Bird flu in humans, H5N1 symptoms, mushroom chocolate recall and AMA 2024 Annual Meeting highlights | AMA Update Video

AMA Update covers a variety of health care topics that affect the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from medical experts about COVID-19, medical education, advocacy issues, burnout, vaccines and more.

How is bird flu transmitted? Is bird flu dangerous to humans? Are mushroom pulps safe? Why don't foods list ingredients? What is the AMA's new public health policy?

Our guest is AMA Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH. AMA Chief Experience Officer Todd Unger hosts.

The speaker

• Andrea Garcia, JD, MPH, vice president, science, medicine and public health, American Medical Association

Unger: Hello and welcome to the AMA Update video and podcast. Today, we have our weekly look at the headlines with AMA Vice President of Science, Medicine and Public Health Andrea Garcia. I'm Todd Unger, Chief Experience Officer at AMA. Welcome, Andrea.

Garcia: Thanks, Todd. It's good to be back.

Unger: Well, it's been a few weeks since we last spoke due to the AMA Annual Meeting being held in Chicago last week. Andrea, before we dive into this week's headlines, any highlights from the Annual Meeting to share?

Garcia: Well, as usual, a lot of policy work was done at that meeting with a focus, of course, on the AMA's top priorities, including Medicare payment reform, prior authorization regulation, addressing inappropriate scope of practice expansions and ensuring doctors have a voice in the development of technology, including AI. Many of these issues, as we know, are creating additional burdens for physicians and threatening patient access and safety.

Both our incoming and outgoing presidents discussed the toll this takes on doctors, which contributes to burnout and ultimately puts health care in crisis. So while I think many physicians left the meeting feeling energized about the progress we've made, it's clear that we still have a lot of work to do.

Unger: Absolutely. And Andrea, as you mentioned, a large part of the meeting is devoted to health policy. What key points do you have to share from your perspective on public health?

Garcia: Well, there really is so much political business going on at this meeting that it's impossible to capture it all in a short conversation here. But one of the main points of public health I think is worth mentioning is the focus on minority communities and rural areas. We know this is important because more than 46 million people, or 15% of our population, live in rural areas in the US, and research shows that people in rural communities experience disproportionately higher rates of cardiovascular disease, stroke, cancer , diabetes and respiratory diseases. And minority communities in rural areas are even more at risk for poor health outcomes.

AMA policy aims to improve these outcomes through efforts specifically tailored to these populations, including increasing access to disease prevention care and education. There are so many policies like this aimed at improving public health. We will put a link to this description of this episode where people can learn more.

Unger: OK. Well, thank you very much, Andrea, for that summary. And now back to the headlines of the past two weeks. And just proof that just because we don't talk about it doesn't mean it's gone. We'll pick up where we left off, Andrea, and that's bird flu. Have things gotten better or worse?

Garcia: Well, when we last spoke, there were two farm workers who had tested positive for H5N1 bird flu, and that number has now risen to three. Unlike the first two farm workers who had high infections, the third farm worker reportedly also had respiratory symptoms, including a cough, sore throat, watery eyes. And this can increase the likelihood of transmission to other people. However, federal officials still say the risk to the public remains low.

All three farm workers have fully recovered. And there was also a recent experiment that showed the virus was less able to spread through respiratory droplets. Although we certainly know this could change as the virus evolves.

Unger: I'm just curious what kind of experiment would be able to prove this.

Garcia: Well, this was an experiment that was done with ferrets, and this is a model that is often used to assess the potential impact on humans. Researchers at the CDC used the H5N1 virus obtained from the Texas farm worker, who tested positive. And when the three healthy ferrets were placed in the same enclosure with three of the infected, they all got sick. So these animals could touch, they could bite their noses, they could lick sick animals. These findings indicate that the virus spreads efficiently between ferrets that are in direct contact.

When the three healthy ferrets were placed in an enclosure where they could breathe the same air as the sick ferrets but could not touch them, only one of those three animals became ill. And this suggests that the virus is currently less able to spread through respiratory droplets. According to the CDC, this is different from what we see with seasonal flu, which infects 100% of ferrets through respiratory droplets.

Unger: Well, let's hope the particular dynamic remains the same. Andrea, is there anything else we learned from these experiments?

Garcia: Well, unlike seasonal flu, which sickens ferrets but doesn't kill them, H5N1 killed all the ferrets that were infected. Now, this isn't really too surprising, as H5 viruses have historically been fatal to ferrets. The CDC concluded that while three cases of H5N1 in the US have been mild, it is possible for serious illness to occur in humans. I think it's becoming increasingly clear that protecting the health of farm workers needs to be a top priority here, and wearing protective clothing is particularly important.

Unger: All right, Andrea. Was there any difference between the spreads between the cattle?

Garcia: Actually, there is, Todd. Wyoming, Iowa and Minnesota all reported their first detections of the virus in recent days. We now have more than 80 dairy herds that have tested positive in at least 12 states.

Wastewater surveillance is still showing limited uptake in the US overall. The CDC is urging doctors to stay alert for signs and symptoms of flu virus infection during the summer and maintain those high levels of testing. They are also encouraging doctors to forward any specimens that test positive for influenza A to public health laboratories for additional testing.

Unger: OK. And that's something we'll continue to track as the summer progresses. Andrea, the CDC also issued a health advisory earlier this week to warn about something completely different that we haven't talked about. What do we need to know?

Garcia: Yeah, like you mentioned, we haven't talked about it before. But according to that health alert from the CDC, the CDC, the FDA, America's poison centers, state and local partners are investigating reports of severe acute illness that may be associated with the consumption of Diamond Shruumz brand chocolate, cones and gummies. These are being marketed as containing a proprietary mushroom blend.

Since June 11, there have been a total of 12 illnesses, ten hospitalizations reported in eight states with ongoing efforts to identify possible additional cases. Although the cause of the reported illness is not known at this time, individuals are advised not to eat, sell or serve any Diamond Shruumz brand chocolate flavor, cone or gum and should discard the products that have been purchased. The CDC and FDA are also working to determine whether other products from this company have been associated with adverse health effects.

Unger: Okay Andrea, for those of us who have never heard of the Diamond Shruumz brand or are at all familiar with it, can you share a little more background? How do people get these products and what kind of illnesses are we seeing?

Garcia: While many of the conditions are serious and patients have experienced central nervous system depression with sedation, seizures, muscle rigidity, clonus, tremors, abnormal heart rate, abnormal blood pressure, gastrointestinal effects, skin rash, diaphoresis, and metabolic acidosis with a increased anion gap. . Ten patients were hospitalized. Some even required intubation, mechanical ventilation, and ICU admission. Fortunately, no one died. These products are mainly distributed online and retailers include those selling hemp-derived products and tobacco or vapor.

Unger: OK. Is this indicative of, say, a larger trend, and do you expect to see more of these types of health tips?

Garcia: That wouldn't surprise me. As we know, products containing psychoactive compounds such as cannabis or mushroom extract are becoming more and more available. These foods are often sold as gummies, chocolates, or other snack foods. But they may actually contain undisclosed ingredients, including illegal substances, other adulterants or potentially harmful contaminants that are not approved for use in food. Products containing mushrooms, in particular, have been marketed as promoting health, but some can actually have the opposite effect and make you sick.

Unger: Okay, Andrea, so given the situation there, what should doctors know and be on the lookout for?

Garcia: So the CDC is asking physicians to advise patients, caregivers, or caregivers not to buy, consume, or serve Diamond Shruumz brand chocolates, cones, or gummies, to avoid consuming any food products that contain mushrooms that claim to produce neurological, cognitive or psychoactive. effects as a whole.

Patients should be aware that foods or food-like products marketed with these nonspecific health benefits or implied psychoactive effects may contain these undisclosed, misformulated, or unapproved ingredients that may cause serious adverse health effects. Doctors should also have a high index of suspicion for serious illness. And any patient who has recently consumed any of these products and early consultation with a medical toxicologist with expertise in the management of these patients with persistent acute ingestions is also really important. Any suspected cases or adverse effects after consuming Diamond Shruumz brand products should be reported to the poison hotline at 1-800-222-1222.

Unger: Again, that poison hotline, 1-800-222-1222. Keep an eye out there for this situation. Andrea, that's all good to know. And that wraps up today's episode. Thanks so much for being here and keeping us posted. We'll be back in a few days for another episode where we'll get further updates on Mpox and what to expect with COVID this summer and more. If you found this discussion valuable, you can support more programs like it by becoming an AMA member at ama-assn.org/join.

We'll be back soon with another AMA update. In the meantime, you can find all of our videos and podcasts at ama-assn.org/podcasts. Thank you for joining us today. Please be careful.

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Disclaimer: The views 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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