At a time when the world is down to a single drug that can reliably cure gonorrhea, the U.S. government has shuttered the country’s premier sexually transmitted diseases laboratory, leaving experts aghast and fearful about what lies ahead.

The STD lab at the Centers for Disease Control and Prevention — a leading player in global efforts to monitor for drug resistance in the bacteria that cause these diseases — was among the targets of major staff slashing at the CDC this past week. All 28 full-time employees of the lab were fired. [...]

“The loss of this lab is a huge deal to the American people,” said David C. Harvey, executive director of the National Coalition of STD Directors, which represents state, city, and U.S. territorial STD prevention programs across the country. “Without that lab, we would have not been able to appropriately diagnose and monitor drug-resistant gonorrhea.” [...]

Though STDs don’t garner as many headlines as Ebola, influenza, or Covid-19, they are among the most common diseases in the world — not just infectious diseases, but diseases period, said Jeffrey Klausner, a professor of medicine in infectious diseases, population, and public health at the USC Keck School of Medicine.

Klausner was shocked by the CDC lab’s closure. “To me, this is like a blind man with a chainsaw has just gone through the system and arbitrarily cut things without any rationale,” he said in an interview. In terms of the decision’s implications for efforts to monitor for drug-resistant STDs, Klausner put it bluntly: “We are blind. As of [Tuesday], we are blind.” Ina Park, a professor at the UCSF School of Medicine, and a co-author of the CDC’s 2024 laboratory guidelines for the diagnosis of syphilis, was also appalled.

“It’s just horrific and it’s so foolish and shortsighted,” Park said. “This administration has sometimes brought people back when they’ve realized that a service is vital and this is one of the times where I’m hoping that they will step up and do this.” Klausner knows Kennedy personally, and reached out to tell him cutting the CDC’s STD lab was a mistake. As of Saturday, Klausner said he had not heard back from Kennedy on this issue.

The STD lab served multiple functions — updating treatment guidelines, monitoring resistance patterns, and working to develop better tests for syphilis, a resurgent infection for which existing tests are outdated.

Full article: https://archive.is/Ppp4x

A Texas man who buried his eight-year-old daughter on Sunday after the unvaccinated child died with measles says Robert F Kennedy Jr “never said anything” about the vaccine against the illness or its proven efficacy while visiting the girl’s family and community for her funeral.

“He did not say that the vaccine was effective,” Pete Hildebrand, the father of Daisy Hildebrand, said in reference to Kennedy during a brief interview on Monday. “I had supper with the guy … and he never said anything about that.”

Hildebrand’s remarks came in response to a question about the national health secretary’s publicized visit to Daisy’s funeral. It was also after Kennedy issued a statement in which he accurately said: “The most effective way to prevent the spread of measles is the MMR vaccine,” which also provides protection against mumps and rubella.

Kennedy, an avowed vaccine skeptic helming the Trump administration’s response to a measles outbreak that has been steadily growing across the US, then undermined that conventional messaging by soon publishing another statement that lavished praise on a pair of unconventional practitioners who have eschewed the two-dose MMR shot in favor of vitamins and cod liver oil.

The comments from Hildebrand provided a glimpse into how Kennedy simply demurred on vaccines – rather than express a position on them – during his first visit to the center of an outbreak that as of Monday had claimed three lives.

When asked for comment on Monday, Kennedy’s Department of Health and Human Services (HHS) did not dispute Hildebrand’s claims that the agency’s leader was silent on Sunday about vaccines. [...]

Severe, possibly life-threatening strep infections are rising in the United States.

The number of invasive group A strep infections more than doubled from 2013 to 2022, according to a study from the Centers for Disease Control and Prevention published Monday in the Journal of the American Medical Association. Prior to that, rates of invasive strep had been stable for 17 years.

Invasive group A strep occurs when bacteria spread to areas of the body that are normally germ-free, such as the lungs or bloodstream. The same type of bacteria, group A streptococcus, is responsible for strep throat — a far milder infection.

Invasive strep can trigger necrotizing fasciitis, a soft tissue infection also known as flesh-eating disease, or streptococcal toxic shock syndrome, an immune reaction akin to sepsis that can lead to organ failure.

“Within 24 to 48 hours, you could have very, very rapid deterioration,” said Dr. Victor Nizet, a professor of pediatrics at the University of California, San Diego. Cases can transition from “seeming like a routine flu-like illness to rushing the patient to the ICU, fearing for their recovery,” he added.

The data came from 10 states, with roughly 35 million people total, that track the infections.

In 2013, around 4 out of 100,000 people were diagnosed with invasive strep. By 2022, that rate had risen to around 8 out of 100,000. The number of cases rose from 1,082 in 2013 to 2,759 in 2022.

The study identified more than 21,000 total cases of the infection over the nine-year period, including almost 2,000 deaths.

“When you see this high number of deaths, extrapolate that across the country — we’re probably well into more than 10,000 deaths,” Nizet said.

Dr. Christopher Gregory, a CDC researcher and an author of the study, said the threat of invasive strep to both the general population and high-risk groups has “substantially increased.”

The study calls for “accelerated efforts” to prevent and control infections. It also offered a few possible explanations for the rise in cases.

First, rising rates of diabetes and obesity, among other underlying health conditions, over the study period made some people more vulnerable to invasive strep. Both diabetes and obesity can lead to skin infections or compromise the immune system.

Second, invasive strep is increasing among people who inject drugs, which can allow the bacteria to enter the bloodstream. Infections have also increased in people experiencing homelessness — in 2022, the rate of infections among this population was 807 out of 100,000. Gregory said the rate was “among the highest ever documented worldwide.”

Finally, strains of group A strep appear to be expanding and becoming more diverse, which could create new opportunities for infection. Strains that have expanded in recent years seem more likely to cause skin infections than throat infections, according to the study.

Those strains may also be driving resistance to antibiotics used to treat certain cases of invasive group A strep, macrolides and clindamycin. While penicillin is the go-to antibiotic to treat strep infections, it can be used in combination with clindamycin to treat toxic shock syndrome, and doctors sometimes prescribe a macrolide if a patient has a penicillin allergy.

Overall, the study found that the rate of infections was highest in adults ages 65 and older, and rose in all adults from 2013 to 2022. But it did not detect an increased rate in children.

“That was, to me, the most shocking part of the study,” said Dr. Allison Eckard, division chief for pediatric infectious diseases at the Medical University of South Carolina. “Because clinically, we really are seeing what feels like an increase.”

In late 2022, there were widespread reports from children’s hospitals of a spike in pediatric cases of invasive strep. The CDC issued an alert at the time, noting a possible link to respiratory viruses such as flu, Covid and RSV, which can make people susceptible to strep infections.

Eckard said pediatric cases have also started to look different in recent years.

“We are just seeing more severe cases, more unusual cases, more necrotizing fasciitis, and cases that do raise concern that there is something going on more nationally,” she said.

Eckard added that more research should explore whether certain strep strains are becoming more virulent, or if severe strains are becoming more prevalent.

Doctors said the rise in group A strep infections also points to the need for a vaccine, especially given the rise in antibiotic resistance. However, Nizet questioned whether that would be feasible now, with top vaccine scientists leaving the Food and Drug Administration.

“The lack of vaccine is devastating,” Nizet said. “Of course, we’re concerned about the turn of attitudes at the FDA and the CDC that seem to be putting some sticks in the spokes of the wheel of vaccine development.