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Super Gonorrhea Has Reached the U.S.

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An illustration of Neisseria gonorrhoeae bacteria.
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Super gonorrhea has infected people in the United States for the first known time. This week, Massachusetts public health officials announced the discovery of two gonorrhea cases appearing to display increased resistance to all known antibiotic classes that can be used against it. These cases were thankfully still curable, but it’s the latest reminder that this common sexually transmitted infection is becoming a more serious threat.

Gonorrhea, caused by the namesake bacteria Neisseria gonorrhoeae, is the second most commonly reported STI in the U.S., with 677,769 cases documented in 2020. Many infected people don’t experience illness, but initial symptoms can include a discolored discharge from the genitals, painful or burning urination, and rectal bleeding if caught from anal sex. When gonorrhea is left untreated, it raises the risk of more serious complications, like damage to the reproductive tract in women and swollen testicles in men, both of which can lead to infertility. And when it’s passed down from mother to child, the infection can be fatal or cause blindness in newborns.

While gonorrhea was once easily treatable with a simple pill of penicillin or other antibiotics, the bacteria has steadily learned to resist almost every drug put in its path. These days, only one or two antibiotics taken at the same time (depending on the region) are considered reliably effective against gonorrhea and are recommended as front-line treatments. But in recent years, doctors have seen cases of gonorrhea where it’s started to evade even these drugs. These extensively hardy, or pan-resistant, infections have been documented in parts of Europe and Asia to date, but at least two similar cases have now been identified in Massachusetts.

According to the state health department, the strain of gonorrhea isolated from one case clearly showed resistance or a reduced response to five classes of antibiotics, while the strain pulled from the second case was genetically close enough that it would likely have similar resistance. A common genetic marker seen in these cases was previously identified in a case reported in Nevada, but that strain still responded normally to at least one class of antibiotics. As far as health officials know, these are the first documented gonorrhea cases to show increased resistance to all of the drug classes known to treat it ever identified in the U.S.

“The discovery of this strain of gonorrhea is a serious public health concern which DPH, the CDC, and other health departments have been vigilant about detecting in the US,” said Public Health Commissioner Margret Cooke, in a statement from the agency.

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Growing rates of resistance to the antibiotic azithromycin led the U.S. to stop recommending it for gonorrhea in late 2020. Now, only the drug ceftriaxone—taken as an injection—is considered a frontline option in the country, and at a higher dose than before. Luckily, despite the reduced response to ceftriaxone, both cases were successfully cleared after patients took these higher doses.

These cases are likely only a warning of what’s to come. Some of the important genetic markers seen in this novel strain have been spotted in pan-resistant cases from Europe and Asia, which shows that these mutations are continuing to spread around the world. Gonorrhea rates in general have increased year after year in the U.S. And perhaps most worryingly, no clear connection between the two Massachusetts cases has been found, indicating that these strains may already be circulating past the point where they could be easily contained.

There are ongoing efforts to develop vaccines and novel antibiotics against gonorrhea, but it may take years before any of these come to fruition, if any do. So it’s only become more important to take precautions against contracting and spreading these STIs in the first place. Health officials are now alerting doctors and testing labs in Massachusetts to look out for and report any similar cases.

“We urge all sexually active people to be regularly tested for sexually transmitted infections and to consider reducing the number of their sexual partners and increasing their use of condoms when having sex. Clinicians are advised to review the clinical alert and assist with our expanded surveillance efforts,” said Cooke.

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Intermittent Fasting May Not Affect Your Chances of Weight Loss, Study Suggests

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New research casts doubt on certain claimed benefits of intermittent fasting, finding no link between a person’s timing of meals and their chances of long-term weight loss. The frequency and size of people’s meals, however, was linked to modest changes in weight.

Scientists from the Johns Hopkins Bloomberg School of Public Health recruited adult patients from one of three major health care systems to use an app (“Daily 24”) where they would report their sleeping and eating habits for up to six months. These reports were then used as a barometer for people’s routine eating and sleeping behavior. The researchers also kept track of the volunteers’ health outcomes, including weight, before and after the study began through their electronic medical records. About 550 people used the app during the study period, and the researchers were able to track these people’s weight over an average length of six years.

The team found no significant association between the timing of meals and annual changes in weight in their study sample. People who reported skipping breakfast or taking long breaks between meals, for instance, didn’t noticeably lose or gain any more weight on average than those who didn’t do that. The findings were published Wednesday in the Journal of the American Heart Association.

This type of study is known as observational research, which can only be used to find correlations between two variables, not necessarily a cause-and-effect relationship. And this study in particular wasn’t measuring what might happen to people who newly decide to start intermittent fasting, but rather the possible effects of someone’s regular eating habits on their weight over time. That said, several small trials, including one published last April, have tracked people as they started dieting and have found that intermittent fasting may not provide any added weight loss over a typical eating schedule.

“Based on other studies that have come out, including ours, we are starting to think that timing of meals through the day most likely doesn’t immediately result in weight loss,” lead author Wendy Bennett, an associate professor of medicine in the division of general internal medicine at Johns Hopkins, told CNN.

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Bennett and other researchers studying the topic have cautioned that their results don’t necessarily rule out that intermittent fasting can have some unique positives. It’s possible that some populations, such as those with type 2 diabetes, could experience greater weight loss than they would otherwise while fasting. And for some people, intermittent fasting might simply be easier or preferable as a way to keep track of their eating.

Still, for those who are trying to diet, these findings suggest that there are other patterns they should be more mindful about than timing. The study found that people who ate more frequent medium or large meals during the day gained modest amounts of weight over time (up to two pounds a year linked to every extra meal a day on average). Conversely, eating many small meals throughout the day was linked to a small amount of annual weight loss.

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Ohio Measles Outbreak Hospitalizes More Than 32 Children

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A child with a measles rash.
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A measles outbreak in Columbus, Ohio has sickened over 80 children and hospitalized dozens. The majority of these cases have involved unvaccinated children who were nonetheless eligible for vaccination. It is not yet clear how long the outbreak will continue, with the most recent case having been detected just last week.

Columbus Public Health officials first reported the outbreak in early November, though the first known cases are now believed to have begun in mid-October. According to the CPH’s publicly available data, updated Tuesday morning, there are now 82 confirmed cases of measles in the area, while 32 children have been hospitalized. None have died.

Measles is an incredibly contagious viral disease that usually causes flu-like illness and a distinctive rash. Though most cases are mild, the risk of severe, life-threatening complications is greater in very young children. Even a typical case can have far-reaching effects, since the measles virus can reset a person’s immunity to other infections. Luckily, there’s a safe and highly effective two-dose vaccine—the combination measles, mumps, and rubella (MMR) vaccine—that has helped drive measles out of local circulation in many countries, the U.S. included.

Unfortunately, many areas of the world remain poorly vaccinated against measles, and the virus continues to kill upwards of 100,000 people a year, mostly children under five. Occasionally, cases imported from other countries can cause outbreaks in the U.S. that largely spread among pockets of unvaccinated individuals and communities—and that seems to be what has happened here.

Of the 82 cases documented so far, at least 74 have been in unvaccinated children. Four other cases have been reported in partially vaccinated children, and four in children whose vaccination status is unknown. Some cases have involved children too young to get their shots, but 66% of cases have involved children between the ages of one to five, meaning that they were eligible for vaccination. So it’s likely that many or most of these children have parents who declined to get them vaccinated.

The first few years of the pandemic saw a drop-off in reported measles cases, both in the U.S. and worldwide. But the virus has likely made a fierce comeback this year, thanks in large part to disrupted childhood vaccination programs and growing anti-vaccination sentiment across the globe. According to the World Health Organization, measles should be considered an imminent public health threat to every region of the world.

Measles remains locally eliminated in the U.S., but there are worrying trends here as well. For instance, a recent survey by the Kaiser Foundation has shown an increase in adults who disagree with childhood vaccination mandates for entering public school, which covers the MMR vaccine and many others. This increase appears to be mostly concentrated among Republican-leaning adults, however. In total, 28% of people now say that parents should decide whether children get these routine vaccinations, even at the cost of endangering others, up from 16% who said the same in 2019. Public support for children needing to get the MMR vaccine specifically has dropped from 82% to 71% during this time as well.

Though newly reported cases in Ohio have declined in recent weeks, the outbreak may not be over. The latest case, defined as someone developing the telltale rash, occurred on December 19, according to CPH data. Measles is typically most contagious four days before and four days after the rash appears, and it can take up to two weeks for symptoms of a new case to emerge.

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‘Super’ Disease-Carrying Mosquitoes Detected in Asia

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An Aedes aegypti mosquito.
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Researchers in Japan say they’ve discovered “super” resistant mosquitoes in Asia. In a study published this week, they detail finding populations of Aedes aegypti mosquitoes—a common disease vector—in Vietnam and Cambodia carrying several mutations believed to confer strong protection against the most widely used insecticides. The discovery should merit urgent action to prevent these mutations from spreading globally, they argue.

A. aegypti mosquitoes are one of the most prolific sources of human misery in the world, thanks in part to the wide assortment of germs they can transmit to us. These mosquito-borne diseases include yellow fever, dengue, Zika, and chikungunya, to name a few. The global presence of A. aegypti (along with a related species, A. albopictus) and the diseases they spread has expanded in recent years. Many experts expect their range to only grow wider over the coming decades as the climate continues to warm, including throughout the southern and eastern parts of the United States. So these new findings, published Wednesday in Science Advances, might add yet another concern to an already serious problem.

The research was led by scientists from Japan’s National Institute of Infectious Diseases, the country’s equivalent to the National Institute of Allergy and Infectious Diseases (NIAID) in the U.S. They studied samples of A. aegypti mosquitoes recently collected throughout Asia, looking specifically for mutations in their voltage-gated sodium channel gene. Some mutations in this gene, called knockdown mutations, can help mosquitos and other insects survive exposure to pyrethroids, a class of chemicals commonly used to control insect populations. To test whether any of the mutations found by the researchers truly protected the mosquitos, they also compared their survival rates against the insecticides to non-resistant mosquitoes in the lab.

The team ultimately identified 10 previously unknown substrains of A. aegypti mosquitoes that seemed to carry one or more of these knockdown mutations. One novel mutation in particular, called a L982W substitution, was found in over 78% of mosquitoes from both countries. And in a specific area of Cambodia, about 90% of mosquitoes carried one of two pairs of mutations that were identified as especially troubling.

Lab experiments also found that these combination mutation-carrying mosquitoes were much harder to kill, with “substantially higher levels of pyrethroid resistance than any other field population ever reported,” the team wrote. In the title of their paper, they describe their results as the “discovery of super-insecticide-resistant dengue mosquitoes in Asia.”

Other studies in recent years have found evidence of growing pyrethroid resistance among A. aegypti mosquitoes in Asia and the Americas, both in the lab and the real world. And the new study is the latest in the team’s ongoing research project to understand pyrethroid resistance in A. aegypti globally. They say it’s the first to try unraveling the molecular mechanisms that have led to these mutations emerging, particularly in the mosquitos from Cambodia.

There are developing non-insecticide technologies that might someday better keep mosquitoes in check, such as sterile insect techniques that sabotage the population from within, but none of these interventions are expected to see widespread use soon. There is also a newer class of insecticides, called neonicotinoids, that’s beginning to be deployed more often against mosquitoes. But these chemicals are controversial due to their damaging effects on important insect pollinators, and there are already signs that mosquitoes have begun to adapt to them as well. There are also no highly effective and/or low-cost vaccines and treatments for the most common diseases that these mosquitos spread, especially dengue.

All of this means that pyrethroids will remain a widely used tool against A. aegypti mosquitoes for the time being. Given that, much more has to be done to keep these worrying mutations from spreading around the world before it’s too late. The L982W mutation hasn’t been found in mosquitoes outside of Vietnam and Cambodia yet, for instance. But “it may be spreading to other areas of Asia, which can cause an unprecedentedly serious threat to the control of dengue fever as well as other Aedes-borne infectious diseases,” the researchers warn.

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Study Links No COVID-19 Vaccination to Increased Car Crash Risk

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Image: Joe Raedle (Getty Images)

Science has a way of presenting actual facts and connecting dots you likely didn’t see ever connecting. For instance, who would have thought to find a link between the people who decided to pass on getting vaccinated against COVID-19 and traffic accidents? A recent study published in The American Journal of Medicine shares the science behind such a link that actually exists.

In the study, Canadian researchers examined over 11 million COVID-19 vaccination records, of individuals over the age of 18, who would be licensed, from different social, economic and health backgrounds. Of those 11 million, 16 percent (1,760,000) were not vaccinated. Researchers then looked into records and identified unvaccinated individuals who might have diseases linked to traffic risks like dementia, diabetes, sleep apnea and alcohol abuse — and then looked into the traffic accident side of things. Those situations included incidents that sent patients to the emergency room, time and day, ambulance involvement and a “triage severity score.”

With all those parameters considered, researchers were able to identify that individuals who hadn’t gotten a COVID-19 vaccine were at a greater risk of traffic accidents. But it wasn’t because of the vaccine. The link actually comes down to risks associated with decision making—in relation to decisions concerning getting vaccinated, and also to obey (or not obey) traffic laws.

Of course, this isn’t saying that if you didn’t get a shot you’re going to get into or cause a traffic incident. The correlation doesn’t work that way. However, researchers concluded if an individual was hesitant or unwilling to “protect themselves” with the vaccine, these same people would be more likely to have no regard for traffic laws. And the data is there to back it up.

Of the unvaccinated, 72 percent were more likely to be involved in a severe car accident. These numbers look worse when the study pointed out that the percentage was “ similar to the relative risk associated with sleep apnea” but still not as bad as those who abused alcohol. But the risk is still there, so much so that the study said that the risk “exceeds the safety gains from modern automobile engineering advances and also imposes risks on other road users.”

One thing the study did admit was that “correlation does not mean causality.” The study didn’t try to touch on whether or not there was a link between not getting the vaccine and driving recklessly. But the authors of the study did speculate.

One possibility relates to a distrust of government or belief in freedom that contributes to both vaccination preferences and increased traffic risks. A different explanation might be misconceptions of everyday risks, faith in natural protection, antipathy toward regulation, chronic poverty, exposure to misinformation, insufficient resources, or other personal beliefs. Alternative factors could include political identity, negative past experiences, limited health literacy, or social networks that lead to misgivings around public health guidelines. These subjective unknowns remain topics for more research.”

If you want to know more you can read more about the study and its results here.

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String of Child Deaths from Strep A Alarm Health Officials

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A common bacterial infection known as Strep A has likely killed over a dozen children in the UK in recent months. On Friday, health officials reported yet another fatality linked to the bacteria, which can, in rare cases, cause a more invasive and life-threatening infection. There are likely several reasons why the outbreak appears to be more severe than usual, though government experts have ruled out the possibility of a more virulent strain behind it.

At least 13 children in England have died within a week of developing a severe Strep A infection since September, according to an update released Thursday from the UK Health Security Agency (UKHSA), while two suspected deaths have been reported in Ireland and Wales. Officials with the UKHSA and the Brighton & Hove City Council jointly announced the latest suspected death Friday, though it’s not yet clear whether this death is in addition to the official tally, according to the BBC. At least 60 deaths overall have been reported in England.

Strep A, also known as group A streptococcus, are bacteria that can cause a variety of infectious diseases along different parts of the body, including strep throat, scarlet fever, and impetigo. Typically, these infections only cause mild illness or can be managed effectively with antibiotics. But every once in a while, they can cause much more serious trouble. The particular form of Strep A tied to these deaths is called invasive group A streptococcus (iGAS) disease, which happens when the bacteria (or their toxins) reach more vulnerable parts of the body like the bloodstream. Once there, the infection can rapidly trigger life-threatening symptoms like septic shock, organ failure, or necrotizing fasciitis (the “flesh-eating” disease)

Strep A outbreaks do occur regularly, but the typical season for it in the UK starts in the beginning of the year. This season is on track to be the most widespread and deadliest in recent years. The last severe Strep A season occurred between 2017 to 2018, which ultimately caused 355 deaths in total, including 27 deaths in children.

A 2019 study found evidence that the recent emergence of new Strep A strains contributed to large spikes of scarlet fever reported in the UK over the latter half of the 2010s. But according to the UKHSA, there’s no data suggesting that a new variant is responsible for the intensity or greater rate of cases seen this year.

Instead, they argue the rise is likely the result of “increased susceptibility to these infections in children due to low numbers of cases during the pandemic, along with current circulation of respiratory viruses.” This year has seen the return of respiratory infections like the flu and RSV in the UK and elsewhere, often in waves outside of their usual season. And it’s known that people can be more vulnerable to developing iGAS if they catch Strep A while sick with another infection like the flu.

Like the UK, the US has been seeing high levels of flu and RSV activity this fall and winter, while cases of covid-19 are currently lower than they have been during the past two winters but are increasing lately. And the Centers for Disease Control and Prevention is looking into whether there’s been an increase in iGAS cases among children in the U.S. this year as well.

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Why Do You Get Sick in the Winter? New Science Points Up Your Nose

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New research appears to provide a clearer picture of why cold and flu cases are more common during the winter. The study found evidence that our nose’s innate immune response weakens in colder temperatures, providing some germs a better opportunity to infect the rest of the body. The findings, the authors say, could provide a biological explanation for the seasonality of many respiratory diseases.

The study comes from scientists at Northeastern University as well as Mass Eye and Ear, a teaching hospital affiliated with Harvard Medical School. In 2018, several of the authors published work suggesting that the body possesses a unique first line of defense against potentially dangerous bacteria that are inhaled through the nose. Cells near the front of the nose, they found, can spew out fluid-filled sacs called extracellular vesicles into our mucus, which then swarm bacteria. These sacs also seem to ferry antimicrobial proteins throughout the rest of the nose, helping protect other cells from harm as they come in contact with the bacteria.

In this new research, published Tuesday in the Journal of Allergy and Clinical Immunology, the scientists wanted to see if the nose had a similar defense mechanism against viruses.

They studied samples in the lab that were taken from healthy people and patients undergoing surgery. They found that nasal cells deployed extracellular vesicles in response to a mock viral infection. And when they exposed the cells to three viruses that usually cause the common cold (two rhinoviruses and a non-covid coronavirus), the vesicles subsequently swarmed them. They also found that this defense was triggered using a different pathway from how extracellular vesicles are deployed against bacteria. And the extracellular vesicles additionally acted as decoys, since they carried receptors that the viruses would latch onto instead of going after cells.

Many respiratory infections tend to become more common during the colder parts of the year. There are thought to be several reasons for this seasonal trend, including the crowding together of people indoors to stay warm. But the team wanted to test whether the cold could directly affect this defense mechanism as well.

They asked healthy volunteers to endure relatively cold weather (39.9 degrees Fahrenheit) for 15 minutes and measured the change in temperature inside the nose, finding that it dropped by about 10 degrees Fahrenheit. They then exposed cells to that temperature. Compared to the normal condition, the nose’s innate immune response against the viruses wasn’t as strong in this new temperature setting, the authors found, with the cells producing fewer extracellular vesicles on average.

The findings should be replicated by other studies before they’re widely accepted, and there are likely multiple factors behind the seasonality of respiratory viruses. Studies of the flu, for instance, have found that humidity plays a major role in its transmission, with either hot and humid or cold and dry conditions being optimal for spreading the virus. And some cold viruses are actually most common during the summer. But the results here suggest that biology plays a leading role in the timing of our vulnerability to these germs, the authors say.

“Conventionally, it was thought that cold and flu season occurred in cooler months because people are stuck indoors more where airborne viruses could spread more easily,” said senior study author Benjamin Bleier, director of Otolaryngology Translational Research at Mass Eye and Ear and senior author of the study, in a statement from Mass Eye and Ear. “Our study however points to a biological root cause for the seasonal variation in upper respiratory viral infections we see each year, most recently demonstrated throughout the COVID-19 pandemic.”

If these findings do hold up, they might also lead to improvements in how we fend off these infections. It’s possible that we could someday create nasal sprays that can boost or strengthen the nose’s supply of extracellular vesicles during the winter, according to the team. In the meantime, they plan to test out if this defense mechanism is triggered against other pathogens.

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What Your Farts Can Tell You About Your Health

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Illustration: Sam Woolley

Breaking wind. Cutting the cheese. Thunder from down under. I could go on, but whatever you call it, farting is a part of life. Farting is usually caused either by swallowing air, which has to get come out somehow, or by bacteria in your guts releasing gas during the digestive process. Everything animal (human or otherwise) farts, but how you fart can actually tell you something about your health.

“Passing gas is normal,” said Eamonn Quigley, a gastroenterologist at Houston Methodist Hospital. “Everyone passes flatulence on a daily basis. We pass more after meals, and we even pass through the night.” But what do your farts mean, and what might they be trying to tell you? For starters, “when a patient complains of excessive gas, one of the first things we look at is the patient’s diet,” Quigley said.

Bloating doesn’t mean more gas 

One important thing to understand about farting is that “there is a big distinction between flatulence and bloating,” according to Quigley. As a classic study showed, the sensation of bloating is not linked to excessive gas production. Instead, bloating tends to happen when gas gets trapped in the gastrointestinal system, causing it to build up and creating an uncomfortable feeling of pressure. In contrast, “flatulence is associated with producing more gas,” Quigley said.

Why you might be farting more than usual 

One of the main reasons why you might start farting more than usual is because of a change in your diet. Whether you’re eating more protein, more fiber, or more veggies, it can cause a short-term perturbation as the bacteria in your gut are spend more time than usual digesting your food. However, “we adapt, and our bacteria adapt,” Quigley said. “If you change your diet, you may have more flatulence in the short term.” So at least you won’t be farting forever once your gut gets used to that all-kale diet.

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Some of the foods that can make you fart more than usual include different types of sugars; beans; dairy products; high-fiber fruits such as apples and pears; sugar alcohols; vegetables with a lot of fiber such as asparagus, cabbage or Brussels sprouts; and whole grains, which contain lots of fiber. For foods with a lot of fiber, “bacteria love them,” Quigley said. “They’re going to digest them, and in the process of digestion, they’re going to produce gas.”

Why your farts might be smellier than normal 

If your farts are smellier than normal, the culprit is usually a specific food you’ve, such as asparagus, coffee, eggs, or prunes. All are likely producers of fouler-than-usual gas, often due to the presence of hydrogen sulfide. Smelly farts can also be caused by meat byproducts and if there is feces in the rectum.

When to see a doctor about your farts

If you are experiencing discomfort or if you have unexplained, persistent changes in your farting behavior, that’s a sign you should see a doctor. Bloating can be associated with irritable bowel syndrome (other symptoms including changes in bowel movements, such as alternating between diarrhea and constipation, or pain that isn’t relieved by passing gas or having a bowel movement). In the future, healthcare tech may even make it possible to detect any changes in your health by monitoring the sounds of your farts. Until then, you’ll just have to settle for listening to (and smelling) your farts the old-fashioned way.

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Whether You Really Need to Pee After Sex, According to Science

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If you have a vagina, you’ve probably been told that it’s an absolute must to pee immediately after having sex to prevent urinary tract infections (UTIs). But it turns out there isn’t a lot of evidence to support this idea. There is shockingly little research on the question of whether this oft-repeated advice actually works. One study in a journal called Evidence Based Practice found that, overall, it doesn’t seem to make a difference. But that’s just one study, and the results didn’t point strongly in either direction.

The American College of Obstetricians and Gynecologists (ACOG) does not include peeing after sex in its tips for preventing UTIs. Here’s what they do recommend:

  • Wash the skin around the anus and the genital area.
  • Drink plenty of fluids (including water) to flush bacteria out of your urinary system.
  • Empty your bladder as soon as you feel the urge or about every two to three hours.

They point out that factors like being pregnant, having diabetes, or going through menopause can increase your risk of contracting a UTI. And some people just seem to be more prone to them: If you’ve had UTIs before, your chances of getting one again are higher than somebody who has never had one.

That said, if you’ve been peeing after sex, there’s no need to quit that habit. While there’s no conclusive evidence that it helps, there’s also no conclusive evidence that it hurts—or even that it’s useless.

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Does peeing after sex prevent pregnancy or STIs?

While we’re at it, I’d like to mention two myths that have gotten mixed up in the whole peeing-after-sex advice. Peeing after sex is not likely to prevent pregnancy, or to prevent sexually transmitted infections.

When it comes to preventing pregnancy, sperm go into the vagina, not the urethra. These two holes are close to each other, but they are not the same thing, and the pee that leaves your urethra has no influence on what’s going on in your vagina, cervix, or uterus. People who are trying to become pregnant may have heard the advice to delay urinating for at least a short time after having sex to let gravity assist their chances in conceiving—but the American Society for Reproductive Medicine notes that “this belief has no scientific foundation.”

Urinating after sex has not been found to have a significant effect on your risk of contracting HIV, chlamydia, herpes, or any other sexually transmitted infection. To prevent STIs, ACOG recommends using condoms, being aware of the increased risk of anal sex or other acts that can result in breaking the skin, and making sure to get vaccinated against HPV and hepatitis B, both of which can be transmitted sexually.

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Virologists Horrified by Sick Emu Cuddlefest

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A highly infectious strain of avian influenza has been raging across the U.S. for months now, claiming the lives of thousands of wild birds and tens of millions of domestic poultry, according to the latest estimates from the CDC.

And now, the bird flu has reportedly come to one of TikTok’s most famous farm’s: Knuckle Bump Farms in Florida, home to Emmanuel the Emu. The bird, who became a viral sensation for his video-bombing tendencies, has now gone viral in the bad way. Emmanuel contracted avian flu, according to multiple tweets from Taylor Blake, the influencer whose family owns the farm.

“We lost 50+ birds in 3 days. I am still trying to wrap my head around it,” she wrote on Twitter. “We thought we were out of the woods, when Emmanuel unexpectedly went down,” Blake added.

As tragic and devastating as bird flu outbreaks are, and as beloved as Emmanuel the Emu may be, virologists on Twitter were horrified to see the type of up-close care Emmanuel seems to be receiving. Many of Blake’s tweets show her cuddling face to face with the ill emu.

Experts are warning: DO NOT DO THIS. “Being face to face with a bird w [sic] avian flu is a bad idea,” posted Boghuma Kabisen Titanij, a doctor and global health and infectious disease researcher at Emory University. “This is how zoonotic transmissions occur, this is why entire farms cull sick birds. We live with the threat of pandemic flu,” Titanij further explained in her tweet thread on the topic.

Although not very common, bird flu can and has jumped from poultry to people multiple times before. A strain closely related to the one currently circulating nationwide has infected hundreds hundreds of people in the past two decades and killed about 50% of those who contracted it, according to the World Health Organization.

In the current U.S. outbreak, only one human is known to have contracted the virus. The person caught the virus at a commercial poultry facility in Colorado and recovered from the disease, according to WHO. Yet the virus has proven that it can mutate to be more transmissible between birds and people.

Close contact with infected birds certainly increases the risk of cross-species spread. “Infected birds shed bird flu virus through their saliva, mucous, and feces,” warns the CDC. “Human infections with bird flu viruses can happen when virus gets into a person’s eyes, nose or mouth, or is inhaled. This can happen when virus is in the air (in droplets or possibly dust) and a person breathes it in, or possibly when a person touches something that has virus on it then touches their mouth, eyes or nose,” the agency further says on its website.

In other words: Absolutely, positively do not go nose to beak with a sick bird. Other virologists voiced their concern online. “I screamed when I saw this,” tweeted Angela Rasmussen, a virologist at Georgetown University and the Vaccine and Infectious Disease Organization.

“If your emu (or any bird) has avian influenza, do not kiss it. Do not cuddle with it. Do not touch it. Bird flu is extremely dangerous to humans and other animals. And it sounds harsh but to prevent [its] spread, birds that get avian flu should be euthanized,” said Rasmussen.

And Tom Peacock, a flu researcher at Imperial College London, posted a lengthy thread outlining the risks of handling sick birds.

Back at the farm, Blake has posted multiple tweets claiming she and her family are following “FDA guidelines” surrounding bird flu, including quarantining. However instead of cuddling infected birds, the CDC recommends that anyone responding directly to an avian influenza outbreak avoid direct contact where possible and wear protective equipment like gloves, a medical face mask, and eye protection when contact can’t be avoided.

More: Surging Bird Flu Cases in the U.S. Have Come for the Bald Eagle



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