcia: Well, Todd, this new study used data from the National Health Interview Survey to measure how often people were screened for various cancers before, during and then after the pandemic. And what it found was that cancer screening rates have had somewhat of an uneven recovery from the pandemic.
So from 2019 to 2013, screening rates for breast cancer increased 7% while those for colorectal cancer increased 12%. However, screening rates for cervical cancer decreased 14% over that time. It's definitely encouraging to see screening levels rebound from the pandemic. But that decline in cervical cancer screenings is troubling.
Unger: It's kind of strange to see that decline. Is there any insight from the study about it?
Garcia: Well, one thing the researchers mentioned is that it could be due to a decline in patient awareness about the procedure. In that regard, health systems and physicians could certainly play a major role in reversing this decline by proactively reaching out to patients who are most at risk and talking with them about the importance of screening for cervical cancer.
The study also found that the rebound in screening for breast and colon cancers was mainly driven by people who made more money, had higher education and are privately insured or Medicare recipients. So it's possible that cost and access could be barriers to screening as well.
Unger: Well, Andrea, staying on the topic of cervical cancer for a moment, last week there was some good news about it related to the CDC's Morbidity and Mortality Weekly Report. What was in that?
Garcia: In that report, there was a study that showed the HPV vaccine has led to a major drop in the incidence of precancerous lesions that are linked to cervical cancer. So this study looked at CDC data on precancerous lesions from 2008 to 2022, and it found that among women aged 20 to 24 years that precancer incidence decreased by 80%. Rates among women aged 25 to 29 years decreased by 37%.
And we think that difference is likely because the older age group was only eligible for catch-up vaccination. So they had a higher likelihood of being exposed to HPV before they received vaccination. This study further underscores the importance of getting that HPV vaccine, which is recommended for routine vaccination at age 11 or 12 years or for everyone through age 26 if they're not adequately vaccinated when they're younger.
Unger: All right. Thank you so much for that update. Andrea, that same CDC report also had some positive news about the latest COVID vaccine. What are the details there?
Garcia: Well, Todd, the CDC has provided midseason vaccine effectiveness data for the 2024-25 COVID season, and the current vaccine was 33% effective in preventing COVID-related ED or urgent care visits in adults. It was 45% to 46% effective at reducing the risk of hospitalization in older adults. That data was too limited to draw broader conclusions about the effectiveness of the vaccine against critical illness for adults of all ages.
Of course, we know that these are just some of the benefits of the COVID vaccine. Last week, we talked about how it can help reduce the risk of long COVID in kids. However, we know that vaccination among all ages is still lower than we'd like to see among adults aged 18 and older.
It's currently around 23%, and while we did not see a large surge of COVID cases over the winter, we do know that COVID usually has two waves. And it wouldn't be out of the ordinary for us to see a COVID wave this summer. So that's definitely something that we should be thinking about preparing for.
Unger: All right. Well, that's all we have time for today, Andrea. Thank you as always for being here and keeping us informed. 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 always find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us and take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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