The week of August 24th, a person with significant underlying health conditions was hospitalized for chest pain, nausea, vomiting, diarrhea, and weakness. The person was not in the intensive care unit. The patient tested positive for flu, and further testing found that it was a H5 bird flu strain. The patient has since fully recovered.

A person who lives with the patient got sick with similar symptoms on the same day as the case. This close contact was not tested and fully recovered. The timing of both people getting sick does not suggest transmission between them, but could suggest a shared source of exposure. It is also possible that the close contact was sick with something different than bird flu.

There is no known source of direct or indirect exposure for this patient. That includes contact with wild birds, domestic poultry, cattle (including raw milk and raw meat), or other wildlife prior to symptoms. There is no evidence of person-to-person transmission at this time, and the CDC reports that the risk to the public remains low.

The Missouri Department of Health in partnership with CDC is still investigating potential sources of exposure for this case.

Information on if the close contact will be given an antibody test for bird-flu has not yet been released.

When the patient who tested positive for bird flu was tested, they had a low viral load which made it difficult to fully sequence the virus’s genome. Partial results show that the strain is similar to those found in cattle. Additional tests are being run.

The main symptoms of Mpox include a spotted rash that may be painful or itchy with flu-like symptoms. The virus spreads through close contact between two people and can be spread up to four days before symptoms appear. Most people recover fully from infection with clade II of Mpox, which has a survival rate of 99.9%. Those most at risk of severe illness include those with severely weakened immune systems, children younger than 1, pregnant people and people with a history of eczema.

The clade Ib of Mpox that caused the current public health emergency has higher rates of severe illness and death than clade II. Global health authorities are working to get the JYNNEOS Mpox vaccine to people in countries with the highest cases of clade Ib Mpox like the Democratic Republic of Congo. Countries that currently need the vaccine most are having challenges getting it.

In the United States, only Mpox clade II is present. While Mpox can infect anybody, people most at risk of getting Mpox are those with multiple sexual partners. The two-shot JYNNEOS vaccine is approved and available in the U.S. CDC recommends people with multiple sexual partners consider vaccination, and a complete list of guidelines can be found on the CDC’s website.

Vaccination distribution efforts are still underway, and it is still not clear when countries like the Democratic Republic of Congo will be able to administer JYNNEOS vaccines.

Whooping cough, also known as pertussis, is a bacterial respiratory disease that can be deadly, especially to young children and babies. Early symptoms (1-2 weeks) usually look like the common cold. The next stage of the illness (2-10 weeks) is more severe and includes violent coughing fits that can cause vomiting, difficulty breathing, and fractured ribs.  After recovery (2-3 weeks), people are more susceptible to respiratory viruses for months.

Antibiotics are only effective within the early stages of this disease; once a severe cough develops, treatment is not effective. This is because the bacteria that antibiotics target are gone after 2-3 weeks, and the severe cough is a result of the damage the bacteria already did to the airways. At this point, antibiotics won’t improve the coughing.

Many babies with whooping cough don’t cough, and instead struggle to breathe or have life-threatening pauses in their breathing. For other babies, the illness looks like a common cold throughout its duration. In general, whooping cough is more likely to be severe in children than in adults. Babies under one year old are especially at risk.

The recent spike in whooping cough cases is particularly affecting unvaccinated children. Everyone should ensure they are up to date on their whooping cough vaccine, either DTaP or Tdap depending on age.

DTaP is given to children in five doses, typically at 2, 4, and 6 months, then at 15-18 months, and again between 4-6 years. The letter "P" in DTaP and Tdap represents protection against pertussis or whooping cough. The letter "T" shows they also help protect against tetanus. The letter "D/d" shows they also help protect against diphtheria. 

Tdap is also recommended for preteens around age 11-12 and for adults every 10 years as a booster. Pregnant women should also get a dose during weeks 27-36 of to protect newborns.

Vaccinations for whooping cough are effective but protection wanes over time.  Even if someone gets the vaccine and still gets sick, the vaccine reduces the severity of the illness and reduces the chance of hospitalization.

In 1997, public health officials began recommending Tdap or DTaP vaccines over the DTP vaccine, which was an older whooping cough vaccine that had rare cases of dangerous vaccine reactions. Today, only Tdap and DTaP vaccines are used. We are still learning about the long-term effectiveness of these vaccines.