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Infectious Disease

Infectious disease physicians and clinicians writing on KevinMD about outbreaks, antimicrobial resistance, vaccines, and the ongoing challenge of preventing and treating infection. Contributors include the physicians who treat infectious disease and the public health physicians who track it. For a maintained record of what physicians have said about vaccines and vaccine refusal since 2004, see Vaccines: what physicians say, in their own words. For what clinicians wrote during the COVID-19 pandemic as it happened, see COVID-19: what physicians wrote as it happened.

Policy

Lancaster County measles outbreak exposes a crisis of trust

For ten years, I lived with my family, 45 minutes from the rolling clover fields and dairy farms of Lancaster County, Pennsylvania, iconic markers of a world defined by quiet tradition. Yet in the fall of 2026, this peaceful landscape…

For ten years, I lived with my family, 45 minutes from the rolling clover fields and dairy farms of Lancaster County, Pennsylvania, iconic markers of a world defined by quiet tradition. Yet in the fall of 2026, this peaceful landscape has become a dark microcosm of modern medicine’s greatest crisis: the weaponization of politics, the spread of bad-faith disinformation, and the collapse of public trust in the medical profession.

As Pennsylvania …

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Lancaster County measles outbreak exposes a crisis of trust

Conditions

Drought and antibiotic resistance are linked in new study

Droughts may be creating the perfect conditions for antibiotic-resistant bacteria to thrive. As the frequency and severity of droughts intensify in regions like California, scientists worry about the potential impact on human health. Throughout the world, the overuse and misuse…

Droughts may be creating the perfect conditions for antibiotic-resistant bacteria to thrive. As the frequency and severity of droughts intensify in regions like California, scientists worry about the potential impact on human health.

Throughout the world, the overuse and misuse of antibiotics have led to the emergence of antimicrobial resistance (AMR), a growing global health threat that contributes to millions of deaths every year. Environmental factors like drought may worsen this …

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Drought and antibiotic resistance are linked in new study

Conditions

The Pennsylvania measles outbreak and the cost of forgetting

On Saturday, August 29, 2026, a headline in my local paper caught my eye. There were 460 confirmed measles cases in Pennsylvania as of Friday, August 28, according to the Pittsburgh Tribune-Review. As of Wednesday, September 16, there are 731…

On Saturday, August 29, 2026, a headline in my local paper caught my eye. There were 460 confirmed measles cases in Pennsylvania as of Friday, August 28, according to the Pittsburgh Tribune-Review. As of Wednesday, September 16, there are 731 cases in 38 of Pennsylvania’s 67 counties, and over 120 hospitalizations.

A brief search of the CDC website shows that since 1991, the number of measles cases nationwide has been in …

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The Pennsylvania measles outbreak and the cost of forgetting

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Conditions

What sepsis in The Pitt gets right, and what it misses

In my free time, I try not to consume too much work-related content. When you're in a medical business, manufacturing devices used for sepsis and septic shock patients, the last thing you want is to be reminded of sepsis outside…

In my free time, I try not to consume too much work-related content. When you’re in a medical business, manufacturing devices used for sepsis and septic shock patients, the last thing you want is to be reminded of sepsis outside of work. So I was very surprised when I found myself binging The Pitt all weekend. I think there’s a reason why it has become the rare medical drama …

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What sepsis in The Pitt gets right, and what it misses

Meds

mRNA hype moves faster than the evidence behind it

mRNA technology may be both a remarkable scientific tool and a very effective marketing machine. Those are not mutually exclusive. The challenge is distinguishing a promising platform, a useful treatment, and a product promoted beyond what the evidence can support.…

mRNA technology may be both a remarkable scientific tool and a very effective marketing machine. Those are not mutually exclusive. The challenge is distinguishing a promising platform, a useful treatment, and a product promoted beyond what the evidence can support.

In early 2020, COVID-19 was frightening. We did not know how readily the original strain would spread or how much illness and death it would cause. We soon learned that risk …

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mRNA hype moves faster than the evidence behind it

Podcast

Antibiotics for sinusitis without a real diagnosis [PODCAST]

Most people who get antibiotics for a sinus infection never needed them, and the real problem goes untreated. Franklyn R. Gergits is a board-certified otolaryngologist who sees the patients that three, four, and five rounds of antibiotics did not fix.…

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Most people who get antibiotics for a sinus infection never needed them, and the real problem goes untreated. Franklyn R. Gergits is a board-certified otolaryngologist who sees the patients that three, four, and five rounds of antibiotics did not fix. This episode is based on his article “We prescribe antibiotics …

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Antibiotics for sinusitis without a real diagnosis [PODCAST]

Conditions

Are naked nails in health care just a beauty trend?

"Rich women no longer paint their nails." Like many provocative declarations born on TikTok, the phrase is exaggerated. Yet it points to a real beauty shift. After years of elaborate nail art, extensions, chrome finishes, and long almond-shaped manicures, the…

“Rich women no longer paint their nails.” Like many provocative declarations born on TikTok, the phrase is exaggerated. Yet it points to a real beauty shift. After years of elaborate nail art, extensions, chrome finishes, and long almond-shaped manicures, the most desirable nails of the moment may be the ones that appear to have nothing on them at all.

The trend has been called “naked nails”: short, natural-looking nails with a …

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Are naked nails in health care just a beauty trend?

Conditions

Why moral injury in health care outlasts the pandemic

History deserves honesty. Years have passed since the height of the COVID-19 pandemic, and with distance comes a natural desire to reflect on what happened. We should absolutely evaluate the decisions that were made. We should question policies, examine the…

History deserves honesty.

Years have passed since the height of the COVID-19 pandemic, and with distance comes a natural desire to reflect on what happened. We should absolutely evaluate the decisions that were made. We should question policies, examine the evidence, and learn from our mistakes. That is how science grows, and health care improves.

But there is a difference between learning from history and rewriting it. Lately, I have watched with …

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Why moral injury in health care outlasts the pandemic

Conditions

Mpox in 2026 no longer looks like 2022

In medicine, we are trained to react to alarms. A monitor beeps. A CT scan lights up. A lab value crosses a dangerous threshold. We move. Public health is harder. Sometimes the most important signal is not a siren, but…

In medicine, we are trained to react to alarms. A monitor beeps. A CT scan lights up. A lab value crosses a dangerous threshold. We move.

Public health is harder. Sometimes the most important signal is not a siren, but a persistent hum. That is where mpox appears to be now.

The latest World Health Organization situation report should not send clinicians into panic, but it should pull mpox back into …

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Mpox in 2026 no longer looks like 2022

Physicians

Why evidence alone doesn’t change minds

If solid evidence reveals that major, long-held beliefs rest on wobbly pillars of false assumptions, how can we convince others to jettison such beliefs and embrace novel approaches? What can we learn from the tragic case of Ignaz Semmelweis in…

If solid evidence reveals that major, long-held beliefs rest on wobbly pillars of false assumptions, how can we convince others to jettison such beliefs and embrace novel approaches? What can we learn from the tragic case of Ignaz Semmelweis in this regard?

In 1847, one in six mothers perished from childbed (puerperal) fever at the Vienna General Hospital where Dr. Semmelweis worked. In some months up to 30 percent of …

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Why evidence alone doesn’t change minds

Conditions

Lead aprons carry MRSA. Most are never cleaned.

While in New Orleans last month for the 2026 AORN Global Surgical Conference and Expo, I attended a session called, "Is It Really Clean? ATP (Adenosine Triphosphate) Contamination Monitoring." The discussion got into the nitty gritty of rapid measurement of…

While in New Orleans last month for the 2026 AORN Global Surgical Conference and Expo, I attended a session called, “Is It Really Clean? ATP (Adenosine Triphosphate) Contamination Monitoring.” The discussion got into the nitty gritty of rapid measurement of cleanliness: what ATP testing is, where it is used inside a hospital, and the surfaces that fail testing most consistently. The real gem of the presentation was the list of …

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Lead aprons carry MRSA. Most are never cleaned.

Conditions

The night septic shock took a patient we fought to save

An excerpt from Blood Poison: The Untold Story of Sepsis. Eduardo's blood pressure failed to respond to one fluid bolus, then another, and another. We instructed his nurse, Jenny, to start a vasopressor called dopamine while Alex and I prepared…

An excerpt from Blood Poison: The Untold Story of Sepsis.

Eduardo’s blood pressure failed to respond to one fluid bolus, then another, and another. We instructed his nurse, Jenny, to start a vasopressor called dopamine while Alex and I prepared to place a central venous catheter in Eduardo’s internal jugular vein. (Dopamine also increases heart rate and cardiac muscle contractility. Although doctors classify drugs as vasopressors and inotropes, many of …

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The night septic shock took a patient we fought to save

Conditions

Measles complications can hide in the brain

The child is already well by the time the virus settles in. The fever broke. The rash faded. The parents exhaled. Life moved forward: first steps, first words, first day of school. In a small number of children, though, the…

The child is already well by the time the virus settles in.

The fever broke. The rash faded. The parents exhaled. Life moved forward: first steps, first words, first day of school. In a small number of children, though, the measles virus does not leave. It retreats inward, past the bloodstream, past the immune system’s reach, and takes up residence in the brain. Quietly. Without announcement. It waits there, sometimes for …

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Measles complications can hide in the brain

Conditions

What Kyle Busch’s death reveals about sepsis

The death of NASCAR driver Kyle Busch, a relatively healthy 41-year-old, startled the public in late May when his severe pneumonia progressed into sepsis. While pneumonia is a common condition, Busch's development of sepsis, when the body goes into organ…

The death of NASCAR driver Kyle Busch, a relatively healthy 41-year-old, startled the public in late May when his severe pneumonia progressed into sepsis. While pneumonia is a common condition, Busch’s development of sepsis, when the body goes into organ failure after an infection, is highly unusual, as sepsis tends to affect patients who are either very young, very old, or have chronic medical conditions.

Despite being one of …

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What Kyle Busch’s death reveals about sepsis

Conditions

The closed door: HIV stigma in clinical training

Her door was always closed. Every other mother on that maternity ward had hers open. You could hear them from the hallway: the soft sounds of newborns, the low voices of partners and grandmothers, the particular exhausted joy of those…

Her door was always closed. Every other mother on that maternity ward had hers open. You could hear them from the hallway: the soft sounds of newborns, the low voices of partners and grandmothers, the particular exhausted joy of those first hours. Nurses moved in and out freely. Students stopped to peek, to congratulate, to practice the small rituals of care that we were there to learn. The ward had …

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The closed door: HIV stigma in clinical training

Conditions

Why does periodontal disease hit South Asians harder?

"Flossing widens the gaps between my teeth. Besides, these teeth aren't even my own." Absolutely no one can convince my grandmother that flossing is important. Notorious in our family because all of her teeth are now implant crowns, she feels…

“Flossing widens the gaps between my teeth. Besides, these teeth aren’t even my own.”

Absolutely no one can convince my grandmother that flossing is important. Notorious in our family because all of her teeth are now implant crowns, she feels an increased disconnect with these “fake” teeth and doesn’t feel the need to take care of them. Many of her relatives in India confirm her beliefs by misguidedly advising against visiting …

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Why does periodontal disease hit South Asians harder?

Conditions

Vaccine hesitancy is a language problem, not just science

"Doctor, I'm not against medicine," the patient said quietly, arms crossed before the conversation had barely begun. "I just don't want any more vaccines." The physician paused. The patient was a 65-year-old man with diabetes, chronic lung disease, and a…

“Doctor, I’m not against medicine,” the patient said quietly, arms crossed before the conversation had barely begun. “I just don’t want any more vaccines.” The physician paused. The patient was a 65-year-old man with diabetes, chronic lung disease, and a recent hospitalization for pneumonia. The patient’s chart showed that he was overdue for influenza, COVID-19 booster, pneumococcal, and RSV immunizations. Ten years earlier, this discussion might have taken less than …

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Vaccine hesitancy is a language problem, not just science

Conditions

5 layers every dengue prevention plan now needs

Dengue is often described as a tropical disease, but that label no longer captures the size of the problem. Over the past six months, dengue has continued to appear across continents, from the Americas and the Pacific to Asia, Europe-linked…

Dengue is often described as a tropical disease, but that label no longer captures the size of the problem. Over the past six months, dengue has continued to appear across continents, from the Americas and the Pacific to Asia, Europe-linked travel cases, and the Caribbean. Some regions are reporting fewer cases than during recent record-breaking years, but the overall message is clear: Dengue remains a major and growing public health …

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5 layers every dengue prevention plan now needs

Conditions

Why the press stays silent on zoonotic viruses

Whether the spread of bird flu to dairy cows, pigs, cats, dogs and seals or the spread of COVID-19 to deer, minks and zoo animals, the press is often mum about zoonotic viruses when they jump species. Who, for example,…

Whether the spread of bird flu to dairy cows, pigs, cats, dogs and seals or the spread of COVID-19 to deer, minks and zoo animals, the press is often mum about zoonotic viruses when they jump species.

Who, for example, knows that Ebola can spread to dogs, pigs and antelopes? Is non-reporting of virus activity to forestall panic or protect commercial markets?

The spread of animal viruses is caused by domestication, warfare, …

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Why the press stays silent on zoonotic viruses

Conditions

How HIV stigma creates barriers to effective HIV care

HIV in Puerto Rico is no longer defined by lack of treatment, but by the persistence of stigma. From my perspective as a Doctor of Nursing Practice (DNP) student and future Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), stigma remains one…

HIV in Puerto Rico is no longer defined by lack of treatment, but by the persistence of stigma. From my perspective as a Doctor of Nursing Practice (DNP) student and future Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), stigma remains one of the most significant barriers to effective HIV care. While biomedical advances such as antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP), and the Undetectable = Untransmittable (U=U) framework have transformed HIV …

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How HIV stigma creates barriers to effective HIV care

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