Brian writes:

I work at a landfill in California.  We are receiving truck loads of chickens that have been ground down into a fine material to make transportation easier.(called Detritus)  This of course makes it easier to become airborne when it dumps out of the truck. We then spread this material with Caterpillar Dozers and mix it with other garbage into our landfill cells before covering it in dirt.  I am concerned for me and  my fellow workers. Should I be concerned?  Does H5N1 die quickly after the bird is killed? Anyone know how long it survives outside a host? Sounds like we should at a minimum be wearing N95 masks when these trucks arrive and offload the dead bird detritus. 

Thank You Dr Griffin and and Dr Racaniello for all that you do, 

Brian

Tom writes:

Dr. Griffin:

Is Doxycycline a medication that qualifies as obfuscation of  “symptom free” for a COVID-19 infection in the same way that Acetaminophen complicates the notion of fever free.

A friend was prescribed Doxycycline (RAT negative) based on 

painful sinus congestion and a HISTORY of hard to control bacterial sinus infections.

The anti-inflammatory quality of the drug was prompt and effective in reducing symptoms with the exception of a cough (post nasal drainage).  However ~36 hours later RAT positive for COVID-19.  <==!

I expect that Hickam might remind the patient to keep taking and finish the antibiotic.  The prompt improvement in sinus discomfort derailed discussions with the doctor about PAXLOVID. 

A persistent cough and a respiratory infection is “trouble” in my opinion.

What to watch for?

How should doctors respond to cases where symptom suppression is very effective but the underlying disease progression is unknowable as a result?

Thank you.

Tom

Ellen writes:

Dear Daniel,

My grandsons (age 2, with a cold and an ear infection; age 6 with a persistent racking but unproductive cough), were prescribed amoxicillin by their pediatrician, and both broke out with a red body rash. I understand that this may occur when there is a concurrent viral infection, but what is the connection between the antibiotic and the virus? Is it just this particular antibiotic that produces this non-allergic reaction?

Then, their pediatrician stopped the amoxicillin (after about 7 days) and is prescribing a different antibiotic (which the parents are ignoring. The Texas Children’s Hospital website encourages continuation with amoxicillin and advises against switching to a different antibiotic as “This can lead to their physician labeling them as allergic, thus leading to the patient being given different antibiotics — potentially causing more harmful side effects.” What is the standard of care in this situation?

Thanks as always for your sage counsel, and happy holidays,

Ellen

Asheville, NC (unfortunately)

Kären writes:

Dr. Griffin,

I am 67 years old. I have had COVID three times. The first two times, I took Paxlovid soon after testing positive. Both illnesses were not horrible but I was definitely ill.

The third COVID came at an interesting point:

1. A family friend — physician 4 months older than me — had just had COVID and advised not taking Paxlovid. He and his spouse both had COVID and did not take Paxlovid. Their illness course did not seem any worse than mine with Paxlovid.

2. I had recently had my annual physical. My doctor also had COVID, did not take Paxlovid, and suggested I really did not need to take it given my lack of comorbidities beyond age.

3. I planned to get the vaccine shot, but another friend came for dinner and brought not only wine, but also COVID. 

The third time, I did not take Paxlovid. The course of the illness was not better or worse. My post COVID experience seems no better or worse. Since I am edging toward elderly (some say I am firmly in it) my memory isn’t what it used to be, my trouble with finding “nouns” (always every present) seems no better or worse, etc.

A long message, for which I apologize, and I am not sure what my question is as well! Possibly… So, to Pax or Not to Pax? That is the question.

Kären

Gary writes:

I am watching TWiV episode 1176 and am still confused about my own polio vaccination. 

I am a 73 year old male and I remember receiving the oral vaccine as a young child along with my siblings and parents.  I have never received the IPV.  Given concerns about vaccine derived virus showing up in waste water, more international travel in my retirement and nut cases like RFK and his supporters who want to eliminate vaccines, should I consider a booster with IPV to reduce my risk? 

I have been an avid viewer and supporter of TWiV and Microbe TV for many years now.  Keep up the good work. You may be saving our country from itself !

Gary