Unger: Hello and welcome to the
AMA Update video and podcast. Today, we have our weekly
look at the headlines with the AMA's Vice President
of Science, Medicine, and Public Health, Andrea Garcia. I'm Todd Unger, AMA's
Chief Experience Officer. Welcome back, Andrea. Garcia: Thanks, Todd. It's great to be back. Unger: Well, it's
been a couple of weeks since we last talked because of
AMA's annual meeting that was held in Chicago this past week. Andrea, before we dive
into this week's headlines, any highlights from the
annual meeting to share? Garcia: Well, as
usual, there was a lot of work
happening at the policy level at that meeting
with the focus, of course, on the AMA's key priorities,
including Medicare payment reform, fixing prior
auth, addressing inappropriate scope of
practice expansions, and ensuring physicians have
a voice in tech development, including AI. Many of these
issues, as we know, are creating additional
burdens for physicians and they're threatening
patient access and safety. Both our incoming and
outgoing presidents discussed the toll that this
takes on physicians, which contributes to burnout
and ultimately puts health care in crisis. So while I think many
physicians left the meeting feeling energized about
the progress we've made, it's clear that we do still
have a lot of work to do. Unger: Absolutely. And Andrea, as you mentioned,
a huge part of the meeting is devoted to health policy. What highlights do you have
to share from your perspective on public health? Garcia: Well, there's
really so much policy work that gets done at
this meeting that it's impossible to capture it all
in a short conversation here. But one of the public
health highlights I think that's worth
mentioning focuses on minority communities and rural areas. We know this is important
because more than 46 million people or
15% of our population live in rural areas in
the U.S. And research shows that people
in rural communities experience disproportionately
higher rates of cardiovascular disease,
stroke, cancer, diabetes, and respiratory illness. And minority communities
in rural areas are even higher risk for
poor health outcomes. The AMA's policy aims to improve
these outcomes through efforts specifically tailored
to these populations, including increased access
to care and education on disease prevention. There are so many policies
like this one that are aimed at improving public health. We will drop a link to this
description of this episode where people can find out more. Unger: All right. Well, thank you very much,
Andrea, for that recap. And now turning to headlines
from over the past couple of weeks. And just proof that just
because we don't talk about it doesn't mean that it's gone. We'll start with where
we left off, Andrea, and that's bird flu. Have things gotten
any better or worse? Garcia: Well, when
we last talked, there were two farmworkers
who had tested positive for H5N1 bird flu,
and that number has now increased to three. Unlike the first two farmworkers
who had high infections, the third farm worker
reportedly also had respiratory symptoms,
including a cough, sore throat, watery eyes. And that may increase the
likelihood of transmission to other people. However, federal officials still
say that the risk to the public remains low. All three farm workers
have fully recovered. And there was also
a recent experiment that showed that the virus
was less capable of spreading by respiratory droplets. Although we certainly know
that could change as the virus evolves. Unger: I'm just curious
about what kind of experiment would be able to prove that. Garcia: Well, this
was an experiment that was done with
ferrets, and that is a model that is
often used to assess potential impact on people. Researchers at the CDC
used the H5N1 virus taken from the farm worker
in Texas who tested positive. And when three
healthy ferrets were placed in the same
enclosure with three of the infected ferrets,
all of them became sick. So these animals could
touch, they could nose, they could lick
the sick animals. Those findings
indicate that the virus spreads efficiently
between ferrets who are in direct contact. When three healthy ferrets were
placed in an enclosure where they could breathe the same
air as the sick ferrets but couldn't touch them, only
one of those three animals became ill. And that suggests that
the virus is currently less capable of spreading
by respiratory droplets. According to the CDC, this
is different than what we see for seasonal flu,
which infects 100% of ferrets via respiratory droplets. Unger: Well, let's hope
that particular dynamic stays the same way. Andrea, is there
anything else that we learned from these experiments? Garcia: Well, unlike seasonal
flu, which makes ferrets sick but doesn't kill
them, the H5N1 killed all of the ferrets
that were infected. Now, that's not
really too surprising, as H5 viruses have historically
been fatal to ferrets. The CDC did conclude that while
three cases of H5N1 in the U.S. have been mild, it is
possible that there will be serious illnesses among people. I think it's becoming
increasingly clear that protecting the
health of farm workers needs to be a top priority here,
and wearing protective gear is especially important. Unger: All right, Andrea. Has there been any change
among the spread among cattle? Garcia: In fact,
there has, Todd. Wyoming, Iowa, and Minnesota all
announced their first detections of the virus in
the past few days. We now have more
than 80 dairy herds who are testing positive
across at least 12 states. Wastewater surveillance is
still showing limited spread in the U.S. overall. The CDC is asking
that physicians remain vigilant for signs and
symptoms of influenza virus infection over the
summer and to maintain those high rates of testing. They're also
encouraging physicians to forward any specimens that
test positive for influenza A to public health labs
for additional testing. Unger: All right. And that's something
we'll continue to track as the summer progresses. Andrea, the CDC also
issued a health advisory earlier this week to warn of
something completely different that we haven't talked about. What do we need to know? Garcia: Yeah, as you
mentioned, we have not talked about this previously. But according to that
health alert from the CDC, the CDC, FDA, America's poison
centers, state and local partners are investigating
reports of severe acute illness potentially associated with
consuming Diamond Shruumz brand chocolate bars,
cones and gummies. These are being marketed as
containing a proprietary blend of mushroom. As of June 11th, there have
been 12 total illnesses, 10 hospitalizations reported
in eight states with ongoing efforts to identify
other potential cases. Although the cause of
the reported illness is not known at this
time, individuals are being advised not
to eat, sell, or serve any flavors of Diamond Shruumz
brand chocolate bars, cones, or gummies, and they
should discard products that have been purchased. CDC and FDA are also
working to determine whether other products
from this company have been associated with
adverse health effects. Unger: All right, Andrea, for
those of us who have never heard of the brand
Diamond Shruumz or familiar with
that at all, can you share a little bit
more background? How do people even
get these products and what kind of
illnesses are we seeing? Garcia: While many of the
conditions are serious and patients have experienced
central nervous system depression with sedation,
seizures, muscle rigidity, clonus, tremor, abnormal heart
rate, abnormal blood pressure, GI effects, skin
flushing, diaphoresis, and metabolic acidosis with
an increased anion gap. 10 patients were hospitalized. Several even
required intubation, mechanical ventilation,
and admission to the ICU. Thankfully, none have died. These products are
mostly distributed online and retailers include those
that sell hemp derived and smoke or vape products. Unger: All right. Is this indicative, say,
of a larger trend and you expect to see more of these
types of health advisories? Garcia: That
wouldn't surprise me. As we know, products containing
psychoactive compounds such as cannabis
or mushroom extract are being made
increasingly available. These edibles are often sold
as gummy candies, chocolate, or other snack foods. But they may actually contain
undisclosed ingredients, including illicit substances,
other adulterants, or potentially harmful
contaminants that are not approved for use in food. Mushroom-containing
products, in particular, have been marketed
for promoting health, but some could, in fact,
lead to the opposite effects in [INAUDIBLE]. Unger: All right, Andrea,
then given the situation out there, what do
physicians need to know and be on the lookout for? Garcia: So the CDC
is asking physicians to counsel patients,
caregivers, or guardians, not to purchase, consume, or
serve Diamond Shruumz brand chocolate bars, cones, or
gummies, to avoid consuming any mushroom-containing edible
products that are claiming to produce neurologic,
cognitive, or psychoactive effects altogether. Patients should be aware that
edibles or food-like products marketed with these
non-specific health benefits or implied psychoactive effects
might contain these undisclosed, misformulated, or unapproved
ingredients that can cause severe adverse health effects. Physicians should also have
a high index of suspicion for severe illness. And any patient who
recently consumed any of these products
and early consultation with a medical
toxicologist with expertise in managing these patients
with acute ongoing ingestion is also really important. Any suspected cases or adverse
effects after consuming any Diamond Shruumz brand products
should be reported to the poison helpline and that number
is 1-800-222-1222. Unger: Again, that poison
helpline, 1-800-222-1222. Keep an eye out there
for this situation. Andrea, all good to know. And that wraps up
today's episode. Thanks so much for being
here and keeping us informed. We'll be back in a few
days for another episode where we're going to get
further updates on Mpox and what to expect with
COVID this summer and more. If you found this
discussion valuable, you can support more programming
like it by becoming an AMA member at AMA-ASSN.org/join. We'll be back soon with
another AMA Update. In the meantime, you can find
all our videos and podcasts at AMA-ASSN.org/podcasts. Thanks for joining us today. Please take care. [MUSIC PLAYING]
