Latest / Morning Medical with Dr. Chow / Pneumonic Plague in Russia, Flu and COVID Vaccines, ADHD Overdiagnosis, and Grief Support

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Pneumonic Plague in Russia, Flu and COVID Vaccines, ADHD Overdiagnosis, and Grief Support · Morning Medical with Dr. Chow

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Hello and welcome to Morning Medical with Dr.
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Chow, your daily update on the latest in medical and health news from around the world.
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I'm your host, Dr.
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Chi-Ming Chow.
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Today, we're diving into a topic that has resurfaced in the headlines: the pneumonic
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plague, following a possible case in Russia.
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This situation has sparked discussions on the importance of communication, transparency, and
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preparedness in public health.
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The recent case involves a laboratory employee in Russia who tragically passed away from
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severe pneumonia.
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While initial reports suggested the possibility of pneumonic plague, Russian authorities have
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yet to confirm it as such, and the information available does not indicate an outbreak.
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This case underscores the critical role of biosafety and biosecurity in laboratories.
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Biosafety measures help prevent accidental infections and releases, while biosecurity
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protects against unauthorized access and misuse.
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Both rely heavily on trained staff, appropriate safeguards, and clear oversight.
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What we know so far is that the employee worked at the Irkutsk Anti-Plague Research Institute
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and developed rapidly worsening pneumonia, leading to her death on October 2.
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There were unverified reports that she might have broken a vial containing Yersinia pestis,
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the bacterium responsible for plague.
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However, Russia's public health watchdog, Rospotrebnadzor, described her illness as
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'pneumonia of unknown cause' and stated that no organisms linked to her lab work were found.
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Despite this, nearly 200 contacts were placed under medical observation, with no secondary
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cases of plague confirmed.
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The World Health Organization, as of October 7, reported that Russian authorities completed
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medical monitoring of all identified contacts without detecting any dangerous infectious
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disease pathogens.
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Although there were media reports of a second employee with pneumonia of undetermined cause,
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these remain unverified and do not confirm a second case of plague.
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The World Health Organization's current risk assessment remains moderate to low for Irkutsk,
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low for Russia, and very low for the European Region, with the understanding that this is
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provisional and subject to change as more information becomes available.
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In response, the United States has escalated its monitoring and is actively seeking more
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information through the Administration for Strategic Preparedness and Response, the
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Centers for Disease Control and Prevention, and the State Department.
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This vigilance does not suggest evidence of the plague spreading to the United States or
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confirmation of plague in Russia, but rather a precautionary measure consistent with federal
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health security roles.
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The history of plague is long, and it is not a new disease.
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It still exists among animals and their fleas, with the Centers for Disease Control and
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Prevention reporting an average of five human cases annually in the United States, mostly in
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the rural West.
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Pneumonic plague, which affects the lungs, can develop through inhalation of infectious
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respiratory droplets or spread from elsewhere in the body.
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Symptoms can include fever, weakness, headache, cough, chest pain, and difficulty breathing.
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Without treatment, it is almost always fatal, but appropriate antibiotics can be life-saving,
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especially when administered early.
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Acting quickly is crucial in managing potential plague cases.
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Recent cases in the United States highlight the importance of prompt response.
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In Arizona, a young adult died of pneumonic plague in July 2025 after working with ill
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cats.
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Forty-six potentially exposed people were given preventive antibiotics, with no subsequent
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illness reported.
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Similarly, in Wyoming in 2021, a patient exposed to ill cats developed pneumonic plague
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and survived after receiving mechanical ventilation.
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These cases emphasize the need for immediate isolation of suspected patients, appropriate
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infection precautions, and public health notification.
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Preparedness drills are essential for readiness against any severe transmissible respiratory
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infection.
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A recent report by the Centers for Disease Control and Prevention found weaknesses in
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drills simulating avian influenza, highlighting the need for reliable protective equipment,
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clear exposure screening, and rapid public health consultation.
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These are vital investments in preparedness.
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As we continue to monitor the situation in Russia, transparency and ongoing communication
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are key.
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The World Health Organization reports that no recent plague cases have been registered in
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Irkutsk and that contact monitoring concluded without detecting any dangerous pathogens.
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However, continued international verification and transparent release of laboratory findings
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remain crucial.
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Public trust depends on openly sharing evidence, acknowledging uncertainties, and
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updating advice as new facts emerge.
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As the cold and flu season approaches, Nova Scotians now have the opportunity to schedule
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appointments for both the influenza and COVID-19 vaccines.
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This initiative is aimed at bolstering public health and minimizing the impact of respiratory
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illnesses on the healthcare system.
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The province of Nova Scotia announced on Thursday that residents can book their
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vaccination appointments through various channels, including online platforms, the
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province's mobile app YourHealthNS, by calling 811, or by consulting with their primary care
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providers.
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This flexibility is part of a broader strategy to ensure ease of access and encourage
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widespread participation in the vaccination program.
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Dr.
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Jesse Kancir, Nova Scotia's deputy chief medical officer of health, emphasized the
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preventive nature of this initiative.
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"This is all about prevention, right?
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We want people to be protected against illness that they might get, or some of the severe
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outcomes," he stated.
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Dr.
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Kancir noted that while COVID-19, respiratory syncytial virus, and flu numbers are currently
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low in Nova Scotia, there are signs of an early start to the flu season in parts of Canada,
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making timely vaccination crucial.
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The province has reintroduced family bookings, allowing up to six people to be scheduled for a
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single appointment.
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This approach is designed to streamline the process for families and ensure that everyone
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aged six months and older receives the recommended vaccinations.
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The vaccines are crucial for supporting healthier communities throughout the
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respiratory season.
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Health officials are particularly urging vulnerable populations, such as children, older
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adults, and individuals with chronic health conditions, to prioritize getting immunized.
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For those at high risk of contracting illnesses, rapid tests or lab tests are
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available by booking online or calling 811.
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"It really is critical for people who are either immunocompromised or older, and in some
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cases quite young, to make sure that they're making that choice to get the immunizations
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because it certainly could be a decision that is life-preserving," Dr.
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Kancir highlighted.
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Moreover, there is evidence suggesting that these immunizations may help reduce the risk of
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serious heart- and stroke-related complications that can occur following infections.
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This added benefit underscores the importance of widespread vaccination as a protective
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measure for the general population.
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Today, we're discussing a significant government review in England that has raised
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concerns about the potential over-diagnosis of Attention Deficit Hyperactivity Disorder and
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autism.
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This review was prompted by a notable increase in diagnoses over the past 25 years, which
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experts suggest may now exceed the expected numbers for some younger age groups in the
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population.
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The review highlights that economic uncertainties, coupled with the pervasive
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influence of social media, are contributing to an increase in mental health issues among young
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individuals.
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It underscores the necessity for enhanced support systems for all mental health
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conditions, advocating for tougher regulations on private firms providing assessments for the
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National Health Service.
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The review also calls for a ban on advertising to ensure quality and consistency in diagnoses.
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Led by prominent doctors in the field, this review was initiated ten months ago following
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comments from the then-health secretary about the risk of young people being over-diagnosed
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and consequently 'written off.' The focus was particularly on young people and children, who
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exhibit the highest rates of these diagnoses.
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The findings are anticipated to influence government policies on National Health Service
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services, benefits, and support for young people not engaged in education, employment, or
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training.
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One significant concern raised by the experts is that diagnoses of mental health issues,
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Attention Deficit Hyperactivity Disorder, and autism often become labels that define
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individuals by their challenges, rather than their strengths and potential.
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This labeling can negatively impact their opportunities in education, employment, and
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personal relationships.
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The review noted that children diagnosed with autism and Attention Deficit Hyperactivity
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Disorder before the age of seventeen are approximately four times more likely to be out
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of education, employment, or training between the ages of sixteen and twenty-four.
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The review also emphasizes the importance of providing better support post-diagnosis,
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suggesting that with improved access to therapies and support for mental health
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conditions, individuals could lead more fulfilling lives.
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However, there is a substantial issue with long waiting times for diagnoses, which can delay
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necessary support.
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The review cites the story of a family who waited three years for an autism assessment for
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their son, highlighting the urgent need for reassessment of waiting lists to prioritize
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those with the most complex needs.
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The review suggests that not every difficulty necessitates a medical response.
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It warns against blurring the lines between diagnosable conditions like Attention Deficit
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Hyperactivity Disorder and autism and what might be considered normal variations in brain
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function, cognition, and behavior.
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The review indicates that society might be shifting from an era of under-diagnosis to one
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of over-diagnosis or mis-diagnosis, with data showing a significant increase in diagnosed
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cases among children.
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Mel Merritt from the National Autistic Society expressed that successive governments have
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failed to adequately support autistic individuals, emphasizing the need for a system
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that truly meets their needs.
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Similarly, Abigail Ampofo from the charity YoungMinds pointed out that young people often
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feel blamed for their mental health struggles, and she hopes this review will help shift
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perceptions and address systemic failures.
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The government has welcomed the review's findings and has announced plans to introduce a
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new model for providing support in its upcoming mental health strategy.
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This strategy is expected to include tougher regulations on Attention Deficit Hyperactivity
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Disorder and autism assessments, aiming to ensure early intervention and reduce the
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distress associated with these conditions.
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In Northern Ireland, a new initiative is focusing on encouraging open dialogues about
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mental health, particularly in the context of bereavement.
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The initiative aims to create a supportive environment where individuals can freely
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express their feelings without fear of judgment.
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This approach is especially significant in areas like Armagh and Dungannon, where
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traditional views on mental health might have previously discouraged such openness.
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The initiative seeks to address the often isolating nature of grief by fostering
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community support and understanding.
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By encouraging people to talk about their emotions in a judgment-free setting, there's a
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hope to break down the barriers that prevent individuals from seeking help when they need it
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most.
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This is particularly crucial in communities where mental health resources might be limited
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or stigmatized.
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Experts involved in the initiative emphasize the importance of conversation as a tool for
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healing.
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They highlight that talking about one's feelings can significantly reduce the burden of
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grief and enhance emotional well-being.
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This is part of a broader movement in Northern Ireland to integrate mental health awareness
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into everyday life, making it as routine as physical health maintenance.
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Community leaders in Armagh and Dungannon have been instrumental in promoting this initiative.
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They organize events and workshops designed to encourage open dialogue and provide resources
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for those dealing with loss.
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These community gatherings serve as a platform for sharing experiences and learning from one
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another, thereby fostering a sense of solidarity and mutual support.
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The initiative also collaborates with local mental health professionals to offer guidance
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and support to those in need.
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This partnership ensures that individuals have access to professional help if their
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discussions reveal deeper issues that require therapeutic intervention.
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The goal is to create a comprehensive support network that addresses both the emotional and
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psychological needs of the community.
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By normalizing conversations about mental health, particularly around sensitive topics
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like bereavement, this initiative hopes to change societal perceptions and reduce stigma.
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The overarching aim is to ensure that no one feels alone in their grief and that everyone
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has the opportunity to heal in a supportive environment.
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Today, we're delving into a compelling topic that's gaining attention in the United Kingdom:
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women reclaiming their anger.
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Recent reports indicate a significant rise in the number of women expressing anger openly,
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with one in five British women in 2024 reporting feelings of anger during much of the
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previous day.
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This is a notable increase from 2020, where only one in ten reported such feelings.
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Music artist Chess Galea is among those who have embraced this shift.
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She recounts how she used to suppress her anger, fearing judgment and labels like
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"hysterical" or "difficult to work with." Galea points out the societal pressures women face,
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from carrying the "mental load" to dealing with sexism and, even worse, violence.
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But now, she no longer holds back her emotions, stating, "If someone catcalls me in the street,
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I rage.
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I don't care."
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This change is not isolated to Galea.
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Psychotherapist Jennifer Cox, co-host of the "Women are Mad" podcast, suggests that both the
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actual experience of anger and the openness about it are on the rise.
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Cox observed a pattern among her female clients who suppressed their anger, leading to physical
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conditions like migraines and stomach issues.
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She started running anger processing groups to help women express these pent-up feelings.
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Cox explains that women have been traditionally brought up with the "good girl" narrative—be
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polite, kind, and caring.
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However, the expectation now is to manage everything: work, household, and mental health.
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Despite working almost as much as men, women spend significantly more time on unpaid chores
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and caring responsibilities.
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The "mental load" of managing a household often falls disproportionately on women.
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Interestingly, there's a cultural shift towards more positive representations of angry women in
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media.
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Characters like Alex Forrest in "Fatal Attraction" were once portrayed as dangerous,
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but now female rage is increasingly seen as understandable and even liberating.
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Artists like Lily Allen and Chappell Roan are releasing music that includes expressions of
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anger, and even the 2023 hit "Barbie" film depicted the iconic doll expressing frustration
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with her perfect world.
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While these media portrayals are helpful, Cox warns that women still face social penalties
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for expressing anger in real life.
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A 2020 study found that women showing anger at work were seen as less deserving of status,
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unlike their male counterparts.
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Life coach Yann Dang advises women to use direct language and "build the muscle" of
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standing up for themselves, even in male-dominated fields.
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She emphasizes that expressing anger authentically is crucial for career
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advancement.
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Beyond workplace challenges, ongoing threats like stalking, harassment, and domestic abuse
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continue to unite women in anger and defiance.
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Violence against women and girls accounts for a significant portion of crime in England and
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Wales, yet it often goes unreported.
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For Chess Galea, discussing her experiences with misogyny and sexual assault has been
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liberating, allowing her to channel her frustration constructively.
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Psychologist Dr.
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Tara Brach highlights that anger can be a messenger, bringing energy to confront
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injustices and set boundaries.
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However, it's important to channel it healthily.
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She recommends the "RAIN" strategy—recognize, allow, investigate, and nurture—as a way to
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process anger effectively.
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This approach can help individuals harness their anger to drive positive change without
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letting it become destructive.
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This episode has explored the nuances of women's anger, its societal implications, and
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the cultural shifts that are encouraging openness.
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It's clear that while challenges remain, there's a growing recognition of the importance
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of expressing and addressing these emotions.
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Thank you for joining me today on Morning Medical with Dr.
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Chow.
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Stay informed and take care of your health.
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Until next time, I'm Dr.
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Chi-Ming Chow.