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.

The measles outbreak and vaccines: We need civil discourse

Janice Boughton, MD

Medications

March 1, 2015

There has been an outbreak of measles, a vaccine preventable disease, along with an outbreak of people yelling at each other. There have been angry exchanges between people who would like all children vaccinated according to the recommended guidelines and people who support the rights of parents to choose which vaccines to give their children, if any, and when to give them. There has been much focus on the assertion, …

Is a doctor allowed to become sick?

Mimi Emig, MD

Physician

March 1, 2015

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I awoke one Saturday morning to a terribly familiar feeling — a tight, barky cough, fast breathing, severe shortness of breath and burning in my chest. Another severe asthma attack. I knew I was in trouble.

Twenty-three years ago, when I was an internal medicine resident, I went to be evaluated for recurrent pneumonia. I wound up being diagnosed with cough variant …

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Is a doctor allowed to become sick?

It’s the year 2015: Why are we still debating vaccines?

Rebecca Weintraub, MD

Medications

February 28, 2015

Recently, as I juggled work, family and shoveling, I prepared a lecture on promoting equity in health delivery. My first slide is a picture of the Ebola virus, and as of this morning, my last slide is a map of the ongoing measles outbreak. That’s because this week, we’ve heard a clear public health message from both President Obama and Surgeon General Vivek Murthy: Vaccines are safe and effective.

Why is this …

Why the Disney measles outbreak could be a game-changer

Claire McCarthy, MD

Conditions and Diseases

February 24, 2015

Cases of measles linked to an exposure at Disneyland continue to spread, not just in California, but in several other states and in Mexico. The numbers of cases are climbing — and so are the number of exposed people who might get sick — and expose more people before they realize they are sick. Measles is extremely contagious; if someone has it, they will infect 90 percent of the people …

What doctors must learn from the anti-vaccination movement

Sayantani DasGupta, MD, MPH

Conditions and Diseases

February 24, 2015

A cartoon of an angry looking physician, a spotted boy, and some anxious parents in The New Yorker reads, “If you connect the measles, it spells out, ‘My parents are idiots’.”

A facetious article in GomerBlog announces, “Big Pharma Admits They’re Just Trying to Kill Everyone with Vaccines.”

Even television host Stephen Colbert gets in on the make-fun-of-anti-vaxxers act, recently declaring, …

Answers to your questions about the measles outbreak

Wendy Sue Swanson, MD

Conditions and Diseases

February 24, 2015

Many parents around the U.S. are asking what to do about a possible measles exposure with a baby at home who is too young to be immunized. Should they stay home? Can they travel? Should they cancel that trip to Utah or to Vermont or even to Disney next month? Can they head out to the store without worry? Are they “safe”?

I hate that I can’t completely say they are …

We have the power to prevent disease. But we’re not using it.

Brad Wright, PhD

Conditions and Diseases

February 22, 2015

We all know them. We see them on TV. We read about them in the paper. And, with the explosion of social media, you hear about it from people you know. If you have a Facebook account with a sizable enough network of friends, you’ve probably seen at least one negative comment about vaccines. On one end of the spectrum, there are the seemingly innocent people who claim that they …

The measles outbreak: Let’s look at the bigger picture

Claudia M. Gold, MD

Conditions and Diseases

February 21, 2015

As the measles outbreak gathers worrisome steam in parallel to the explosion of passionate rants both pro and anti-vaccination, I find myself wondering; what is this really about? Rather than get bogged down in the myriad of issues on either side- though at the outset I will say that as a pediatrician I unequivocally recommend vaccination; I will aim to look at the bigger picture.

Is this issue really about trying …

A tale of two strep throats: Retail clinic vs. PCP

Leslie Kernisan, MD, MPH

Conditions and Diseases

February 21, 2015

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Six years ago, just after arriving in Baltimore for a winter conference, I fell sick with fever and a bad sore throat.

After a night of feeling awful, I went looking for help. I found it at a Minute Clinic in a CVS near the hotel. I was seen right away by a friendly NP, who did a rapid strep test …

When should parents be vaccinated against measles?

Natasha Burgert, MD

Conditions and Diseases

February 20, 2015

“Nervous.”

I’ve heard that word a lot lately. It keeps falling from the mouths of my families in clinic, landing on the floor with a silent thud.

I mean, we have a right to be. We should be. It is one of the most infectious diseases on the planet, today about 400 people worldwide will have died of it, and the number of infected people in the U.S. is climbing.

Does Tamiflu work and what are the side effects?

Janice Boughton, MD

Medications

February 20, 2015

The flu season has really gotten into gear now with 46 of our 50 states reporting widespread influenza activity as of January 3, 2015. Influenza is a virus that infects the respiratory tract, causing sore throat, runny nose, fever, and cough. Rarely people with the flu will have nausea, vomiting and diarrhea, but this is not “stomach flu” which is a term some of us use to describe any one …

Should we give more Tamiflu for influenza? A look at the evidence.

Kenneth Lin, MD

Medications

February 18, 2015

As the Centers for Disease Control and Prevention (CDC) reported that people who received this season’s influenza vaccine were only 23 percent less likely to be diagnosed with influenza than unvaccinated persons, CDC director Tom Frieden was publicly urging high-risk patients and their physicians to use antiviral medications to prevent complications and disease transmission:

People who are sick with flu, if they’re very sick in the hospital or if they have …

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Should we give more Tamiflu for influenza? A look at the evidence.

So what’s the big deal about measles?

Chad Hayes, MD

Conditions and Diseases

February 18, 2015

In a recent post (“Dear Anti-Vax Parents: We’re Not Mad At You”), I wrote about the critical need for better education and communication between doctors and vaccine-hesitant parents. It was far more popular than I would have imagined, and I appreciate all of you who shared it. And in the spirit of providing reliable information about vaccine-preventable illnesses, I wanted to take the time to write about why measles matters.

The measles vaccine …

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So what’s the big deal about measles?

5 things to remember when considering vaccines

Jennifer Gunter, MD

Medications

February 12, 2015

The measles outbreak from Disneyland is a potent reminder of a) how infectious measles actually is; and, b) what happens when people don’t vaccinate.

However, despite a mountain of evidence that vaccination is safe and does not cause autism or immune dysfunction or really anything terrible at all people still refuse. I live in a county that is on the leading edge of this scientific ignorance, but we are not …

Don’t give life to the killers of yesteryear

Emily Gibson, MD

Conditions and Diseases

February 11, 2015

Disneyland is in the news, and not because it is the most magical place on earth. It also is the origin of the most recent rubeola measles outbreak, now spread to seven states and Mexico with over eighty cases diagnosed so far. Unvaccinated children are being kept home from school in some California districts and vaccination requirements once again have become a battleground between public health agencies and the “right …

Measles in Disneyland: How is the media reacting?

Roy Benaroch, MD

Conditions and Diseases

February 11, 2015

This past Christmas holiday, an as-yet-unidentified “index case” — the first person to start an epidemic — visited Disneyland in California. Five employees became infected, along with dozens of visitors to the park. Since then, the outbreak has spread to about 80 people, including people who’ve caught it not directly from visiting Disney, but by coming in contact with Disney cases. These “secondary” cases will soon lead to “tertiary” cases …

Is there a cure for the anti-vaxxers?

Lauren Crawford, MD

Medications

February 10, 2015

Headlines still appear about the vaccine “controversy.” However, there really isn’t one is there? Vaccines hold no controversy in the arenas of science, public health records, and medical schools across the country. In fact, the use of vaccines is considered standard of care. All mainstream religions uphold their immense value and even make them a part of their humanitarian relief programs. So, what is happening?

I am a physician and a …

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Is there a cure for the anti-vaxxers?

The bacteria that almost killed my grandmother

Natalia Birgisson

Conditions and Diseases

February 8, 2015

“Hefur þú lært um Staphylococcus aureus?” I almost don’t recognize the bacteria name because my grandmother pronounces it differently in Icelandic.

“Já–” I’m about to translate my microbiology flashcard for her when she interrupts, her hands busy kneading the cookie dough and her eyes on my little sister near the oven.

That’s the bacteria that almost killed her eleven years ago, she tells me. I can hear her words building up. This …

A doctor’s first-hand account of the flu

Mike Sevilla, MD

Conditions and Diseases

February 3, 2015

Even I am not immune to influenza. In Northeastern Ohio, there have been more hospitalizations and school closings this year from influenza. And, let me tell you, as a family physician who also sees patients in the hospital and the office, we have seen a lot more respiratory illnesses versus last year.

No, I’m not one of those Dr. Oz hypocrites who skip the influenza vaccine. …

Why getting your yearly flu shot matters, even if it’s not 100 percent effective

Chris Carroll, MD and Deep Ramachandran, MD

Medications

February 2, 2015

There’s been a lot in the press lately about the flu shot not being effective this year. This provides an excellent opportunity to educate about what the flu vaccine is and why it is important.

First, a review of basic biology and immunology. Antigens are proteins on the surface of organisms that trigger an immune response. Recognition of these antigens is how your body …

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