In his weekly clinical update, Daniel Griffin and Vincent Racaniello discuss their continuing struggle to understand the ongoing outbreak of cyclospora, decimation of US public health including 30% or greater loss of personnel from the CDC, continuing measles outbreaks here and aboard, a mumps outbreak in San Diego and a Hib death in Montana, criminalization of pediatricians in Texas, dengue associated death in Florida, Ebola in Kenya, a new Legionnaires outbreak, screw worm cases, and a hearing in Florida to end requirements of four vaccines including Hib and chickenpox, before Dr. Griffin deep dives into recent statistics RSV, influenza, SARS-CoV-2 infections, the continued measles outbreak in Pennsylvania, US, Canada, statistics on vaccine preventable disease mortality in children, effectiveness of adjuvanted high dose influenza vaccine and contacting your federal government representative to stop the assault on science and biomedical research. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Smallpox History and Decisive Actions of George Washington (CDC: Emerging Infectious Diseases) Christina Jewett (NY Times) Caroline Hopkins Legaspi (NY Times) F.D.A. Found Cyclospora During Taylor Farms Inspection in Mexico (NY Times) Suspected plague incident leaves 1 dead, 200 under quarantine in Siberia (CIDRAP) Dozens quarantined in Siberia after plague institute lab worker dies (Reuters) Russia tells WHO there are no plague cases in Siberian city (Reuters) 30% effective workforce loss across CDC (AFGE Local 2883) CDC Leadership (CDC: About CDC) CDC Leadership 2025 (CDC) They Fought Outbreaks Worldwide. Now They’re Fighting for New Lives. (NY Times) ‘Zombified’ C.D.C., Hobbled by Cuts, Struggles to Fulfill Scientific Mission(NY Times) San Diego State football hit by mumps outbreak with 14 confirmed cases ahead of Pac-12 opener (CBS Sports) Texas Pediatricians Face Paxton Investigations for Vaccinating Children (NY Times) Montana DPHHS reports pediatric death from complications of invasive Hib infection (NBC: Montana) Florida announces Oct. 8 hearing on plan to end rules for four vaccines (WUSF: NPR Health News Florida) Legionnaires’ Disease (NYC: Health) 2 confirmed cases of Legionnaires’ disease at Queens apartment complex prompt NYC Health Department probe (CBS News) Dashboard SCREWWORM.Gov (USDA: Animal and Plant Health Inspection Service) CDC Activates Emergency Operations Center for New World Screwworm Response (CDC Newroom) Kenya Records Ebola Case for First Time (NY Times) Ebola DRC (X) Ebola dashboard (ebola.fyi) EBOLA: The Democratic Republic of the Congo, 2026 (WHO) Bundibugyo virus disease outbreak Democratic Republic of the Congo (WHO: Democratic Republic of Congo) Ebola Outbreak: Current Situation (CDC:Ebola) Hochul Declares a Measles Emergency as Cases Rise in Rural New York( NY Times) Pediatric Deaths during Measles Outbreak, Jerusalem, Israel, 2025–2026 (CDC: Emerging Infectious Diseases) Small quantity lipid-based nutritional supplementation and measles vaccination coverage in children aged 6−23 months: a pragmatic cluster-randomized trial (Nature Medicine) Measles Outbreak in Amish Country Forces Some to Rethink Vaccines (NY Times) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Big outbreak, bright lights…Measles Dashboard (South Carolina Department of Public Health) Utah measles outbreak response (Utah Department of Health and Human Services) Utah Measles Dashboard (Utah Department of Health and Human Services) Measles (VDH: Virginia Department of Health) Tracking Measles Cases in the U.S. (Johns Hopkins) HAP’s Latest News Pa. Launches New Measles Dashboard (Hospital + HealthSystem Association of Pennsylvania) Measles (Commonwealth of Pennsylvania) Measles Dashboard (New York State: Department of Health) Governor Hochul Declares State Disaster Emergency in Response to Ongoing Measles Outbreak (New York State: Department of Health) Weekly measles and rubella monitoring (Government of Canada) Measles (WHO) Get the FACTS about measles (NY State Department of Health) Measles (CDC Measles (Rubeola)) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts(ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Measles and rubella weekly monitoring report (2025) (Government of Canada) Measles Cases and Outbreaks (CDC: Rubeola) Laboratory Testing for Measles (CDC: Measles (Rubeola) Measles Clinical Diagnosis Fact Sheet (CDC: Measles (Rubeola) Measles Serology Testing (CDC: Measles (Rubeola) Annual flu vaccines are far from ideal — this is why (Nature) Virology’s most wanted: the influenza virus (Nature) Early flu spike closes schools, clinics move up vaccinations (The Asahi Shimbun) Flu season could kick off ‘incredibly’ early — what scientists are watching (Nature) Near real-time data on the human neutralizing antibody landscape to influenza virus as of the summer of 2026 to inform vaccine-strain selection (Summary results)(Jbloomlab) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) Respiratory virus activity levels (CDC Respiratory Illnesses) Vaccine-Preventable Infectious Disease Mortality Among Children in the Post-vaccine Era: Persistent Burden and Emerging Temporal Trends (Cureus Journal of Medical Science) Flu vaccine recommendations: Vaccines and Related Biological Products Advisory Committee March 12, 2026 Meeting Announcement (FDA) WHO updates all 3 viral strains to be included in fall flu shots (CIDRAP) FDA vaccine advisers recommend adding subclade K to fall shots (CIDRAP) Weekly surveillance report: clift notes (CDC FluView) OPTION 2: XOFLUZA $50 Cash Pay Option (xofluza) Adjuvanted and high-dose influenza vaccines had comparable effectiveness against test-confirmed influenza outcomes including hospitalizations in overall and high-risk older adults in the 2022–2023 and 2023–2024 seasons (International Journal of Infectious Diseases) Influenza vaccine effectiveness against influenza A-associated hospitalization and severe in-hospital outcomes among adults in the United States, 2024–2025 (CID) RSV: Waste water scan for 11 pathogens (WastewaterSCan) Respiratory Diseases (Yale School of Public Health) US respiratory virus activity (CDC Respiratory Illnesses) RSV-Network (CDC Respiratory Syncytial virus Infection) Vaccines for Adults (CDC: Respiratory Syncytial Virus Infection (RSV)) Economic Analysis of Protein Subunit and mRNA RSV Vaccination in Adults aged 50-59 Years (CDC: ACIP) RSV Immunization Effectiveness and Safety for the 2026-2027 Respiratory Season (JAMA) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) Respiratory Illnesses Data Channel (CDC: Respiratory Illnesses) COVID-19 national and regional trends (CDC) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) Moderna Receives U.S. FDA Approval for Updated 2026-2027 COVID-19 Vaccines (Moderna) Novavax’s Partnership Strategy Continues to Deliver with XFG-adapted Nuvaxovid™ Approvals in the U.S., EU and Japan for 2026-2027 Vaccination Season (novavax) Pfizer and BioNTech Receive U.S. FDA Approval for XFG-adapted COVID-19 Vaccine (Pfizer) FDA approves new COVID vaccines (CIDRAP) Coronavirus Disease 2019 (COVID-19) Hospitalization Surveillance Network (COVID-NET) (CDC: Covid) Temporary Cessation of DMARD Therapy and COVID-19 Supplemental Dose Vaccine Immunogenicity in Patients With Inflammatory Arthritis (JAMA Internal Medicine) Where to get pemgarda (Pemgarda) EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Drug interaction checker (University of Liverpool) Help your eligible patients access PAXLOVID with the PAXCESS Patient Support Program (Pfizer Pro) Understanding Coverage Options (PAXCESS) Prophylactic vs Therapeutic Anticoagulation in Hospitalized Patients With COVID-19 (JAMA: Open Network) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) Anticoagulation guidelines (hematology.org) Daniel Griffin’s evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID Reaching out to US house representative Letters read on TWiV 1364 Dr. Griffin’s COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.