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Dr. Casey

Virus Spotlight: Influenza A

In one of my most recent posts, I talked about the differences between the major viruses that have been affecting the U.S. this season (the “quademic,” as some have dubbed it): influenza, COVID-19, RSV, and norovirus. Today, though, I want to focus special attention on one of these that has had a particularly notable surge across the country lately, reaching some of the highest levels we use to measure activity. I do not think it will come as a surprise that I am talking about the influenza A virus. I have received several questions and comments about influenza A recently, likely due to these increased levels, so I will answer as many of those as I can (and more) in today’s post.

Some basics about influenza viruses

Just for some background, I will give you a little information about types of influenza, so you can get a better understanding of influenza A. There are four types of influenza viruses: A, B, C, D. Influenzas A, B, and C can affect humans, while influenza D mainly affects animals (such as cattle). Even though influenza C can infect humans, it is much less common and typically causes milder illnesses than A and B. The ones we are most interested in, because they affect us most significantly, are types A and B.

Influenza A and B are the most common, and are the types of influenza that cause “flu season” almost every winter in the U.S. “Flu season” is actually a seasonal epidemic of disease. Influenza A is the only type of influenza known to cause flu pandemics. Influenza A viruses are classified into different types based on two proteins found on the virus’s surface. The first is hemagglutinin (H) and the other is neuraminidase (N). Each of these has multiple subtypes, and that is how different types of influenza A are named, as we sometimes read and hear about (for example, H1N1). These subtypes can be broken down even further, becoming even more detailed and specific, but instead of getting into Virology 101, I will post a resource below if you are interested in getting into the more intricate processes of this.

Why are we concerned right now in the U.S.?

The flu continues to surge all over the U.S., and the majority of these flu cases are influenza A. Another concern is that influenza A usually causes worse symptoms compared to influenza B, and patients with influenza A are more likely to get hospitalized. Influenza B can definitely be severe, too, but right now, influenza A is what is sweeping the nation. In fact, of all the flu tests that have been reported to the Centers for Disease Control and Prevention (CDC) since flu season started last fall, approximately 97% have been positive for influenza A.

This year’s flu season has reached unusually high levels compared to recent years. Currently, we are in what is considered a “second wave” of flu, which is common after the holidays when many people gather in small settings, frequently offering the opportunity for greater viral spread. Figures from the CDC show that national levels of influenza are currently the highest they have been since the peak of the 2009 swine flu pandemic (link below to the website with the figures and other data you can look at). However, the high rates this season are not from a new strain like in 2009. Rather, these high rates seem to be from the usual seasonal types of the influenza virus.

According to the CDC (and a helpful map to which I will also post a link below), most states are at “high” or “very high” levels of influenza. This is based on the most recent data which is from the week ending February 1, 2025. While some states may have reached their peak of flu, others are still growing, and unfortunately, there is not much we can do in the way of predicting how these trends with go.

Why are flu levels so high this year?

Many things can influence overall high levels of flu. One major contributor is that the CDC reports that flu vaccination rates among children are the lowest they have been in six years. Children, particularly, with more vulnerable immune systems, are often infected more easily than adults, and then attend schools which are a prime breeding ground to share germs and spread viruses. In fact, many schools throughout the country have briefly closed to try to stop the cycle of viral spreading among students, faculty/staff, and families. Also, this year, less than half of American adults have received a flu vaccination, making these individuals more susceptible to being infected by flu viruses and for those flu viruses to be more severe.

For example, as time has passed since the COVID-19 pandemic, many people have become more relaxed in their prevention practices. Far fewer people are wearing masks; quarantining or even just staying home from work or school when feeling sick has become an outdated idea for many people, and fewer people are as vigilant about washing their hands, using hand sanitizer, and disinfecting surfaces regularly. People also feel much more comfortable being in large crowds again, as well as in enclosed spaces lacking much ventilation. Many of us feel like life is, “back to normal,” meaning — like it was before COVID-19. But we need to remember that while we no longer have to live in the strict conditions of the pandemic, we need to adopt a new normal, in which we find a balance or compromise between our old ways and the rigid pandemic standards.

Other Questions?

I hope this helps with understanding more about the major flu surges going on around the U.S. right now, and gives you some ways to protect yourself from these viruses. Even if you have had the flu once this season, you can get it again, so do not think you are in the clear. And it is important to take all the prevention steps we can to protect both ourselves and all of those around us. If you can, try to spend some time thinking about the middle ground of the new normal I mentioned above. Maybe even talk about it with others. It is going to be very important going forward to keeping all of us safe and healthy. As always, your questions and comments are welcome, as well as topic suggestions if you have anything in particular you would like to read more about. I am particularly excited about my next piece, so stay tuned! Thank you all, and take care.

Be Well; Be Kind,

Dr. Casey

Want to Learn More?

Can’t get enough about how influenza viruses are broken down into even more detailed subtypes, lineages, and more? Learn more at this CDC site:

https://www.cdc.gov/flu/about/viruses-types.html

The CDC posts a Weekly Influenza Surveillance Report, and one part of it is a Weekly US Map of an Influenza Summary Update. This shows “Influenza Like Illness” Activity Level per state and tracks how it changes by week:

https://www.cdc.gov/fluview/surveillance/usmap.html

The CDC also posts Weekly Influenza Surveillance Report “Key Updates” each week, with the most recent report from the week ending February 1, 2025 (it takes a while to collect and process data from the entire nation so there is a lag time). You can look at these key updates here:

https://www.cdc.gov/fluview/surveillance/2025-week-05.html

Here is a great article that talks about this year’s intense flu season and the impact it has had on many states and communities:

https://www.pbs.org/newshour/health/u-s-facing-most-intense-flu-season-in-at-least-15-years

In case anyone needs a refresher on what symptoms to be on the lookout for when it comes to the flu, here is a tidy list to refer to:

https://www.cdc.gov/flu/signs-symptoms/index.html

Why We Need to Maintain a 95% Immunization Rate and How to Combat Misinformation

Vaccine-preventable diseases are rising despite the widespread availability of a highly effective vaccine, showing a decline in vaccine confidence. Measles, once nearly eradicated in the U.S., is popping up in certain states due to declining childhood vaccination rates. This resurgence of vaccine-preventable diseases should be a warning to parents, as it poses a serious risk to children’s health.

There has always been an immunization rate target that public health experts set out which is the baseline to prevent certain diseases from spreading. That’s a 95% immunization rate. Once this rate falls below the 95% threshold, a critical barrier of protection is lost and could result in widespread outbreaks. Reaching 95% may seem daunting, but parents can play an important role by taking the right steps, understanding the importance of vaccinations, and actively combating misinformation.

Why 95% Immunization Coverage Matters

So, why 95%? This target is set out because it ensures a majority of children have the needed protection against vaccine-preventable diseases. The vaccine works by preparing the immune system to fight infections, preventing severe illness, complications, and long-term health effects that can come from diseases like measles, polio, and whooping cough.

For children, vaccination is particularly important because their immune systems are still developing, making them more vulnerable to infections. Many vaccine-preventable diseases can lead to serious complications, including hospitalization, long-term disabilities, or even death. Measles, for example, is one of the most contagious diseases, spreading to 90% of unvaccinated people exposed to an infected person. Once infected, symptoms can become severe, ranging from ear infections and pneumonia to encephalitis and even death.

Addressing Misinformation and Vaccine Hesitancy

The decline in vaccination rates is not due to a lack of access to vaccines but has been largely driven by misinformation and vaccine hesitancy. The internet and social media platforms have become breeding grounds for misleading claims, making it difficult for parents to discern facts from fiction. According to a study by Pew Research, social media plays a big role in news consumption, with 54% of U.S. adults saying they get some of their news input from social apps, which can contain misinformation, conspiracy theories, and other misleading content.

During a time when technology is easily accessible but online information can be unreliable, parents can take several steps to verify the accuracy of what they read:

● Rely on Credible Sources: Trustworthy organizations such as the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and state health departments provide accurate, research-backed information on vaccines.

● Consult Healthcare Professionals: Pediatricians and family doctors are the best resources for addressing concerns about vaccine safety and efficacy. These experts rely on decades of clinical research and firsthand experience.

● Understand the Science: Vaccines undergo rigorous testing for safety and effectiveness before being approved. The risk of serious side effects is extremely low compared to the dangers posed by preventable diseases.

● Engage in Constructive Conversations: When discussing vaccines with skeptical friends or family members, approach the conversation with empathy, addressing their concerns with factual, non-confrontational responses.

Taking Action: Keeping Your Child Vaccinated

If your child is due for immunizations, schedule an appointment with your healthcare provider or local public health department. The worst thing you can do is put it off until it’s too late. No one wants their child to be sick, especially if they contract a preventable disease.

While discussions and debates around vaccines continue, the fundamental truth remains: vaccines save lives. Throughout history, vaccines have been proven to prevent the spread of infectious diseases. From eradicating smallpox to significantly lowering cases of polio, measles, and other life-threatening illnesses, their impact is undeniable. While it is natural for people to seek information and question medical advancements, the overwhelming body of evidence supports the fact that vaccines protect people.

By keeping up to date with vaccine information and ensuring your child receives vaccinations on time, you can help reach that 95% threshold and prevent the resurgence of preventable diseases.

Sources:

CDC: Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2023–24 School Year

Pew Research Centre: Social Media and News Fact Sheet

U.S. Food and Drug: Vaccines Protect Children From Harmful Infectious Diseases

The Importance of Vaccinations for Pregnant Mothers

Pregnancy triggers many changes within the body, and it’s key to stay healthy during this crucial time for both mother and baby. These changes temporarily make the body more susceptible to illnesses, especially for the child in the womb. The best way to ensure you stay healthy through all stages is vaccination. It’s essential for new mothers to get vaccinated not only for themselves but also for the baby they’re carrying, as this provides early protection during a time when the baby is highly vulnerable in the first few months of life.

Why Pregnant Mothers Need Vaccines

The immune system naturally adapts during pregnancy to nurture the developing baby, but this adjustment can also make mothers more prone to complications from infectious diseases. Pregnant women can easily become sick with things like the common cold and the flu. Since it’s peak flu season, vaccination is essential right now. It helps strengthen the mother’s immunity, reducing the risk of illness.

Another reason for vaccination is passive immunity, where the mother transfers protective antibodies to the baby. This helps strengthen the baby’s immune system early on, giving them a head start in fighting off infections.

Diseases Prevented by Vaccination During Pregnancy

There are several vaccines recommended for pregnant women, all of which can help protect against life-threatening illnesses.

1. Influenza (Flu) Vaccine

● Why it’s important: Pregnant women are more likely to experience severe complications from the flu, including pneumonia, hospitalization, and preterm birth.

● Benefit to the baby: The flu vaccine protects the newborn from influenza in the first few months of life when they are too young to receive their vaccination.

2. Tdap (Tetanus, Diphtheria, and Pertussis) Vaccine

● Why it’s important: Pertussis (whooping cough) is a highly contagious respiratory infection that can be life-threatening for newborns.

● Benefit to the baby: The antibodies passed from the mother protect against whooping cough before the infant can get vaccinated at two months old.

3. COVID-19 Vaccine

● Why it’s important: COVID-19 can lead to severe illness in pregnant women, increasing the risk of preterm birth and other complications.

● Benefit to the baby: Babies born to vaccinated mothers may have some protection against COVID-19 in their early months.

4. RSV (Respiratory Syncytial Virus) Vaccine

● Why it’s important: RSV can cause severe respiratory illness in infants, including bronchiolitis and pneumonia.

● Benefit to the baby: RSV vaccination during pregnancy helps reduce the risk of severe RSV infection in newborns.

Vaccines After Pregnancy

After pregnancy, certain vaccines may be recommended. Breastfeeding mothers can also pass some antibodies to their babies through breast milk. Postpartum vaccination is particularly important for those who did not receive specific vaccines before or during pregnancy.

Addressing Concerns About Vaccination During Pregnancy

Some pregnant women may worry about vaccine safety. However, it’s important to note that there has been extensive research that confirms vaccination during pregnancy is safe. If you have concerns, discussing them with your healthcare provider can help you make an informed decision.

Next Steps

Vaccines are one of the best tools available to help pregnant women as their bodies go through changes. Scheduling an appointment to receive vaccines such as the flu, Tdap, COVID-19, and RSV vaccines can reduce health risks and pass on vital immunity to newborns. If you’re pregnant or planning to become pregnant, the first step is to understand what your body needs by talking to your healthcare provider. Making a call is a simple yet important step in giving yourself and your newborn a head start in building protection for the exciting years ahead.

Sources:

CDC: Vaccine Recommendations Before, During, and After Pregnancy

Mayo Clinic: Pregnancy week by week

National Library of Medicine: The Immune System in Pregnancy: A Unique Complexity

The Story of Mumps and How Vaccines Keep Us Safe

As we enter February, a common sickness that surfaces around this time is mumps. This infection has been around for a long time, probably longer than you think, but its impact on children and adults hasn’t changed. Mumps is a sickness that spreads easily from one person to another, making people feel tired and achy, and causing their cheeks to puff up. Sometimes, mumps can impact the brain, pancreas, or even the ears, which can lead to hearing problems. The good news is that there is a way to avoid contracting this virus, and that’s through vaccines. But how did we figure out how to stop mumps? The story is a great example of scientific excellence, medical innovation, and vaccine effectiveness.

The First Mumps Cases

The mumps can be dated all the way back to around 410 BC when it was written down in a journal. The individual who wrote about mumps noticed that people’s cheeks swelled up and that they felt sick for a while, but usually got better. This was one of the first times anyone wrote a description of what we now know as mumps.

1934 — Scientists Discover What Causes Mumps

Fast forward all the way to the 20th century; this disease kept appearing, but no one knew exactly what was causing it. Then, in 1934, two scientists discovered that mumps was caused by a virus. They figured this out by studying monkeys that got sick from a virus found in people’s saliva. This discovery was important because it was the first step in helping doctors determine how they could develop a potential vaccine.

1945 — The First Step Toward a Mumps Vaccine

In 1945, scientists had another breakthrough. They were able to isolate the virus and began studying it. Just a few years later, in 1948, scientists were able to create a vaccine that could help protect people. As time went on, this first vaccine didn’t work for very long, but that didn’t stop them from continuing to try to make it better.

1967 — A Doctor Helps His Daughter and the World

One day, a little girl named Jeryl Lynn became infected with mumps. Her dad, Maurice Hilleman, was a scientist and decided to use the virus from her sickness to make a vaccine. In 1967, his vaccine was approved. This was the tipping point that led to the first robust vaccine, ultimately helping millions of people stay healthy. This special strain is still used in mumps vaccines today.

1971 — Measles, Mumps, and Rubella Vaccine

Instead of giving kids separate shots for measles, mumps, and rubella, scientists decided to combine them into one vaccine called MMR. This made it easier for kids to get protected from all three diseases at the same time. A second dose was added in 1989 to help the vaccine work even better.

1998 — A Major Setback for the MMR Vaccine

In 1998, a doctor named Andrew Wakefield wrote a report in which he falsely suggested that there was a possible link between the MMR vaccine and autism. His study, which involved only 12 children, claimed that they had developed gastrointestinal issues and signs of autism after receiving the vaccine.

Despite the small sample size and lack of scientific evidence, the study generated widespread fear and led to a decline in vaccination rates, especially in the United States. His research was eventually proven false, and his study was retracted. However, many people got scared and stopped getting the MMR vaccine, which made mumps cases go up again.

2009 — No Link Between Vaccines and Autism

To ensure vaccines were safe, scientists did many studies, and in 2009, a special U.S. court ruled that there was no link between vaccines and autism. Doctors around the world agree that vaccines are safe and important for keeping kids healthy.

2018 — Mumps Comes Back in Some Places

Even though vaccines have been proven to work, scientists found that the mumps vaccine doesn’t last forever. Some adults who got the vaccine as kids started getting mumps again. Doctors are now thinking about giving older kids and teenagers a booster shot to keep them protected for longer.

How Many People Has the Vaccine Helped?

Before the vaccine was created, about 162,000 people got mumps every year in the U.S. But thanks to vaccines, only 429 cases were reported in 2023. That means the vaccine has saved millions of kids from getting sick and having serious problems like deafness or brain infections.

The Future of Mumps Prevention

Even though mumps is rare today, scientists continue to work to ensure the vaccine is at its best. Children may need an additional dose beyond the two they receive as infants and young children to ensure prolonged protection. One thing is for sure, getting vaccinated is the best way to keep mumps away.

Sources:

CDC: Chapter 15: Mumps

CDC: Mumps Cases and Outbreaks

The Rising Threat of Flu Illness Among Children

The 2025 flu season is off to a concerning start. The Centers for Disease Control and Prevention (CDC) reported 11 new pediatric deaths in the week ending January 11. This brings the total number of pediatric flu-related deaths this season to 27. Overall, the flu accounted for 1.5% of all deaths during the second week of January.

Children are the most vulnerable to severe flu complications, given their immune systems are still developing and they are constantly in environments where they interact with other children. The recent rise in young deaths highlights the need for families to take preventive measures, including vaccination and early medical care when they notice symptoms appear.

Current Flu Activity and Trends

The CDC estimates that the flu has caused over 12 million illnesses, 160,000 hospitalizations, and 6,600 deaths so far. January’s data shows an 18.8% positivity rate for flu tests, and seasonal activity remains high across most regions in the United States.

While visits to doctors’ offices for the flu appear to be declining, this might not mean that the U.S. has reached the season’s peak. Typically, flu season is at its highest in February.

Common Flu Symptoms and How to Tell Them Apart

It’s very easy for someone to confuse the symptoms of one illness with another. Many common viruses share overlapping features that can make it hard to determine the specific cause. For example, flu symptoms typically include:

  • Fever or chills
  • Cough and sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Fatigue
  • Headache
  • Vomiting or diarrhea (especially in children)

However, the flu isn’t the only illness making the rounds. COVID-19, RSV, and the common cold are also making people sick around this time, and distinguishing between them can be tricky without testing. Some key differences include:

  • COVID-19: Symptoms appear later than the flu and include a dry cough, muscle aches, and fatigue.
  • RSV: Mild cold-like symptoms for most, but serious for infants, young children, and older adults.
  • Common Cold: Typically lacks fever, headache, or significant fatigue, which are signs of the flu or COVID-19.

How Flu Spreads

The flu is mainly spread through droplets from coughing, sneezing, or talking. Touching a contaminated surface followed by touching your face can also spread the virus. This is why it’s important to wash your hands and clean surfaces regularly.

Types of Flu Vaccines

But no matter how often you wash your hands, gaps will remain that the flu can exploit. The best way to combat the flu is by getting vaccinated. For kids, there are a few types of flu vaccines to choose from:

  • The inactivated influenza vaccine (IIV) is the most common and is given as a shot. It’s safe for kids as young as six months old.
  • If your child has an egg allergy, there’s the recombinant influenza vaccine (RIV), which is made without eggs.
  • For kids who don’t like shots, the live attenuated influenza vaccine (LAIV) is available as a nasal spray for those aged two and older.

These vaccines are updated every year to protect against the flu strains most likely to spread during flu season.

When to Get Vaccinated

The best time for kids to get their flu vaccine is early in the fall, around September or October. This helps their bodies prepare for flu season, which usually peaks between December and February. However, if you missed the earlier months, kids can still get their flu shot in January or even later. It takes about two weeks for the vaccine to fully work, and since flu season can last into the spring, it’s never too late to protect your little ones.

Preparing for the Weeks Ahead

As February approaches, flu activity is expected to remain high. Staying informed, practicing preventive measures, and seeking medical attention early when you notice symptoms are important steps in protecting your loved ones. By staying proactive, families can ensure they stay safe through these peak months and enjoy the beginning of 2025.

Sources:

CDC: Weekly US Influenza Surveillance Report: Key Updates for Week 2, ending January 11, 2025

National Foundations for Infectious Diseases: Influenza Vaccine Options: 2023–2024 Season

Whooping Cough in Children: Symptoms, Vaccination, and What Parents Need to Know

It’s a rise that the United States hasn’t seen in decades. Pertussis, more commonly known as whooping cough, is under the watchful eye of health officials following a rise in cases. According to the Centers for Disease Control and Prevention (CDC), Tennessee reported 226 cases of whooping cough in 2024, compared to 64 cases in 2023. In 2024, the number of cases in the U.S. increased more than sixfold compared to the same period last year, reaching levels not seen since 2014. This is a concern for children, as this infection is notorious for its severe, painful coughing fits that can last for weeks or even months. With this increase comes the responsibility for parents to understand the illness, its stages, vaccination options, and preventive measures.

What Is Whooping Cough?

Whooping cough typically begins with mild, cold-like symptoms such as:

  • Runny nose
  • Sneezing
  • Low-grade fever
  • Mild cough

Within a week or two, these symptoms become more severe, resulting in children experiencing intense coughing fits. The cough is often so severe that it causes vomiting, breaks ribs, or produces a distinctive “whooping” sound. This stage can last for weeks. Even after recovery begins, residual coughing may persist for months.

This infectious disease is highly contagious, spreading through airborne droplets when an infected person coughs or sneezes. People can transmit the bacteria for weeks after symptoms develop, even if they feel well enough to resume daily activities.

Recent Trends in Whooping Cough

Cases of whooping cough dropped significantly during the COVID-19 pandemic, likely due to masking, reduced social interactions, and other mitigation measures. However, 2024, as noted above, has seen a sharp resurgence. This rise coincides with a recent decline in vaccination rates. The CDC reports that routine childhood vaccination among kindergarteners fell below 93% in the 2023–24 school year, down from 95% in 2019–20, with exemptions reaching a record 3.3%.

The Best Line of Defense

Vaccination remains the most effective way to protect children against whooping cough. The vaccines used have been proven to significantly reduce the risk of severe illness, hospitalization, and death. Studies have shown that those who are vaccinated are less likely to contract whooping cough, and if they do, the symptoms are generally milder and less likely to result in complications. When getting the vaccine, the CDC recommends:

  • DTaP vaccine for children at 2, 4, and 6 months, with booster doses at 15–18 months and 4–6 years.
  • Tdap vaccine for adolescents and adults as a booster, typically at age 11–12 and during every pregnancy to protect newborns.

Diagnosis and Treatment

It’s important for parents to understand the signs of whooping cough because doctors can prescribe antibiotics during the initial weeks before severe coughing begins. Once the illness progresses, treatment focuses on managing symptoms with rest, fluids, and comfort care. Parents should monitor their children closely and seek medical attention if they observe prolonged coughing fits, vomiting after coughing, or signs of respiratory distress.

Preventing Whooping Cough and Other Respiratory Illnesses in 2025

Whooping cough, once a leading cause of childhood mortality in the early 20th century, has been largely controlled through vaccination. However, recent numbers showing an increase in cases highlight the need for families to maintain high vaccination rates. The winter months can be brutal for respiratory illnesses, including the flu, RSV, the common cold, and COVID-19. All of these can impact children but can be mitigated with the help of vaccinations.

An important step parents can take is to reduce the spread and impact of this challenging illness. The best way to do this is by maintaining a vaccine schedule and talking to your doctor about what other steps you can take to ensure your family stays happy and healthy through these months.

Sources:

CDC: Nationally Notifiable Infectious Diseases and Conditions, United States: Weekly Tables

CDC: Whooping Cough Vaccination

CDC: Vaccination Coverage and Exemptions among Kindergartners

Tennessee Department of Health: Pertussis (Whooping Cough)

Categories
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:

How to Tell the Difference between Flu, RSV, COVID-19, and the Common Cold

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

Top Infectious Diseases to Watch in 2025 and the Best Vaccines to Combat Them

As 2025 begins, several infectious diseases, both familiar and emerging, could challenge families. Declining vaccination rates are creating conditions that result in the reemergence of certain diseases.

While a new year brings challenges, families can take steps to protect themselves from infectious diseases. The best place to start is by understanding the current environment, the risks, and how to address them effectively.

1. Bird Flu (Avian Influenza)

Bird flu has become a growing threat in the U.S. after human cases were found in 2024. Currently, there are 66 confirmed human cases. While the risk of human-to-human transmission remains low, experts warn that the virus poses a risk of mutating further.

Best Vaccine: Current avian influenza vaccines have only been developed for poultry, but clinical trials for human vaccines are ongoing. A stockpiled H5N1 vaccine may be deployed if a significant human outbreak occurs.

2. Measles

Once nearly eradicated in the U.S., measles is making a concerning comeback due to declining vaccination rates. In 2024, the CDC reported the highest annual case total in five years, with outbreaks linked to unvaccinated populations. Measles is highly contagious and can lead to severe complications such as pneumonia and encephalitis.

Best Vaccine: The Measles, Mumps, and Rubella (MMR) vaccine remains the gold standard, with 97% efficacy with two doses. Parents should ensure their children are up to date on their immunizations to avoid any complications.

3. Polio

Polio, a disease that has been largely eradicated in most of the world, has become a threat once again due to low vaccination coverage in some areas. Polio outbreaks in countries like Pakistan and Afghanistan show how easily it can spread and its impact. In the U.S., vaccine hesitancy could create conditions for its resurgence, particularly among unvaccinated children.

Best Vaccine: The Inactivated Polio Vaccine (IPV) is highly effective at preventing polio and is part of the routine childhood immunization schedule in the U.S.

4. COVID-19 and Respiratory Syncytial Virus (RSV)

COVID-19 and RSV remain ongoing public health concerns. New variants of COVID-19 continue to emerge, requiring updated vaccines and boosters. RSV, which surged during the 2024 winter season, remains a risk, particularly for infants and older adults.

Best Vaccines:

● COVID-19: Updated mRNA vaccines from Pfizer-BioNTech and Moderna targeting current variants.

● RSV: Recently approved RSV vaccines, including those by Pfizer and GSK, are recommended for older adults and pregnant women to protect newborns.

Addressing the Challenge

Some of the infectious diseases highlighted above are a concern only due to declining vaccination rates, coupled with vaccine misinformation, which exacerbates the risk of outbreaks. Parents can protect their children by educating themselves on how vaccines are developed and the rigorous steps taken to ensure they are safe for human use.

In 2025, parents remain central to protecting their children amidst the dual threats of falling vaccination rates and widespread misinformation. Staying informed and proactive is essential to ensure children’s health and safety. By understanding the importance of vaccines, parents can take steps to safeguard their families.

One of the most effective ways for parents to stay informed is by talking to their child’s pediatrician. Medical professionals offer evidence-based guidance, addressing concerns about vaccine safety and efficacy while debunking myths or misconceptions. Open conversations with a trusted doctor can help parents make confident, well-informed decisions about their child’s health.

Amidst the activity and excitement of 2025, protecting yourself and your family from infectious diseases is essential to achieve your plans and goals for the year.

Sources:

CDC: H5 Bird Flu: Current Situation

CDC: About Polio in the United States

CDC: Measles Cases and Outbreaks

National Foundation for Infectious DIsease: How to Tell the Difference between Flu, RSV, COVID-19, and the Common Cold

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