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Dr. Casey

January is Cervical Cancer Awareness Month

I have talked at length about the benefits of vaccines, with the most obvious benefit being the prevention of disease. I have touched on immunizations for several different diseases, too, such as mpox, smallpox, COVID, and influenza. However, these are just a handful of the many vaccines that have been thoroughly tested, approved, and are available to protect individuals’ health. Many tend to think about (most) vaccinations as important for protecting one’s health at that particular point in time. For example, an influenza vaccine is intended to protect the recipient from that year’s strain/s of the flu — an immediate threat.

We know that another, somewhat altered influenza vaccine will be needed the following year to protect the same individual from a similar (but altered, as the virus mutates) threat. So, in the case of influenza immunization, the protection it provides is immediate but not long-lasting. The same is true of other vaccines, such as the COVID-19 vaccine, and any vaccine that you may need a “booster” dose at some point.

From extensive conversations I have had with more people than I can count, I have been fascinated to find that — excluding childhood vaccinations — many people think about vaccines in the context that: 1.) most vaccines address short-term, “acute” issues like seasonal illnesses, outbreaks, or epidemics, and/or 2.) most vaccines address problems in the present rather than the long-term. When people think about getting a vaccine, they are thinking about the next 1–5 years, typically not 20+ years.

This leads me to my topic for this piece, which is that vaccines have many more benefits than most people realize, and they can span a lifetime in the case of some vaccines. Today, I’m going to talk about the human papillomavirus (HPV) vaccine, which is one of the most significant areas of my research.

Approximately 42.5 million Americans are infected with some type of HPV, with at least 13 million new infections every year. There are over 200 types of HPV, and while most HPV infections resolve on their own, persistent infection with high-risk strains (also called types) can cause cancer. Strains of HPV are considered high-risk if they can lead to cancer, and these high-risk types of HPV can cause six different types of cancer in both men and women. These cancers are: vaginal, vulvar, penile, anal, oropharyngeal (the back of the throat), and cervical. In this post, I’m going to focus on the impact that HPV vaccination has made and continues to have on cervical cancer. One reason I have chosen this focus is because January is Cervical Cancer Awareness Month — so this is a great opportunity to raise awareness!

The basics of cervical cancer

Every year in the U.S., around 11,500 new cases of cervical cancers are diagnosed, and around 4,000 women die from cervical cancer. However, this is just the “tip of the iceberg,” as the Centers for Disease Control and Prevention (CDC) says, with approximately 196,000 cervical precancers diagnosed each year. These precancers can lead to cervical cancer if left untreated, and both the progression of cervical dysplasia and some treatments for these cervical precancers can be invasive, painful, affect fertility, and potentially increase the risk of miscarriage. Long-lasting infections with high-risk types of HPV cause essentially all cervical cancers and precancers. Two high-risk types of HPV (16 and 18) cause approximately 70% of cervical cancers in the world.

But cervical cancer is preventable!

Nearly all cervical cancers could be prevented by HPV vaccination! Through vaccination, regular screening for cervical cancer, and follow-up treatment when/if needed, cervical cancer could be precluded. The World Health Organization (WHO) has developed a global strategy for cervical cancer elimination. You read that correctly. We are talking about an actual plan to eliminate a type of cancer. I am including links to the WHO’s Cervical Cancer Elimination Initiative and to the WHO’s global strategy to eliminate cervical cancer below, and highly suggest that you look into them. They are fascinating, exciting, and inspiring — to think we can accomplish something as monumental as eliminating a type of cancer. Australia is on track to be the first country to eliminate cervical cancer, with a goal date of 2035, and is ahead of schedule in meeting its objectives to achieve this.

What else should I know about the HPV vaccine?

The HPV vaccine is safe, effective, and long-lasting. With over 15 years of monitoring and additional research (after passing the multiple clinical trials phases to be approved for patient use), there is extensive data to demonstrate that the HPV vaccine is extremely safe. Also, its safety is continually monitored to ensure that safety is always ensured.

As for its effectiveness, there are plenty of numbers and statistics that demonstrate this, but I will choose just one to highlight here: Since 2006, when HPV vaccines were first used in the U.S., infections with HPV types that cause most HPV cancers have dropped 88%. That is just one of the astounding outcomes we have seen from this vaccine, and only from one of the cancers that it prevents. These outcomes are nothing less than remarkable.

Other Questions?

I don’t know if you are as astounded as I am by the concept that we have the capability and are likely to eliminate a cancer in our lifetimes, but I hope you can sit with that thought and soak in what it means. How many lives will be saved, how many families not be broken by grief, and how much pain and suffering spared.

The vaccine is recommended to start as early as age 9 to complete the 2-dose series by age 12 (it provides the strongest immunity when given at a younger age and before exposure to HPV). Individuals ages 15–26 will need a 3-dose series if they have not been vaccinated to ensure the best immunity. Additionally, adults ages 27–45 who have not been vaccinated should talk to their healthcare providers about receiving the vaccine, as it is approved up to age 45. Both males and females should be vaccinated. Talk to your healthcare provider about the HPV vaccine for you or your children, or your grandchildren. I have personally received the HPV vaccine, and as a mother, I will do anything I can to keep my children safe and healthy. The HPV vaccine is one way I can help keep them healthy even decades from now, so you better believe I am making sure they are protected! As always, don’t hesitate to reach out with questions or requests for topics. And please support cervical cancer awareness this January!

Be Well; Be Kind,

Dr. Casey

Want to Learn More?

For more information about cervical cancer, risk factors, prevention, and related details, I highly recommend the National Institutes of Health’s site here:

https://www.cancer.gov/types/cervical/causes-risk-prevention

As mentioned above, here are links to the WHO’s information and strategies regarding their Cervical Cancer Elimination Initiative. It is an amazing concept.

WHO Cervical Cancer Elimination Initiative:

https://www.who.int/initiatives/cervical-cancer-elimination-initiative

WHO: Global strategy to accelerate the elimination of cervical cancer as a public health problem:

https://www.who.int/publications/i/item/9789240014107

To read Australia’s innovative national strategy and the incredible progress the country is making to eliminate cervical cancer by 2035, click here:

https://www.health.gov.au/sites/default/files/2023-11/national-strategy-for-the-elimination-of-cervical-cancer-in-australia.pdf

For more about the safety and effectiveness data of the HPV vaccine, the CDC provides great information here:

https://www.cdc.gov/hpv/hcp/vaccination-considerations/safety-and-effectiveness-data.html

Want to see more details of how the HPV vaccine has impacted cervical cancer? Check here:

https://www.cdc.gov/hpv/vaccination-impact/index.html#:~:text=HPV%20vaccination%20prevents%20cancer%2Dcausing,has%20dropped%20by%2040%20percent.

Categories
Dr. Casey

What Viruses Are Surging This Year?

I don’t know about you, but it seems like everyone I know either has some kind of cold or “bug,” or is just getting over one. Truth be told, I’m not feeling that great, myself. High rates of minor, contagious illnesses are typical around this time of year. Many people have been spending time with friends and family in close quarters during the holiday season, which is a perfect opportunity to share special moments as well as a lot of less special germs and viruses. And then, without meaning to, and usually without even knowing it, we go back to work and school and spread whatever we have picked up to people there.

This year, some of the most common viruses we see this time of year are starting to surge, so it is extremely important to be aware of what is going around, what symptoms to look out for, and how to protect yourself from getting sick. So let’s do a rundown of some of the main infectious diseases in the U.S. this year.

What viruses are surging this year?

The main infectious disease threats this year are not necessarily new, but they are aggressive and cases are definitely rising. The ones to watch out for are: influenza, COVID, RSV, and norovirus. I’ll go into a little more about each of them below.

Influenza

Influenza, or “the flu,” is especially bad across the U.S. this year. The Centers for Disease Control and Prevention (CDC), who monitors rates of illnesses and keeps the public informed about potential outbreaks and health risks, has categorized the risk levels of flu as high or very high all around the U.S., and continues to increase.

Contributing to such high rates is that fewer people seem to be getting the flu vaccine. With fewer people vaccinated, the virus is able to infect more individuals and spread more easily. People who contract the flu are also more likely to have more severe symptoms and a longer recovery time, compared to those who have been vaccinated.

Common Symptoms: Fever, chills, cough, sore throat, body aches, feeling tired, runny nose

How Long Does It Last? Flu symptoms usually hit more quickly than a cold

Flu can last from a few days to 2 weeks

COVID-19

The pandemic may be over, but COVID-19 has become part of our accepted lives, in the same way as the flu. The number of cases is nowhere near pandemic numbers, but between October 1, 2024, and December 14, 2024, the CDC estimates there were somewhere between 2.7 million and almost 5 million COVID-19 illnesses. Vaccine rates for COVID-19 are drastically lower than in years past (polling shows only about one-fifth of adults in the U.S. say they have gotten the newest COVID-19 vaccine). COVID-19 is no longer at emergency status, but it still causes more hospitalizations and deaths than flu and RSV.

Common Symptoms: Cough, congestion, runny nose, fever or chills, headache, body aches, sore throat, feeling tired, loss of taste or smell, shortness of breath, diarrhea, nausea or vomiting

How Long Does It Last? Mild to moderate cases of COVID-19 usually last an average of 10 days. More severe cases may take longer to recover.

RSV

Respiratory syncytial virus (RSV) is a respiratory illness affecting the nose, throat, and lungs with symptoms similar to the common cold and flu. Those most vulnerable to RSV include infants, older adults, and individuals with weakened immune systems. Levels of RSV have increased, with levels in half of U.S. states categorized as high or very high through the end of December. Currently, vaccination for RSV is available for infants and young children, adults 60 years and older, and pregnant individuals. However, while rates of RSV vaccination are generally high among infants, they are far below desired in older adults, who face a higher risk of severe RSV, side effects, and hospitalization.

Common Symptoms: Fever, feeling tired/low energy, cough, congestion, sore throat, headache, runny nose

How Long Does It Last? Illness typically appears 4–6 days after exposure.

RSV usually 1–2 weeks, although it depends on how severe the illness is

Norovirus

Norovirus is a common and highly contagious virus that causes vomiting, diarrhea, and stomach cramping. In the past month, the U.S. has seen a steep surge in cases of norovirus, spreading in the country and on cruise ships. Scientists think part of the reason for this large wave of cases could be that we are dealing with a new strain of norovirus. This new strain has accounted for almost 7 in 10 norovirus outbreaks this season, and only 7% of outbreaks have been linked to the strain that has been most common in the past. Right now, the best we can do is use traditional prevention measures (described below) to protect against norovirus, but there is a norovirus vaccine in development.

Common Symptoms: Vomiting, diarrhea, stomach pain or cramping, nausea, loss of taste, headache, muscle aches, weakness, feeling tired

How Long Does It Last? Illness usually appears suddenly and is typically short, with symptoms lasting 1–2 days

Protect yourself: What can you do?

There are many ways to protect yourself and your loved ones from all of the viruses described above. I’m going to walk through them, but it will probably seem a little silly because many people think of these things as “common sense.” Consider this just a good reminder, if that is the case for you.

  • Wash Your Hands. With soap. Scrub. Do this many times throughout the day, especially after using the bathroom, before eating, and before preparing food. And take your time — most sources suggest at least 20 seconds. While hand sanitizer with at least 60% alcohol is a good option on the go, be aware that it is not effective against norovirus.
  • Keep surfaces clean. Particularly for norovirus exposure, you should immediately disinfect surfaces that have come in contact with food or any bodily fluids. Disinfecting with a chlorine bleach solution is recommended by CDC. Remember to wash clothing that may have been exposed, as well. I’m including a link to the CDC’s guide to disinfecting your home below.
  • Keep your mouth covered and your hands away from your face. If you need to cough or sneeze, make sure to cover your nose and mouth with a tissue. If one isn’t handy, aim for the inside of your elbow to cover your face, since that will come in less contact with surfaces that will be touched by others. And, of course, wash your hands as soon as possible. And try to keep your hands away from your face. That is an easy way to spread germs from your hands to the mucus membranes of your eyes, nose, or mouth and infect yourself.
  • Don’t fall back into pre-pandemic practices. By this, I mean, we are all now more aware of ways to keep ourselves and others from infecting those around us. If you are sick — stay home! Don’t expose others if you have symptoms or suspect you have a virus. And practice social distancing when you know viruses are going around. You can spend time with others without sharing a seat (most of the time).
  • Get vaccinated for what you can. Vaccines for flu and COVID-19 are easily accessible (and sometimes places will offer perks like a grocery gift card or discount on a purchase — check their policy/promotion), quick, and pretty painless. They are less painful than the flu and/or COVID-19! Have your children vaccinated, too. Schools are breeding grounds for germs and viruses.

Other Questions?

I wanted to cover these viruses in this post because they are very relevant right now and with their high rates as well as their surging at the same time, some people are even referring to them as the ‘Quad-demic’. But I have just scratched the surface of these most common winter viruses, providing you with the basics of each one, and letting you know what to be aware of this year based on the illness rates we are seeing so far in the U.S. I am including links to more detailed information on each illness below if you want to read more about any or all of them.

I want to call out this link, especially, because I find it very helpful in trying to tell apart some of the respiratory viruses with very similar symptoms. It is from the National Foundation for Infectious Diseases and is a chart showing how to tell the difference between flu, RSV, COVID-19, and the common cold. I find it handy and pretty interesting:

I hope you will take note of the prevention practices I suggest to keep yourself and your loved ones safe and healthy. I find life hectic enough without being out of commission for a week or two feeling terrible, and I’m sure you do, too. Please send me questions, comments, thoughts, etc. as you see fit. I love hearing from you and appreciate your engagement!

Until next time…

Be Well; Be Kind,

Dr. Casey

Want to Learn More?

Here, CDC breaks down everything you have ever wanted to know about influenza:

https://www.cdc.gov/flu/index.html

Find answers for any COVID-19 or COVID-19 vaccine question you have ever had here:

https://www.cdc.gov/covid/about/index.html

CDC details all about RSV here:

https://www.cdc.gov/rsv/index.html

Information about norovirus, how it spreads, and how to prevent it:

https://www.cdc.gov/norovirus/index.html

For information on norovirus outbreaks, the CDC has a great page that provides excellent information, including current alerts and advisories:

https://www.cdc.gov/norovirus/outbreak-basics/index.html

Here is CDC’s guidance on how to best clean and disinfect your home:

https://www.cdc.gov/hygiene/about/when-and-how-to-clean-and-disinfect-your-home.html#:~:text=Clean%20first%20and%20clean%20regularly,viruses%20or%20bacteria%20from%20surfaces.

Interested in keeping up with the respiratory activity levels around the U.S.? CDC tracks this and provides information on the spread of COVID-19, influenza, and RSV here:

https://www.cdc.gov/respiratory-viruses/data/activity-levels.html

Understanding Measles: Symptoms and Stages Explained

Measles, a disease once declared eradicated in the United States in 2000, is making a troubling comeback. This highly contagious illness, which poses significant risks to children, is on the rise again. Just before we entered the new year, the Centers for Disease Control and Prevention (CDC) reported that there were 284 measles cases reported across several jurisdictions. A bulk of these were found in children under the age of 5. For parents, this rise in cases is an opportunity to understand the stages of measles and how vaccines play an important role in preventing its spread and protecting their families from its potentially serious consequences.

How Serious is Measles?

Very. Measles is a highly contagious viral illness caused by the measles virus, known for its airborne transmission and potential severity. Before the introduction of the measles vaccine, the disease caused significant damage in the U.S., with an estimated 48,000 hospitalizations and 400–500 deaths annually. Although measles is not a seasonal virus, it often spreads during high travel periods, such as spring break, or in close-contact settings like summer camps, particularly among unvaccinated individuals. Recognizing the symptoms and understanding the stages of measles is essential for early detection and proper care.

Stages of Measles

Measles has three main stages, each characterized by distinct symptoms and progression:

  1. Incubation Period (7–14 Days)
  • This is the period after exposure to the virus and before symptoms appear. During this time, the virus replicates in the respiratory tract and spreads to the lymphatic system. At this stage, there shouldn’t be any noticeable symptoms, and individuals are not yet contagious.
  1. Prodromal (Initial) Stage (2–4 Days)
  • Symptoms start to appear, often resembling a common cold or flu. Common signs include:
  • Fever (often high, above 101°F or 38.5°C)
  • Runny nose
  • Cough
  • Red, watery eyes (conjunctivitis)
  • Sore throat
  • During this stage, tiny white spots with bluish centers start to develop inside the mouth, typically on the inner cheeks. This is a unique feature of measles and can help with early diagnosis.
  1. Exanthem (Rash) Stage (3–7 Days)
  • The measles rash is the most recognizable symptom. It starts as flat red spots on the face and hairline and gradually spreads downward to the neck, trunk, arms, legs, and feet. Some of the spots may become slightly raised.
  • Other symptoms during this stage can include:
  • Persistent high fever, which may peak above 104°F (40°C)
  • Intensified cough and runny nose
  • General discomfort and fatigue
  • The rash typically lasts about 5–6 days before fading.

Complications of Measles

Once contracted and not properly dealt with, measles can lead to complications, especially in young children, pregnant women, or those with weakened immune systems. Potential complications include:

  • Ear infections: Measles can lead to otitis media, causing ear pain and potential hearing issues.
  • Diarrhea: A common complication, especially in children, that can lead to dehydration.
  • Pneumonia: This serious complication occurs when the virus affects the lungs and is a leading cause of measles-related deaths.
  • Encephalitis: A rare but severe inflammation of the brain that can cause seizures, permanent brain damage, or, in rare cases, death.
  • Subacute sclerosing panencephalitis (SSPE): A very rare, progressive, and fatal disease of the central nervous system that can develop years after a measles infection.

When to Seek Medical Attention

If you suspect measles or notice symptoms such as high fever, widespread rash, or white spots inside the mouth, it’s important to get in contact with a healthcare provider. Early diagnosis not only helps in managing symptoms but also prevents the spread of the virus to others.

Seek immediate medical attention if:

  • The individual experiences difficulty breathing or persistent chest pain.
  • Symptoms worsen after initial improvement.
  • There are signs of dehydration, such as reduced urination, dry mouth, or extreme fatigue.
  • Neurological symptoms like confusion or seizures occur.

The Impact of Declining Vaccination Rates

One major reason for the rise in measles cases in the U.S. is the decline in childhood vaccination rates. According to the CDC, less than 93% of kindergartners were vaccinated against measles during the 2023–2024 school year, a drop from 95% in 2019–2020. Vaccination rates against other diseases, including polio and whooping cough, have also fallen.

The most effective way to prevent measles is through vaccination. The Measles, Mumps, and Rubella (MMR) vaccine has been proven to give protection against the virus and has significantly reduced measles cases worldwide.

Keeping a Calm Perspective

While measles is a serious illness, knowledge is power. By recognizing and understanding the symptoms, stages, and complications, you can take proactive steps to prevent illness. If you or someone you know shows signs of measles, consult a healthcare professional for guidance. Early recognition and supportive care are key to managing the illness effectively.

Sources

CDC: Measles Cases and Outbreaks

Mayo Clinic: Answers to 3 common questions about measles

Infectious Diseases Society of America: Measles Vaccination: Know the Facts