Bird flu researchers hone in on Finland’s mink farms

Trying to predict an H5N1 pandemic is almost like warning about an earthquake. It could happen, next year, in five years, or who knows when.

August 11, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. I think we have a crowd pleaser, with all the caveats because it's just in mice now. Angus Chen tantalizes us with his report on scientists hoping to replace colonoscopy prep with something like yogurt.

infectious disease Waiting for the Big One: Bird flu's spread among mammals alarms scientists Sergai Grits/AP When infectious disease specialist Tarja Sironen and her colleagues went to a farm in Finland housing foxes and mink last week, the normal shrieking of the birds around the barns was gone. Dead gulls littered the ground. Foxes weren't barking. In the near-silence, they were seeing the reach of the highly pathogenic avian influenza, H5N1, moving beyond millions of domestic and wild birds to outbreaks among mammals at a scale previously unseen. That includes mink, foxes, and raccoon dogs on Finnish fur farms. "How is it mutating? That is the key question," Sironen said. The H5N1 virus does not infect people easily right now, but, as STAT's Andrew Joseph writes, "trying to predict an H5N1 pandemic is almost like warning about an earthquake. It could very well happen, perhaps next year, or in five years, or who knows when." Read his report from Helsinki on a virus with pandemic potential. infectious disease  Deadly TB outbreaks came from bone grafts. There is no test required for them It may be hard to imagine that bone tissue used in spinal or dental surgeries might be contaminated with tuberculosis, but two fatal outbreaks — one in 2021 and one in July — have been tied to the bone grafts. Maybe more difficult to fathom: There is no commercially available TB test for bone tissue and neither the FDA nor the American Association of Tissue Banks require companies to test donor materials for TB. An FDA spokesperson declined to speculate on whether the agency might update its human tissue testing standards, which now include HIV, hepatitis, and syphilis. The risk of contracting TB through bone grafts is generally low, but still potentially deadly, especially for patients already taking immunosuppressive drugs so as to not reject the needed bone implant. The biomaterial company Aziyo did test the tissue in the latest outbreak, but it said the samples were negative for TB. STAT's Lizzy Lawrence has more. cancer  If downing a yogurt one day replaces colonoscopy prep, you can thank CRISPR'd bacteria Colonoscopy is a very good tool to detect colorectal cancer. It's also very unpleasant for patients. With rates of the cancer rising among younger people, a less ghastly process would be welcome. Someday that could mean downing food — say, yogurt — containing bacteria engineered to detect and treat precancerous colorectal polyps or cancer itself. Don't cancel your appointment yet: The research, published in Science yesterday, was based on experiments squirting a concoction up the butts of mice with tumors grafted into their GI tracts. Here's how it works: Certain bacteria were engineered to slurp up a common cancer mutation that drives normal cells into tumors. Then scientists instructed the bacteria to use the CRISPR gene editing system to react to those mutated genes by turning on an antibacterial resistance gene. That signal indicated the cancer DNA had been found and responded to it. STAT's Angus Chen explains what could be next.

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Closer Look What to know about compounders' versions of the new weight loss drugs If you were paying really close attention to government warnings, as STAT's Ed Silverman does, you'd have seen that in May, the FDA said it'd received a "few" adverse event reports concerning compounded versions of the injectable medicines containing semaglutide. That's the active ingredient in both Wegovy, approved for weight loss, and Ozempic, prescribed for diabetes but sometimes used to treat obesity. Novo Nordisk, which makes both drugs, recently filed lawsuits against a number of compounders.  Some compounders make versions of commercially approved drugs for individual patients who have a prescription, but others act as outsourcers. Amid shortages of these wildly popular drugs, compounders may look attractive. Something to remember: The FDA says patients should not use a compounded version of a medicine if an FDA-approved one is available, but it does not review compounded versions of these drugs for safety, effectiveness, or quality. Read more on legal and other questions. long covid CDC: Fewer people report long Covid symptoms, but for 1 in 4, daily life is impaired Two new reports from the CDC say fewer people are still living with symptoms long after their Covid infections but they can come and go: One analysis comparing June 2022 to June 2023 says long Covid rates fell from 7.5% to 6% of all U.S. adults and from 19% to 11% among those infected. Among those still troubled by conditions like extreme fatigue, brain fog, or musculoskeletal pain, 1 in 4 say their daily lives are severely limited.  The other report says among nearly 1,300 people surveyed every three months between December 2020 and March 2023, some symptoms — especially cognitive difficulties and extreme fatigue — came back or came up for the first time in the year after infection. "Post-Covid conditions, or long Covid, can persist for months or years after an acute Covid-19 illness and can include emergence of new symptoms or the occurrence of symptoms that come and go," the researchers warn. opioid crisis Supreme Court blocks Purdue bankruptcy plan that shielded Sacklers  In all the years of legal news about holding Purdue Pharma and its owners to account for the opioid crisis, the last word might have looked like a nationwide settlement with the OxyContin maker that would shield Sackler family members from civil lawsuits. But yesterday the U.S. Supreme Court blocked the settlement in response to a request from the Biden administration to halt a bankruptcy plan reached with state and local governments. The arrangement would have traded the Sacklers' immunity for a contribution of up to $6 billion to the proposed settlement. "This is a good sign" for those who filed lawsuits over OxyContin marketing,  Carl Tobias at the University of Richmond said. "This action says there are people who question the use of bankruptcy to offer a shield, because it may not be fair to people who allege they were harmed." STAT's Ed Silverman explains.

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Thanks for reading! More Monday,

elizabeth.cooney@statnews.com

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