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Mary-Margaret Fill, MD, MPH

@mmfill.bsky.social
2.5K followers 61 following 30 posts

Physician (IM/Peds). Epidemiologist. Mom. Wife. EIS ('15) and ELBI ('17) alum. Public health, biosecurity & medicine. Posts rep only me. Reposts ≠ endorsement.

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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 01/02/2026
Day 8 with no power. Two young kids (4 & 7), a sweet senior dog (10.5) and their grown ups (physicians serving VUMC & the State of TN) are desperate to get back home. It's a simple repair of a severed line between 2 NES poles. @wsmv.com @thetnholler.bsky.social @freddieoconnell.bsky.social
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 11/09/2025
I’m so sorry to see this news from Los Angeles 💔 Subacute sclerosing panencephalitis (SSPE) is a progressive, almost uniformly fatal, neurological disorder caused by reactivation of the measles virus or an inappropriate immune response to the measles infection. abc7.com/post/child-d...
abc7.com
Child dies from rare measles-related complication, LA County health officials say
Health officials reported the death of a Los Angeles County child from a complication of measles infection acquired during infancy.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 10/09/2025
"The vast majority of [state health department] communicable-diseases budgets are paid for with C.D.C. dollars". In fact, ~80% of CDC's budget goes directly out the door to state, tribal, local and territorial health departments. @newyorker.com www.newyorker.com/news/the-led...
newyorker.com
Inside the Chaos at the C.D.C.
A former senior official and two current employees describe the turmoil at the agency under R.F.K., Jr.,’s stewardship.
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Reposted by Mary-Margaret Fill, MD, MPH
USA TODAY @usatoday.com · 09/06/2025
Health Secretary Robert F. Kennedy Jr. ousted all 17 members of a panel that advises the CDC on the safety, efficacy and clinical needs of vaccines.
bit.ly
RFK Jr. fires entire CDC vaccine advisory panel
Health Secretary Robert F. Kennedy Jr. ousted all 17 members of a panel that advises the CDC on the safety, efficacy and clinical needs of vaccines.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 09/06/2025
"Never doubt that a small group of thoughtful committed individuals can change the world. In fact, it's the only thing that ever has." (Margaret Mead) As we kick off the CSTE 2025 Annual Conference, I am immensely grateful to serve among these incredible STLT public health leaders.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 20/04/2025
Immensely grateful to Dr. McDonald (@milbankfund.bsky.social) and many others lending their voices to this critically important conversation.
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Reposted by Mary-Margaret Fill, MD, MPH
Milbank Memorial Fund & The Milbank Quarterly @milbankfund.bsky.social · 18/04/2025
In a new blog, Milbank Memorial Fund’s Morgan McDonald highlights the challenges and dangers of the abrupt termination of $11 billion in federal funds that occurred on March 24 and the mass layoffs at US Department of Health and Human Services that followed. www.milbank.org/2025/04/pray...
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Reposted by Mary-Margaret Fill, MD, MPH
Alexander Tin @alexander-a-tin.bsky.social · 10/04/2025
The CDC's cruise ship inspectors have been laid off, as well as agency's head epidemiologist for investigating cruise ship outbreaks That baffled health officials since this program is paid for by cruise ship fees, not taxpayer dollars www.cbsnews.com/news/cdc-cru...
cbsnews.com
CDC's cruise ship inspectors laid off amid bad year for outbreaks
The steep cuts to the cruise ship inspection team baffled officials in the program, which is not paid for by taxpayer dollars.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 10/04/2025
These comments from Secretary Kennedy are quite disappointing. The abrupt clawback of $11B in federal funds allocated to state & local HDs has had dramatic negative impacts on public health capacity nationwide. A more cohesive approach between DOGE & HHS would be beneficial. www.com/news/rfk-jr-...
cbsnews.com
RFK Jr. says he's "not familiar" with all health program cuts in exclusive interview
Health and Human Services Secretary Robert F. Kennedy Jr. addressed health program cuts and the measles vaccine in his first network TV interview since joining the Trump administration.
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Reposted by Mary-Margaret Fill, MD, MPH
Alan Regenberg @aregenberg.bsky.social · 02/04/2025
50 canceled vaccination clinics, and other local impact from HHS cuts: ‘Mass layoffs is not how you make America healthier,’ city and county health officials say www.statnews.com/2025/04/01/h... via @statnews.com
statnews.com
50 canceled vaccination clinics, and other local impact from HHS cuts
"Mass layoffs is not how you make America healthier," city and county health officials say in reaction to large-scale dismissals of federal health workers.
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Reposted by Mary-Margaret Fill, MD, MPH
WIRED @wired.com · 01/04/2025
NEW: Thousands of CDC employees who worked on things like preventing HIV and lead poisoning have been told they were subject to a reduction in force. Experts say people will die.
wired.com
The CDC Has Been Gutted
Thousands of CDC employees who worked on things like preventing HIV and lead poisoning have been told they were subject to a reduction in force. Experts say people will die.
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Reposted by Mary-Margaret Fill, MD, MPH
Dan Diamond @ddiamond.bsky.social · 01/04/2025
Hearing from all corners of HHS this morning about a total bloodletting — firings of scientists, analysts and many more as delayed RIFs take effect. Many folks didn’t see early AM email and showed up, only to be turned away when badges didn’t work. Was sent this photo of long lines at one HHS site.
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Helen Branswell 🇨🇦 @helenbranswell.bsky.social · 01/04/2025
Employees of #HHS and its agencies who are being fired — RIF'd — started to receive termination notices today starting at 5 am. Big swaths of the #CDC appear to have been cut. Developing story. www.statnews.com/2025/04/01/h...
statnews.com
HHS starts layoffs of thousands of workers across its agencies
Layoff notices began arriving early Tuesday for thousands of employees of HHS and its subsidiary agencies, with as many 10,000 workers potentially expected to be hit by the cuts.
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Reposted by Mary-Margaret Fill, MD, MPH
NBC News @nbcnews.com · 25/03/2025
“Now that the pandemic is over, the grants and cooperative agreements are no longer necessary," federal health authorities wrote to funding recipients this week.
nbcnews.to
CDC is pulling back $11B in Covid funding sent to health departments across the U.S.
“Now that the pandemic is over, the grants and cooperative agreements are no longer necessary," federal health authorities wrote to funding recipients this week.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 25/02/2025
In 2011, the city of Calgary took fluoride out of their water. Children developed a higher rate of cavities (+ req'd treatments, i.e. general anesthesia) than in other communities. Calgary is now in the process of putting fluoride *back* into their water supply. Let's learn from other communities.
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Reposted by Mary-Margaret Fill, MD, MPH
NPR @npr.org · 19/02/2025
As flu rages, the Trump administration has pulled the plug on a Centers for Disease Control and Prevention flu immunization campaign that targeted high-risk groups, including pregnant women.
npr.org
Trump administration yanks CDC flu vaccine campaign
As flu rages, the Trump administration has pulled the plug on a Centers for Disease Control and Prevention flu immunization campaign that targeted high-risk groups, including pregnant women.
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Reposted by Mary-Margaret Fill, MD, MPH
CBS News @cbsnews.com · 19/02/2025
Some lots of raw pet food sold in two states are being recalled after two indoor cats became ill with bird flu earlier this month and were euthanized due to the severity of their illnesses. cbsn.ws/41xxzzH
cbsn.ws
Raw pet food is recalled and warnings issued in two states after cats die of bird flu
Pet owners cautioned after tests confirm Highly Pathogenic Avian Influenza (HPAI) in two cats living in different households.
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Reposted by Mary-Margaret Fill, MD, MPH
BNO News @bnonews.com · 17/02/2025
BREAKING: At least 8 injured after Delta plane crash landed at Toronto Pearson International Airport - CP24
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 16/02/2025
While reports are that the EIS program has been spared, many other brilliant, dedicated, experienced public health professionals were terminated yesterday. Our country is healthiest when we have a strong public health enterprise (from the federal to local levels). bsky.app/profile/alex...
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 15/02/2025
I had the great privilege of serving in the EIS Class of 2015, responding to dozens of disease outbreaks and novel health threats. The program is a crowned jewel of U.S. public health and a model for other countries. Cutting this program does not, in any way, make our country healthier.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 14/02/2025
68 children have died of influenza this season. And I've heard anecdotes that busy children's hospitals are at capacity with available ECMO circuits to support children critically ill with influenza. The *vast* majority of these children are unvaccinated.
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STAT @statnews.com · 14/02/2025
#Breaking - Trump administration to fire thousands at health agencies. Employees across agencies who were hired in the past one to two years are being targeted
buff.ly
Trump administration to fire thousands at health agencies
The Trump administration is set to eliminate thousands of federal health care jobs Friday, targeting employees across agencies who were hired in the past one to two years.
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Emily Ricotta, PhD @emilyricotta.bsky.social · 12/02/2025
I am SO THRILLED to finally present our new paper on reforming observational studies in epidemic settings, published in @bmj.com BMJ Global Health. gh.bmj.com/cgi/content/... #Episky #Epidemiology #clinicalresearch #observational #IDSky
gh.bmj.com
Observational research in epidemic settings: a roadmap to reform
Observational studies are critical tools in clinical research and public health response, but challenges arise in ensuring the data produced by these studies are scientifically robust and socially val...
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Edward Nirenberg @enirenberg.bsky.social · 05/02/2025
So there's a new development in the bird flu situation -the bird genotype of the virus (D1.1), which has, in the current panzootic, been responsible for all of the severe cases of H5N1 in humans- has been detected in 4 dairy herds in Nevada. Here's what that could mean:🧵
statnews.com
USDA milk testing shows different strain of H5N1 bird flu in Nevada dairy herds
The USDA said four Nevada dairy herds were infected with an H5N1 bird flu strain that has circulated in wild birds, making prospects for containment in cows appear dim.
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Reposted by Mary-Margaret Fill, MD, MPH
Helen Branswell 🇨🇦 @helenbranswell.bsky.social · 05/02/2025
4 dairy herds in Nevada recently diagnosed with #H5N1 #birdflu were infected with a different version of the virus than has been spreading in cows elsewhere. Evidence of a second (at a minimum) spillover points to the challenge of stopping spread, experts say. www.statnews.com/2025/02/05/u...
statnews.com
USDA milk testing shows different strain of H5N1 bird flu in Nevada dairy herds
The USDA said four Nevada dairy herds were infected with an H5N1 bird flu strain that has circulated in wild birds, making prospects for containment in cows appear dim.
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Caitlin Rivers @cmyeaton.bsky.social · 03/02/2025
If you feel like everyone is sick right now, you are right. Flu is doing something unusual - outpatient visits just hit 7.0%, surpassing January's peak. substack.com/home/post/p-...
substack.com
Flu spikes
Influenza-like illness hits a second peak
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Reposted by Mary-Margaret Fill, MD, MPH
CNN @cnn.com · 30/01/2025
60 passengers and four crew were on board American Airlines jet that collided with Army Black Hawk helicopter in Washington, DC. Follow live updates.
cnn.com
Live updates: American Airlines plane crash near Washington, DC; Reagan National Airport takeoffs and landings halted | CNN
A passenger aircraft crashed into the Potomac River near Reagan National Airport outside of Washington, DC, after it collided midair with a helicopter as it approached the runway, according to the Fed...
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 28/01/2025
The American Academy of Pediatrics (www.aap.org) has submitted ~200 pediatrician stories to Senate committees about the importance of childhood vaccinations. Almost every pediatrician has experienced cases like these. They are not imagined, they are devastating. And they are preventable.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 28/01/2025
The partisan divide in this @kff.org poll is staggering but not surprising. There is much work for public health to do to (re)build trust with all Americans. These data also reinforce the critical educational role of front line clinicians. Full poll data here: www.kff.org/health-infor...
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 27/01/2025
At least 15 state legislatures have proposed bills to "create new religious exemptions from immunization mandates, establish state-level vaccine injury databases or dictate what providers must tell patients about the shots." apnews.com/article/vacc...
apnews.com
Vaccine bills stack up in statehouses across the US
Vaccination bills are popping up in more than 15 states as lawmakers aim to potentially resurrect or create new religious exemptions from immunization mandates, establish state-level vaccine injury da...
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Dr. Tom Frieden @drtomfrieden.bsky.social · 23/01/2025
CDC's Morbidity and Mortality Weekly Report (MMWR) has provided real-time data and analysis about disease outbreaks and emerging health threats without a break every week since 1960. Until today.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 23/01/2025
There are *zero* eggs at my grocery store. Even if you don't care about H5N1 from a human health perspective, you should care about the economic impact: ">13 million egg-laying hens died in December due to [H5N1] ... and another 3.3M died in early January". www.kcur.org/news/2025-01...
kcur.org
Egg prices are soaring again. Here’s why and what to expect
Bird flu has killed millions of hens in recent weeks, shrinking the supply of eggs and hiking up prices at grocery stores.
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Eric Topol @erictopol.bsky.social · 15/01/2025
The US Primary care physician shortage (county level) and marked geographic variation in health outcomes www.nejm.org/doi/full/10.... @nejm.org
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 15/01/2025
This article from @nejm.org requires a subscription, but man does this quote nail it. www.nejm.org/doi/full/10....
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 15/01/2025
💯 "Ultimately, like many effective public health interventions, vaccines are a victim of their own success ...most people haven’t seen outbreaks of measles or polio, so they forget how dangerous the diseases are." www.nbcnews.com/health/healt...
nbcnews.com
Childhood vaccination rates, a health bright spot in struggling states, are slipping
Mississippi, Tennessee and West Virginia have some of the highest childhood vaccination rates. Experts worry a rising tide of vaccine skepticism is causing those bright spots to dim.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 12/01/2025
We obviously worry about the human health risks of consuming raw milk, but this @apnews.com article highlights the risk to our beloved domestic pets as well. Protect yourself, your family and your pets with pasteurization! apnews.com/article/raw-...
apnews.com
He gave his cats raw milk because he thought it was healthier. He says it tragically backfired
A California man says his two cats died and a third was hospitalized after he fed them raw milk recalled for bird flu risk.
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Alexandra Phelan 余雪莲 @alexandraphelan.bsky.social · 18/12/2024
A big day for Bird Flu and bad day for us: ▶️ First US severe H5N1 case hospitalized in Louisiana (likely from backyard poultry) ▶️ First Wisconsin human H5N1 case (likely from commercial poultry) ▶️ California Gov declares State of Emergency (driven by state spread of positive tests at dairies)
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Reuters @reuters.com · 18/12/2024
The US reported its first severe human case of bird flu in a Louisiana resident who is hospitalized and in critical condition after suspected contact with an infected backyard flock reut.rs/49IqFtM
reut.rs
US suffers first severe human case of bird flu; California declares emergency
The U.S. reported its first severe human case of bird flu on Wednesday in a Louisiana resident who is hospitalized in critical condition after suspected contact with an infected backyard flock.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 13/12/2024
National data reported by CDC through November 30th shows that only 36.6% of children have received flu vaccine this year (as compared to 43.7% at this time last year). In 2023-24, flu vaccine reduced the risk of flu-related hospitalization for children by half. www.cdc.gov/fluvaxview/d...
cdc.gov
Weekly Flu Vaccination Dashboard
Get weekly flu vaccination data for local areas, states, HHS regions, and the nation.
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NEJM.org @nejm.org · 10/12/2024
On this day in 1981, a landmark paper in NEJM described four patients with evidence of immunodeficiency associated with PJP pneumonia, disseminated CMV, and Kaposi sarcoma. The disease would come to be known as HIV/AIDS. Revisit the paper: nej.md/41iekKD #MedSky #IDSky
Published on This Day in 1981.  
Pneumocystis carinii Pneumonia and Mucosal Candidiasis in Previously Healthy Homosexual Men — Evidence of a New Acquired Cellular Immunodeficiency  

An illustration showing the reproductive cycle of human immunodeficiency virus type 1 (HIV-1) and sites of action of the major classes of antiretroviral medications.  

The NEJM identity sits at the bottom.
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Reuters @reuters.com · 08/12/2024
Syrian President Bashar al-Assad boarded a plane and left Damascus for an unknown destination on Sunday, two senior army officers told Reuters, as rebels said they had entered the capital with no sign of army deployments reut.rs/3ORxDTn
reut.rs
Assad has left Damascus, say senior army officers; Syria rebels say they are in capital
Insurgents gained control after only a day of fighting, leaving President Bashar al-Assad's 24-year rule dangling by a thread as rebels marched on Damascus.
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BK. Titanji @boghuma.bsky.social · 07/12/2024
Health officials in Marin country are investigated another potential case of H5N1 in a child with no clear exposures. If the positive test is confirmed by the CDC this will be third human case reported during this outbreak without clear zoonotic exposure. www.latimes.com/california/s...
latimes.com
Possible H5N1 bird flu case in Marin County child; source of infection unknown
A second CA child has tested positive for H5N1 bird flu in Marin Co.; confirmation needed from CDC
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The Associated Press @apnews.com · 07/12/2024
On Dec. 7, 1941, the Empire of Japan launched an air raid on the U.S. Navy base at Pearl Harbor in Hawaii, killing more than 2,300 Americans. The United States declared war against Japan the following day. Read more about what happened on this date: t.ly/sJ7Un
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Kai Kupferschmidt @kakape.bsky.social · 06/12/2024
If an #H5N1 pandemic starts tomorrow or in three months, there will be little mystery as to how it happened. The conditions are all there. They have been for a while. So in some ways the more interesting question to me at the moment is: Why aren’t we in a pandemic yet? Story here, 🧵 to come: 🧪#IDSky
science.org
Why hasn’t the bird flu pandemic started?
Some scientists examining mutations found in H5N1 viruses fear major outbreak is imminent but others says pathogen remains unpredictable
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 06/12/2024
At least 1 new state added human H5N1 cases today ... The drip ... drip ... drip ... of human cases is feeling more and more like a steady stream. www.cdc.gov/bird-flu/sit...
cdc.gov
H5 Bird Flu: Current Situation
H5 bird flu is causing outbreaks in wild birds and poultry, other animals and sporadic human cases.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 05/12/2024
Updates from the DRC MoH on the unidentified illness circulating: ➡️376 cases | 79 deaths | ~300 recovered ➡️~40% of cases are among children <5 yo ➡️Primary symptoms: fever, cough, runny nose, headache, myalgia, respiratory distress ➡️Suspicion is for respiratory disease apnews.com/article/cong...
apnews.com
Congo government says it's 'on alert' over mystery flu-like disease that killed dozens
Congo’s health minister says the government is on alert over a mystery flu-like disease that in recent weeks killed dozens of people.
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Helen Branswell 🇨🇦 @helenbranswell.bsky.social · 04/12/2024
I asked #USDA if a herd (like the one in CO) that tested positive, later cleared quarantine, then tested positive a 2nd time would be counted again against the state's infected herds total. The answer is no. So even though CO currently has an active outbreak, it's not on the map. Seems misleading.
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Scott Gottlieb, MD @scottgottliebmd.bsky.social · 04/12/2024
CDC confirms that the California child who previously tested positive for H5N1 last month had the same strain previously identified in the dairy cattle outbreak, with no clear theory on how the virus spread to the child who had no known contact with infected animals www.paho.org/sites/defaul...
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Helen Branswell 🇨🇦 @helenbranswell.bsky.social · 22/11/2024
California's human #H5N1 #birdflu case count is now up to 29. National total this year is now 55.
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Mary-Margaret Fill, MD, MPH @mmfill.bsky.social · 22/11/2024
Tragic news reported from Laos as a 6th tourist dies after suspected methanol poisoning. Sobering reminder of the health risks from methanol ingestion. We reported on 2 deaths from methanol intoxication in Tennessee several years ago in the CDC MMWR: www.cdc.gov/mmwr/volumes....
cdc.gov
Notes from the Field: Intoxication and Deaths Associated with Ingestion of a Racing Fuel and Carbonated Soft Drink Mixture — Tennessee, January 2016 | MMWRMinusSASstats
Two methanol poisoning deaths are linked to drinking racing fuel.
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