Measles, Cyclosporiasis, & More with Dr. Donald Dumford

A lot to talk about this morning with my next guest, been looking forward to his visit with us since he agreed to come on. And that's Dr. Don Dumpford. Don is a doctor of infectious disease with Cleveland Clinic, Akron General. And, Don, if you don't mind, let's start right now with this food and parasites in Salmanilla. Unfortunately, it looks like we're getting more of these food outbreaks and these food problems that we've had in quite some time. Well, thanks for having your back, Ray. And you're right. We are seeing quite a bit of foodborne outbreaks these past a couple months. Obviously, we had the cyclospor outbreak, which got pretty bad. That was probably our worst cyclistore outbreak, you know, to this point. And then now last week we had the, you know, the salmonella outbreak. It sounds like associated with jalapeno peppers. I think, you know, the issue here is just that we really do have a global food supply. And, you know, we just have to kind of take into account that, you know, what's going on in other countries, whether, like, with cyclospora, you know, a lot of times it's associated with flooding and, you know, contamination water supply. It really kind of plays into the road that we get within the United States. Yeah, and I even read over the weekend, Don, too, that now this thing, originally we were talking about lettuce. for a couple of weeks, and now they're saying, which made sense to me, I kind of saw this coming, some fruits and even more vegetables on this. From a doctor of infectious disease, when you look at this type of situation, what would be your recommendation to my listeners? Now, well, I think, you know, whenever we talk about this with cyclists or any foodborne illness, is I think the first thing to talk about is really what we should be all doing all the time with our food. You know, one is, you know, your produce, make sure you wash it well. If it's got a hard skin, make sure you take, you know, one of those scrubbers and scrub the surface. That's even something like with melon where... You say, well, I'm only going to be in the inside, but you need to scrub that surface to try to break loose any of those microorganisms might be there. So we can take that knife through the skin that it doesn't take it through. And I think also hand hygiene is very important. You want to make sure you're washing your hands before, during, and after food preparation. And then when you do our cutting, you know, things on the countertop, you want to make sure you're kind of not cross-contaminating. We usually talk about this more at Thanksgiving and Christmas with saying, hey, don't take that. thing you just use to cut raw chicken and then use it for your vegetables. But even say like for, you know, right now, if you say, oh, I've got this fresh produce that could be contaminated, you know, you don't want to then cut something else on top of that like a loaf of bread or your cooked chicken and then introduce it into there. I think those are the basics. You know, if you have a bad immune system, you might want to take for the precautions, make sure you only think, you know,

eating things that you can peel or cook is sort of the most extreme version of that. But I think really it's just getting down the basics and make sure we're doing the things we can do. And that I think I just like personally to say also buy local because it doesn't seem a lot of times like local produce. It's probably a big effort. Yeah, I agree with that 100%. I know my... Family, we've really starting going to all the markets locally and getting the produce. With us as Dr. Don Dunford. He's Doctor of Infectious Disease, Cleveland Clinic, Akron General. One of the main reasons I reached out the Don is to get his opinion with these vaccine rates that unfortunately seem really drop in the United States and actually globally. And what that has done to, for example, measles, flu, and we can go on and on. So, Don, take the story from there and what you've seen. This is something you're doing each and every day. Yeah, you know, I think the most glaring thing right now really is. You know, we, this is a disease that we really had under control. We had very few cases within the United States for a really long time. Most of those were actually introduced from travel. You'd have travelers coming in who would have measles, but it really wouldn't get past maybe a very small handful of cases. But what we're seeing now is that there's been, you know, local, sustained transmission in the United States for pretty much the past couple of years. And this year right now, there's... our worst measles season probably since 1991. And really, when you look at it, like the numbers show that we don't have to go that far down as far as our vaccination rates for us to start to see transmission because measles is such a contagious disease. If you look at it, you introduce somebody with measles into a room of a lot of people who aren't in view. Nine out of ten people are going to come away with measles from that encounter. And one person with measles typically infects about 15 other people just on average. It's really probably our most contagious infectious disease. And, you know, I think probably part of this is that we, you know, it's something that people don't remember. So we used to have about 500,000 cases in measles every year in the United States. We'd have about 50,000 hospitalizations. We'd have about 6,000 deaths. And then, you know, also in there was that there's a lot of people who develop, you know, neurologic issues from the infection. And we just, because the vaccine's been so effective, we don't see that, and people forget that those really bad things can happen with this infection.

Yeah, well, this is Dr. Don Dunfer, a doctor of infectious disease, Cleveland Clinic Hacker General. Don, have you seen it also trickle down to things like the flu, things like, you know, I think of tetanus shots and those type of thing. Have those also gone down to your knowledge? It has. And I think we've seen that, you know, a couple different ways. I think, you know, flu vaccine has really kind of come down. probably quite a bit in about the past five years. And if you think about the flu, you know, there's things like measles where I say, yes, this is preventative. If you get a measles vaccine, you're almost surely not to get measles. Now, if flu is a little bit different and flu, you get about a 40% reduction in your likelihood of getting infected. But then on top of that, if you do get infected, you're known to get a much more reduced case, much less severe case. And what we really see is a reduction in that severity and reduction in those civilizations. I think this is, you know, important for all of us because, one, we want to make sure if we'll get our flu shot, we're not, you know, we're reducing our likelihood of getting it and reducing our likelihood of transmitting. So it's really important definitely to get your flu vaccine for those with respiratory conditions, the elderly, and those with bad immune systems. And then, interestingly enough, you kind of mentioned tetanus. We have seen a reduction in tetanus vaccinations. This is kind of important in a couple of different ways. One is that, you know, the tetanus vaccine actually has three different things in it. It has tetanus, it has dyspheria, and then it has pertussis. Protusses, particularly, and that's also known as whooping cough, has made quite a comeback in the past few years, such that we're really recommending when, you know, kind of a catch-up dose of this vaccination so that people are sure to be immune to whooping cough. But that's also a very contagious and can be a dangerous thing. And then interestingly enough, I was kind of reminded last year about how bad tetanus can be. We actually had a case of tetanus at Akron General. I was an unvaccined person who'd injured themselves just while working on a fence and having that classic, you know, punctured, you know, punctured myself or scratched myself with a nail. And then the person actually ended up being hospitalized for about six months until they recovered, where, you know, because tennis will cause a, pretty much a paralytic condition. And it took that long for that paralysis to, to discate. It just really reminded you how bad an infection that really is. Yeah, for sure. Dr. Don Dunford with us, Doctor of Infectious Disease.

Cleveland Clinic, Akron, General. And Don, while we're talking about vaccines, we would be remiss because you and I started talking about this five years ago, COVID flu. Where are we in the fight against COVID specifically? And is the vaccine still a necessity? Educate us on that side right now. Yeah, you know, COVID interestingly has, you know, obviously things are a lot different than five years ago. That was, you know, that was a evidence of when you. introduce a novel virus into a population what happens because there's absolutely no, you know, sort of like, I guess, memory among the population of how to fight against that. And you really saw right up front once COVID came in and that we had had really bad cases. We had a lot of people hospitalized, a lot of people die from COVID. And I think the vaccine was really just such a robust way to fight that. And I think it really reduced our burden and disease with vaccine. You know, now we see that a lot of people have had COVID. They have some memory to it so that now when people get COVID, typically it's a much milder infection. We see that, you know, people a lot of times are having cases where it's just coughs or throat, you know, fever, a lot of muscle aches. And then the, you know, just goes away, but you still have to remember that we have populations still do get really sick from COVID, you know, our elderly populations. those with bad immune systems, those with pre-existing conditions like heart and lung conditions. And it's really important for those populations that we try to reduce the overall burden. So I think right now COVID vaccine is very much important, you know, especially very important for those and those vulnerable populations to make sure they're getting vaccinated. And if you live with somebody who has health problems, if you're close to somebody, an elderly parent, it's also important for you to get vaccinated so that you reduce that risk of spreading it to them. Don, let me ask you this, and you're very much glued into this sector of medical treatment and Ebola. Sometimes we don't talk a whole lot about in the United States until it becomes a problem in the United States. But I was reading.

a couple of weeks ago that there's a lot of enthusiasm about the possibility of this new Ebola vaccine. Have you read something like that? And maybe where are they with that? Yeah, well, right now there's, you know, right now there's actually this really big outbreak going on in Africa. It's actually our second largest outbreak of Ebola probably ever. And right now there's kind of two different strategies they're looking at. One is that because we've already got a product that is a vaccine not necessarily for this strain that's going around for a different strain, they're thinking about trying to give that and see if there's actually help for this current strength. They think that, you know, it's one of those things where we've got it in hand, so let's try it. Let's give it a shot. Although because it's not strain specific and not specific for the species, there's a concern that's not really going to help. There's also right now a vaccine that's being developed specifically for this strain. It's called the Bimabugio strain. And what they're looking at right now is using an MRNA technology. And actually they're starting off, as we usually do with whether it's vaccines or any medications, starting off with testing on a healthy subject, see if they actually have immune response, look at the safety of the vaccine before they start to do clinical trials in Africa, which then would look to see if we actually have a reduction in the number of cases. All right. So that's encouraging. And Don, when we talk and you mentioned big outbreak in the continent of Africa. The world is so small, right? This is something to pay attention to because you've educated me in the past. Ebola because of where it is as a disease can spread rapidly. Yes, it's a very contagious disease, a very dangerous disease. And I think so that when we say something to look out for, make sure right now for your listeners, it's, I think, something to take an interest in keeping an eye on, but not something to panic about right now. We don't have any cases that have come into the United States yet. This is really, you know, there's been a couple cases that have been into Europe from return travelers, but really this has stayed localized Africa. So I want to make sure that people aren't panicking about it. But it is something to look at, something to keep an eye on. And you're right, the world is getting smaller, but I think, you know, right now we've got a lot of really great, really talented public health officials who are making sure they're keeping us safe. And there's a lot going on as far as people being monitored and they're coming into the country to think about whether or not they could be somebody that needs to be quarantined for Ebola.

So right now, you know, I think there's not the danger to the usual, you know, the everyday population in the U.S. is very low. But just I'm going to keep an eye on right now. Boy, a ton of good information there. Don, thank you for getting up with this this morning, especially from what I hear. You were bike riding a little bit yesterday. Is that true from what I hear? About 50 miles yesterday? Did I hear that right, my friend? Yes, that is true. This was for the organization called the Ohio and Erie Canal Way Coalition. They're one of the key partners in sponsoring and supporting the towpath. which, you know, everybody knows that runs throughout a lot of our communities down from, you know, Cleveland down to New Philly. Yeah, so this is a 50-mile ride as a fundraiser for the towpath and actually working towards a 100-mile in September also for the towpath as a fundraiser. Awesome job, my friend. And I imagine you were studying for the show while you were riding yesterday, is that right? Oh, of course. I was just thinking about infectious disease the entire time. Don, thank you, my friend. I always appreciate. I know your times are busy and appreciate the education. Really good insight for all the listeners. Thanks for making time. And by the way, job well done yesterday for taking to the bike yesterday and raising those dollars and awareness. Thanks a lot. Thanks so much, great. Thanks for having me. For more interviews on 93.5-1590 WAKR, tune in to the Ray Horner Morning Show Monday through Fridays between 6 and 9 o'clock and listen for more interviews at wakr.net and our WAKR app.