TWiV 1312: Clinical update with Dr. Daniel Griffin

In this episode of TWIV, Vincent Racaniello and guest Dr. Daniel Griffin deliver a comprehensive clinical update on current viral threats and public health challenges. The discussion opens with sharp criticism of the Trump administration's dismantling of CDC capabilities, including the suspension of critical testing for rabies and mpox, and the controversial rechartering of the Advisory Committee on Immunization Practices (ACIP) to include non-experts such as vaccine injury advocates. The hosts emphasize the dangers of politicizing public health, warning that these moves undermine scientific integrity and endanger communities. They highlight a new study linking Epstein-Barr virus-positive mononucleosis to a threefold increased risk of multiple sclerosis, reinforcing the growing evidence of EBV's role in autoimmune diseases. Measles is on the rise with sustained local transmission in Utah and Texas, and the CDC's delayed release of genetic data raises concerns about political interference. In contrast, flu and RSV activity are declining, while COVID-19 remains at low levels. Updated IDSA guidelines recommend early antiviral treatment with Paxlovid for high-risk individuals, and emerging data suggest potential off-label use of the monoclonal antibody pemgarda for treating immunocompromised patients. Long COVID research continues to explore microbiome disruptions, the risks of antibiotic overuse, and promising but preliminary findings on IV immunoglobulin therapy. The episode concludes with listener questions on fomite transmission, which the hosts affirm is rare for SARS-CoV-2, and the importance of combo home tests for early treatment decisions, especially for aging-in-place seniors.