Health
Why Explosive Anger Isn’t Just a ‘Bad Attitude,’ But a Symptom
Aug. 31, 2023 – This is a true story.
I went to high school with a guy named Frankie. He was a hothead – always in trouble because he couldn’t control his temper. Sassing teachers, getting into fights – there may have even been a few run-ins with the law. We called him Frankie the Fuse, but never to his face.
Jump ahead 20 years. I’m at a minor-league baseball game, and sitting across the aisle is none other than Frankie the Fuse. He looks at me, I look at him, and soon we’re fast friends again. By the end of the game, we’ve made plans to golf the following weekend.
And so began what would become a tortuous and ultimately ill-fated renewal of our relationship. Even though Frankie was pushing 40, his fuse hadn’t grown any longer. During our first round of golf, he duffed a chip shot, unleashed a string of curses, and threw his wedge into a pond. On other outings, he bent a 5-iron around a tree and cracked the windshield on our cart with his fist. If we were paired with golfers we didn’t know, I’d have to take them aside beforehand and warn them of Frankie’s outbursts.
Finally, things got so bad I started inventing excuses when he called or emailed until he got the hint.
The Age of the Jerk?
Everyone gets frustrated, upset, and angry. It’s even normal to yell, curse, throw things, or beat up a cushion now and then. But some people, like Frankie, can get out of control.
Judging from news reports and my social media feed, the number of “Frankies” in the world seems to be multiplying. Maybe we’re getting angrier as a society, or perhaps we’re just less inhibited about acting out.
We’ve all seen videos of road rage, or someone on an airplane yelling at a flight attendant, or an irate customer busting up a fast-food restaurant.
I used to think these people were just jerks, but it turns out these angry outbursts may be caused by a little-known psychological condition called intermittent explosive disorder, or IED. Those who have it may not realize they have it or that it can be treated.
In the last few decades, science has been steadily unraveling IED, and in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM5), there’s a whole section on it. (The fact that it shares an acronym with improvised explosive device is an unintended but convenient coincidence, experts contend.)
The disorder is more than being “quick to anger,” said Michael McCloskey, PhD, a professor of psychology and neuroscience at Temple University and a leading IED researcher. “When they get angry, they act out aggressively – yelling and screaming, breaking things, and getting into physical altercations.”
That reaction is out of proportion to the trigger, he said. “For example, if someone tries to punch you and you punch them back, that’s not IED. But if someone says they don’t like what you’re wearing and you punch them, that could be indicative.”
About 1 in 25 (or 13.5 million) Americans have the disorder, said Emil Coccaro, MD, the vice chair of research in the Department of Psychiatry and Behavioral Health at Ohio State University and the recognized world expert on IED.
“We don’t have any data on whether it’s increasing or not,” he said. “But clearly life is faster paced, people feel more stressed, and that could be promoting it.” Or we’re just seeing more incidents because everyone has a cellphone now, or the DSM5 entry makes diagnosis easier.
About 80% of those with IED are untreated, said Coccaro. (To my knowledge, Frankie never sought help for his angry outbursts and probably never heard of IED. But when I described his behavior to the experts, they agreed he probably has it.)
The Science of Anger
There are two things happening in the brain that are believed to cause this type of reaction. Coccaro points out that aggression is an evolutionary necessity. We need a defense mechanism to protect ourselves from threats. So, when a threat is perceived, “the amygdala, which is the reptilian part of our brain, kicks in to trigger either a fight or flight response,” he explained. “But in people with IED, the amygdala reacts more quickly and strongly. Their fuse is shorter.”
“Overly aggressive people tend to have lower levels of brain serotonin function,” Coccaro said. This naturally occurring chemical messenger, among other jobs, works to ease aggression. “Think of serotonin as your braking system,” he said. If your brake fluid is low, you won’t be able to stop.
People with IED don’t plan to have their outbursts. They just happen. Nor do they typically use them to manipulate or intimidate others. (That would be antisocial or psychopathic behavior.) Rather they simply misperceive threats and then can’t control their reaction to those threats. They snap.
But they’re not oblivious to their behavior. Although they may not apologize directly, “they feel the impact it has on their family and friends and how it’s alienating them,” said McCloskey. “It’s not something they enjoy. They’re distressed by it.”
IED tends to be a bit more common in men. Males are typically more physically aggressive, while women with IED are more verbally so. IED is most common among those in their teens, 20s, and 30s, after which it gradually eases with age, although the threat of an outburst always remains.
Research hasn’t determined if any jobs or socioeconomic conditions make people more likely to have IED, but genes certainly can. “The more severe the manifestation of aggression, the more genetic influence underlies that aggression,” said Coccaro. That influence is less strong (mid-20%) for verbal aggression, stronger (mid-30%) for hitting things, and strongest (mid-40%) for hitting others.
Learning also plays a role. It’s not uncommon for people with IED to have been raised in angry households with violent parents.
Another potential cause of IED is inflammation, which also plays a role in other behavioral disorders, such as depression, schizophrenia, and bipolar. “There’s some research with cats that show when you introduce inflammatory molecules to their brains, they become more aggressive,” said Coccaro. IED can also result from a head strike that damages the brain’s temporal lobe, where the amygdala is located.
We don’t yet know whether anger outbursts, left untreated, can get more severe. In other words, can years of tantrums lead to an especially violent outburst – toward others or oneself?
“We don’t know if it progresses like that,” said Coccaro, “but we do know that about 20% of people with IED attempt suicide or some other form of self-harm.” And alcohol or drugs can make people more sensitive to provocation and more uncontrolled in their outbursts. IED could lead to domestic violence, but the experts we spoke with don’t connect it to mass shootings. Those are planned, while IED is spontaneous.
Getting Help
Fortunately, there are ways to manage IED.
The first is cognitive behavioral therapy, the classic form of psychotherapy used to treat common behavior problems. “We teach patients how to tell if their perception of an anger-inducing situation is based in fact and then how to not act out aggressively. This type of therapy has been shown to reduce aggression by 50% or more over 12 weeks,” said McCloskey.
The second treatment, which can be combined with the first, is medication. “Serotonin reuptake inhibitors have been shown to be effective,” said Coccaro. These antidepressant-type drugs improve the behavioral braking system mentioned earlier. Anti-epileptic drugs also appear to have some benefit.
McCloskey’s lab is also working on a new computer intervention that shows some promise in treating aggression. It teaches coping skills by having people view threatening and nonthreatening words or pictures on a screen. “Technology could make treatment more accessible and more engaging,” he said.
These treatments require the patient to realize (or be convinced) that they need help. As with alcoholism or drug addiction, that’s not an easy threshold to cross.
“We all have our defense systems,” said Jon Grant, MD, a professor of psychiatry and behavioral neuroscience at the University of Chicago. “It’s easier to blame others than ourselves.”
And if you encounter someone raging? “Don’t tell them to calm down or try to reason with them, just walk away and get to a position of safety,” he said. “And don’t video them. That’s insensitive. There’s no reason to make them a topic of ridicule or embarrassment. In fact, if they see you filming them, they might get angrier.”
But later, when they’ve settled down, Grant recommends talking with them. “Say listen, you just threw your club into a pond, and you scared the hell out of me. I’m not going to play golf with you anymore if you continue to do this.” Season the ultimatum with sympathy. Say you’d like to understand better why they react this way and ask if you can help.
“Most people think it’s just bad behavior, and the person who’s acting out needs an attitude adjustment,” said Coccaro. “But the truth is, there’s lots of biological evidence that IED is a real thing. It’s not simply an attitude.”
“It takes a brave person to admit to this disorder,” said Grant. “Even though many athletes, celebrities, and politicians probably [have] it, no one is stepping forward as the poster child.”
Depression evokes sympathy, but aggression scares us, Grant said. “And when someone admits to abuse, we automatically want to give our attention to the victim, not the abuser.”
Should We Let Our Rage Out?
You may have heard of rage, anger, or smash rooms. These are commercial places you can go and, for a fee, destroy computers, furniture, mannequins, or just about anything you’d like. The theory is that venting your anger in a controlled setting is better and safer than letting it out in the real world.
“If you don’t have an aggression problem, it’s probably just good fun,” said McCloskey. “But if you do, then it’s unlikely that it’ll be an effective strategy for managing it. All it’s doing is reinforcing the way to approach a problem is to act out aggressively.”
“There’s also a concept called ‘acquired capability,’” he continued. “If you get more comfortable with a behavior and it becomes part of your repertoire, then you’re more likely to do it.”
McCloskey stressed that anger is a normal human emotion and expressing that anger (within limits) can be healthy. Occasional small acts of excessive aggression are normal. But if it goes beyond that, get help.
“What’s interesting about all this,” said McCloskey, “is that people with depression or anxiety will say, ‘Oh, I get treatment for that.’ But people with IED tend to think, ‘I’m just an aggressive person, and there’s nothing that can be done about it.’ That’s just not true.”
May 10, 2024 – When we’re young, we take our macula for granted. At the center of our retina – the deepest layer of the eye that’s chock-full of photoreceptors and that confers color to our world – the macula is like a high-resolution camera. As light hits our eyes, the retina’s macula recasts our world in a bloom of color with astoundingly high visual sharpness.
But as you age, your vision dulls. What once stood out sharply becomes foggy, like condensation on a windowpane. After some time, a coal-black smudge or cloudy circular area begins to affect your central vision.
This effective blind spot widens over time if left untreated. What remains is a “macular hole” in the center of your retina.
This unfortunate series of events marks the advanced stage of age-related macular degeneration, a dangerous retinal disease that affects about 20 million people in the U.S., and nearly 200 million people worldwide.
And it’s not getting better. Estimates are that by 2040, the disease may affect nearly 300 million people worldwide. We are very limited in our ability to treat or prevent it. Read on for what to know.
First, What Causes Age-Related Macular Degeneration?
AMD’s causes are varied, and whether it will affect you is mostly determined by age and genetics, said Marco Alejandro Gonzalez, MD, an ophthalmologist and vitreoretinal specialist in Delray Beach, FL.
Because of the different cocktails that we have in terms of our genetic makeup, some people’s photoreceptor cells in the macula “basically start to shut down,” he said.
AMD’s development involves over 30 genes, and if you have a first-degree relative – parent, sibling, child – who has the disease, you’re three times more likely to get it, too.
Gonzalez explained how the expected rise to 300 million cases by 2040 is due mostly to improved diagnostic tools, along with the fact that the world is getting older and living longer. (Usually, an optometrist can detect signs of AMD during a routine eye exam.)
Eye experts still struggle to stop AMD’s most harmful sign – the cause of those muddy, milky, or even coal-colored circles in your central vision: geographic atrophy.
Geographic atrophy can occur in either of the two forms of age-related AMD: “dry” AMD and “wet” AMD.
Nearly every case of AMD begins as the dry kind, affecting 80% to 90% of AMD patients.
Retinal disease expert Tiarnán Keenan, MD, PhD, offered a vivid image of geographic atrophy for those who have dry AMD.
“As time passes, the circular patches of GA expand like a brushfire, taking more and more vision with it, often to the point of legal blindness,” he said.
A researcher in the Division of Epidemiology and Clinical Applications at the National Eye Institute, Keenan recently led a study that tested the efficacy of the antibiotic minocycline in slowing geographic atrophy expansion in dry AMD. The study operated on the grounds that the body’s immune system could be at play in developing the disease.
When your body’s immune system is overactive, microglial cells (central nervous system immune cells) can get into the sub-retinal space and possibly eat away at the macula and its sensitive photoreceptors.
Though minocycline had been shown to reduce inflammation and microglial activity in the eye in diabetic retinopathy, it didn’t slow the expansion of geographic atrophy or vision loss in patients with dry AMD during Keenan’s study.
When asked if microglial activity could have very little to do with the atrophy expansion, Keenan said it’s something to consider: “Maybe microglia are just there as bystanders clearing up the debris … so inhibiting them is less likely to slow down progression.”
In future drug trials, “maybe it’s possible the minocycline or another approach to target microglia would be helpful, but it would be needed in combination with some other therapy and be ineffective by itself,” he said.
Two Sides of the Same Disease
In dry AMD, Gonzalez compares macular degeneration to the loss of pixels on a screen. “Some of those pixels burn out … and that’s the way you lose vision classically in the dry form.”
Wet AMD is a more progressive form of the disease. It causes abrupt vision loss due to abnormal blood vessel growth.
“If you don’t treat wet AMD quickly, it’s game over,” warned Gonzalez. “Wet macular degeneration is the quicker process of vision loss because these blood vessels wreak havoc.” These new blood vessels bleed, causing fluid to build in the macula, which ultimately leads to scarring.
Gonzalez shed light on why wet AMD develops. “The wet form, for some reason, is the body’s last-ditch effort to try to kind of ‘help’ a dying macula. … When these blood vessels start to grow under the retina, they quickly destroy the architecture of the macula.”
Stopping the Bleeding in Wet AMD
Though wet AMD is rarer, it’s more treatable than dry AMD. Signs and symptoms can be eased with various therapies injected into the eye.
Putting it simply, Gonzalez said these therapies to treat wet AMD “all basically do the same thing. They make these new blood vessels regress temporarily before they cause damage to the macula.”
The injected medication clears away those blood vessels and restores the architecture of the macula. People can recover some vision in this way, but it’s only a temporary tune-up, and shots must be given as often as once a month.
“Degeneration of the cells is still the main problem. You’re not stopping that. But degeneration itself is a lot slower than actual vision loss associated with these blood vessels.”
The Struggle in Developing New Treatments
According to Keenan, “nobody has been able to stop geographic atrophy from happening” in either form of AMD. “So, that’s the main work in the field with trials.”
In December 2023, the FDA approved two new drugs: Syfovre and Izervay, both of which only slow geographic atrophy. Degeneration still happens, regardless.
Keenan explained how these two new drugs are “complement inhibitors … given by injection into the eye once a month or so.”
“Complement” refers to the body’s complement pathway, a trigger that activates a cascade of proteins in enhancing immune response.
Clinical trials showed Syfovre slowing the rate of geographic atrophy by up to 22% over 2 years, and Izervay up to 14% over 1 year.
Though these drugs are a new weapon against this troublesome affliction, they aren’t without their complications.
“Anytime you give an injection in the eye, there’s always the risk of an infection because you’re introducing something from the outside. So that’s the biggest risk,” explained Gonzalez.
An infection is uncommon, but potentially devastating, as you can lose your eye altogether. There’s also the chance of a damaging reaction to the shot.
“You have to pick and choose your patients,” said Gonzalez. “Not everybody is a good candidate for those new shots … and the patient is never going to see better. … It’s a harder sell than the ones for wet AMD.”
A Common Protective Measure
Keenan and Gonzalez both have a fair degree of confidence in reducing the risk of AMD with vitamin therapy.
As a bit of background on how vitamins were found to act as a sort of preventive measure, Gonzalez said, “In the early and late ‘90s, there were series of studies which were called the age-related eye disease studies.” These are now referred to as AREDS 1 and AREDS 2.
Researchers proved that a certain cocktail of vitamins slowed down degeneration. The most is a combo of antioxidants: vitamins C and E and lutein and zeaxanthin, all of which are in the AREDS 2 formula.
People who took these vitamins had a lower chance of losing their vision over the next 2 to 5 years. “[The combo] seems to be complementary and additive … with a combined treatment effect of 55% to 60%, an excellent safety record, and very low cost,” Keenan said.
Gonzalez recommends the AREDS 2 formula of vitamins to every patient of his. “It’s such an easy thing to take, and the downside is minimal.”
Unfortunately, if your genes make you more likely to have the condition, a change in diet or vitamin use could have no effect.
Dire? Possibly. But not all is lost in this fight.
Vigilance with AMD and What to Do Next if You’re Diagnosed
Gonzalez is adamant in educating his patients before time has run out on treating AMD. Recognition is key. “The most common reason a lot of these people get to me ‘too late’ is they don’t realize there’s a problem.”
He explained a typical scenario: “Let’s say you have macular degeneration in both eyes at different stages. One of your eyes starts developing wet macular degeneration … so the better eye takes over and you may not notice there’s a problem.”
Even after a patient is diagnosed with AMD, they usually see a specialist only twice a year. Gonzalez often tells his patients to cover one of their eyes to make sure their vision is intact in both eyes. “You’ll be able to pick up on subtle differences” in each eye, he said.
This type of self-care and vigilance can be the difference between successfully living with and treating the disease for the rest of your life, and trying to get help when it’s simply too late.
For wet AMD, as mentioned before, a round of injections is basically what everyone does. Without quick, invasive treatment, the point of no return approaches rapidly.
May 16, 2024 – Multiple U.S. agencies are working to contain the recent bird flu outbreak among cattle to prevent further spread to humans (beyond one case reported in early April) and use what we learned before, during, and after the COVID-19 pandemic to keep farm workers and the general public safe.
Fingers crossed, the bird flu will be contained and peter out. Or the outbreak could continue to spread among dairy cattle and other animals, threatening the health and livelihoods of farmers and others who work with livestock.
Or the virus could change in a way that makes it easier to infect and spread among people. If this happens, the worst-case scenario could be a new influenza pandemic.
With so many unknowns, WebMD brought together experts from four federal agencies to talk prevention, monitoring, and what the “what ifs” of bird flu might look like.
Communication with the public “about what we know, what we don’t know, and ways you and your family can stay safe is a priority for us at CDC,” said Nirav D. Shah, MD, JD, the CDC’s principal deputy director. “We at the federal level are responding, and we want the public to be following along.”
People should consult the websites for the CDC, FDA, U.S. Department of Agriculture (USDA), and the Administration for Strategic Preparedness and Response (ASPR) for updates.
It is essential to not only stay informed, but to seek trusted sources of information, Shah said during “Bird Flu 2024 – What You Need to Know,” an online briefing jointly sponsored by the CDC and WebMD.
An ‘Experimental Hamburger’
If one take-home message emerged from the event, it was that the threat to the general public remains low.
The retail milk supply is safe, although consuming raw or unpasteurized milk is not recommended. “While commercial milk supply is safe, we strongly advise against drinking raw milk,” said Donald A. Prater, DVM, acting director for the FDA’s Center for Food Safety and Applied Nutrition.
As for other foods, thoroughly cooked eggs are less risky than raw eggs, and the nation’s beef supply remains free of the virus as well.
For years, federal inspectors have purchased and tested meat at retail stores, said Eric Deeble, DVM, USDA deputy assistant secretary for the Office of Congressional Relations. So far, H5N1, the virus behind bird flu, has not been detected in beef.
The USDA took testing a step further and recently cooked ground beef from dairy cows in their lab. Using what Deeble described as an “experimental hamburger,” the agency showed cooking beef to 165 F or higher kills the virus if it ever becomes necessary.
The federal government now requires all cattle be tested and be free of bird flu virus before crossing any state lines. The government is also reimbursing farmers for veterinary care and loss of business related to the outbreak, and supply personal protective equipment (PPE) like gloves, masks, and face shields to workers.
Vaccination Not Recommended Now
Federal scientists know enough about H5N1 virus to create vaccines against it quickly if the need arises. It’s more about planning ahead at this point. “Vaccines are not part of our response right now,” said David Boucher, PhD, director of infectious diseases preparedness and response at the Administration for Strategic Preparedness and Response.
If the virus changes and becomes a bigger threat to people, “we have the building blocks to produce a vaccine,” Boucher added.
An event attendee asked if the seasonal flu shot offers any protection. “Unfortunately, the flu shot you got last year does not provide great protection from the avian flu,” Shah responded. “It might do a little bit … but that is the vaccine for seasonal flu. This is something more novel.”
Treatments Stockpiled and Ready
Antiviral medications, which if given early in the course of bird flu infection could shorten the severity or duration of illness, are available now, Shah said. The dairy farmer who was infected with bird flu earlier this year responded to oseltamivir (Tamiflu) treatment, for example.
When it comes to bird flu symptoms, the fact that the only infected person reported so far this year developed pink eye, also known as conjunctivitis, is interesting, Shah said. Officials would have expected to see more typical seasonal flu symptoms, he added.
“Influenza is not a new virus,” Boucher said. “With this strain of influenza, we are not seeing any genetic markers associated with resistance to antivirals. That means the antivirals we take for seasonal influenza would also be available if needed to treat H5N1.”
ASPR has stockpiled Tamiflu and three other antivirals. “We do have tens of millions of courses that can be distributed around the country if we need them,” he added.
“Influenza is an enemy we know well,” Boucher said. That is why “we have antivirals ready to go now and many types of PPE.”
Science in Action
The feds intend to stay on the case. They will continue to monitor emergency department visits, lab test orders, and wastewater samples for any changes suggesting a human pandemic risk is growing.
“While we’ve learned a great deal, there are still many things we do not know,” Deeble said.
Shah added, “As in any outbreak, this is an evolving situation and things can change. What you are seeing now is science in action.”
For the latest updates on bird flu in the United States, visit the CDC’s H5N1 Bird Flu: Current Situation Summary website.
May 16, 2024 – Multiple U.S. agencies are working to contain the recent bird flu outbreak among cattle to prevent further spread to humans (beyond one case reported in early April) and use what we learned before, during, and after the COVID-19 pandemic to keep farm workers and the general public safe.
Fingers crossed, the bird flu will be contained and peter out. Or the outbreak could continue to spread among dairy cattle and other animals, threatening the health and livelihoods of farmers and others who work with livestock.
Or the virus could change in a way that makes it easier to infect and spread among people. If this happens, the worst-case scenario could be a new influenza pandemic.
With so many unknowns, WebMD brought together experts from four federal agencies to talk prevention, monitoring, and what the “what ifs” of bird flu might look like.
Communication with the public “about what we know, what we don’t know, and ways you and your family can stay safe is a priority for us at CDC,” said Nirav D. Shah, MD, JD, the CDC’s principal deputy director. “We at the federal level are responding, and we want the public to be following along.”
People should consult the websites for the CDC, FDA, U.S. Department of Agriculture (USDA), and the Administration for Strategic Preparedness and Response (ASPR) for updates.
It is essential to not only stay informed, but to seek trusted sources of information, Shah said during “Bird Flu 2024 – What You Need to Know,” an online briefing jointly sponsored by the CDC and WebMD.
An ‘Experimental Hamburger’
If one take-home message emerged from the event, it was that the threat to the general public remains low.
The retail milk supply is safe, although consuming raw or unpasteurized milk is not recommended. “While commercial milk supply is safe, we strongly advise against drinking raw milk,” said Donald A. Prater, DVM, acting director for the FDA’s Center for Food Safety and Applied Nutrition.
As for other foods, thoroughly cooked eggs are less risky than raw eggs, and the nation’s beef supply remains free of the virus as well.
For years, federal inspectors have purchased and tested meat at retail stores, said Eric Deeble, DVM, USDA deputy assistant secretary for the Office of Congressional Relations. So far, H5N1, the virus behind bird flu, has not been detected in beef.
The USDA took testing a step further and recently cooked ground beef from dairy cows in their lab. Using what Deeble described as an “experimental hamburger,” the agency showed cooking beef to 165 F or higher kills the virus if it ever becomes necessary.
The federal government now requires all cattle be tested and be free of bird flu virus before crossing any state lines. The government is also reimbursing farmers for veterinary care and loss of business related to the outbreak, and supply personal protective equipment (PPE) like gloves, masks, and face shields to workers.
Vaccination Not Recommended Now
Federal scientists know enough about H5N1 virus to create vaccines against it quickly if the need arises. It’s more about planning ahead at this point. “Vaccines are not part of our response right now,” said David Boucher, PhD, director of infectious diseases preparedness and response at the Administration for Strategic Preparedness and Response.
If the virus changes and becomes a bigger threat to people, “we have the building blocks to produce a vaccine,” Boucher added.
An event attendee asked if the seasonal flu shot offers any protection. “Unfortunately, the flu shot you got last year does not provide great protection from the avian flu,” Shah responded. “It might do a little bit … but that is the vaccine for seasonal flu. This is something more novel.”
Treatments Stockpiled and Ready
Antiviral medications, which if given early in the course of bird flu infection could shorten the severity or duration of illness, are available now, Shah said. The dairy farmer who was infected with bird flu earlier this year responded to oseltamivir (Tamiflu) treatment, for example.
When it comes to bird flu symptoms, the fact that the only infected person reported so far this year developed pink eye, also known as conjunctivitis, is interesting, Shah said. Officials would have expected to see more typical seasonal flu symptoms, he added.
“Influenza is not a new virus,” Boucher said. “With this strain of influenza, we are not seeing any genetic markers associated with resistance to antivirals. That means the antivirals we take for seasonal influenza would also be available if needed to treat H5N1.”
ASPR has stockpiled Tamiflu and three other antivirals. “We do have tens of millions of courses that can be distributed around the country if we need them,” he added.
“Influenza is an enemy we know well,” Boucher said. That is why “we have antivirals ready to go now and many types of PPE.”
Science in Action
The feds intend to stay on the case. They will continue to monitor emergency department visits, lab test orders, and wastewater samples for any changes suggesting a human pandemic risk is growing.
“While we’ve learned a great deal, there are still many things we do not know,” Deeble said.
Shah added, “As in any outbreak, this is an evolving situation and things can change. What you are seeing now is science in action.”
For the latest updates on bird flu in the United States, visit the CDC’s H5N1 Bird Flu: Current Situation Summary website.
‘I’m a die-hard Beatles fan – only two albums can be considered best’ | Music | Entertainment
UK seaside town with rich history and its own island | Travel News | Travel
RBI to inject Rs 1.9 trillion liquidity: What it means | Indian economy | Business news
Bangladesh3 weeks agoDHS Autos Introduces Deepal S07 and L07 Electric Vehicles in Bangladesh
- Fashion3 weeks ago
Sign up to our Royal Style newsletter for the world of royal fashion | Royal | News
- Sports4 weeks ago
Dan Ashworth lands new job after Man Utd exit as he works freelance | Football | Sport
- Top Stories4 weeks ago
“Even Monkeys Don’t…”: Wasim Akram Lambasts Pakistan’s Act Against India In Champions Trophy
- Entertainment4 weeks ago
Phil Collins says he’s ‘very sick’ and ‘can’t hold drumsticks properly’ | Celebrity News | Showbiz & TV
- Video2 weeks ago
'एक मुस्लिम 13 साल की लड़की से शादी कर सकता है' | Mahakumbh | IITian Baba Abhay Singh
- Top Stories4 weeks ago
Imran Khan Blamed For Pakistan’s Downfall After Champions Trophy 2025 Exit By Najam Sethi
- Sports4 weeks ago
Man Utd ‘sick of Sir Alex Ferguson pressure’ as INEOS accused of burying club | Football | Sport
