United States: The holiday period often feels overwhelming, with individuals juggling travel, hosting duties, and social engagements alongside professional obligations and caregiving tasks. Amidst this whirlwind of activity, safeguarding our immune systems becomes imperative. 

This season prompts reflection on the critical habits that fortify immune defenses—such as ensuring restorative sleep, consuming nutrient-rich foods, and maintaining physical activity. Conversely, are there practices we should relinquish due to their detrimental effects on our immunity? 

What role do vaccinations play during this period? Is it still opportune to receive immunizations against respiratory illnesses when gathering with vulnerable family members such as infants or the elderly? Furthermore, what preventative measures can minimize the likelihood of falling ill during festive gatherings? 

To delve into these pressing questions, CNN sought insights from Dr Leana Wen, a wellness expert for CNN, emergency physician, and clinical associate professor at George Washington University, who previously served as Baltimore’s health commissioner. 

CNN: Why is sustaining a robust immune system particularly crucial? 

Dr. Leana Wen: The immune system functions as the body’s intrinsic safeguard against viruses, bacteria, and other harmful pathogens. A resilient immune system significantly reduces susceptibility to infectious diseases and mitigates the severity of illnesses. Moreover, immunity intertwines with various chronic conditions, highlighting its broader significance. 

Several elements influence immunity, and many are within our grasp. Vaccinations, for instance, strengthen the body’s defenses against specific ailments. Beyond immunizations, a plethora of lifestyle choices has been scientifically validated to enhance immune functionality. 

CNN: What practices should individuals adopt to bolster their immune health? 

Wen: There are three pivotal habits to cultivate: 

1. Engage in Regular Physical Activity 

   Beyond mitigating the risk of chronic illnesses like diabetes, cancer, and cardiovascular diseases, exercise invigorates the immune system. According to the CDC, maintaining physical activity may lower mortality risks from influenza or pneumonia. Strive for at least 150 minutes of moderate-to-intense exercise weekly, focusing on activities that sustain vitality. 

2. Embrace Whole, Unprocessed Foods 

   Ultra-processed foods, laden with preservatives, emulsifiers, and artificial additives, are detrimental. Studies indicate that high consumption of such foods correlates with a shortened lifespan and heightened inflammation. Prioritize a diet abundant in vegetables, lean proteins, legumes, whole grains, and nuts to reduce these risks and support optimal immune performance. 

3. Prioritize Quality Sleep 

   Sleep deprivation triggers immune disruptions, increasing vulnerability to various illnesses. Those consistently sleeping fewer than seven hours per night face elevated risks of hypertension, diabetes, and obesity. Establish a routine by dedicating at least eight hours to rest and maintaining consistent sleep-wake times. Create a serene sleeping environment—dark, quiet, and cool—and minimize screen usage before bedtime to enhance sleep quality. 

CNN: Are there practices individuals should discontinue to optimize immunity? 

Wen: Indeed. Foremost, avoid smoking and excessive alcohol consumption. 

Smoking undermines immune defenses, compromising the body’s ability to combat infections. However, cessation yields significant improvements in immunity over time. Excessive alcohol intake similarly diminishes immune response. 

Those seeking to quit smoking can explore options with healthcare providers, including nicotine replacement therapies and medications. During the holidays, while reducing alcohol intake might prove challenging, strive to avoid binge drinking and adhere to moderation guidelines—up to two drinks daily for men and one for women. 

CNN: Is it too late to receive vaccinations for respiratory viruses when planning gatherings with vulnerable loved ones? 

Wen: Vaccines generally require a couple of weeks to elicit robust antibody responses. Staying current with recommended vaccinations, including annual flu and COVID-19 shots, remains prudent. If your gathering occurs within a few days, vaccination may not provide immediate protection for that specific event but will bolster defenses for the season ahead. 

CNN: What precautions should high-risk individuals take during the holidays? 

Wen: Vulnerable individuals should limit exposure to crowded environments, especially where voices are raised. Utilizing an N95 mask or equivalent in public or during travel can provide added protection. 

Requesting visitors to adopt precautionary measures, like reducing exposure to crowded places before the gathering, is also wise. Rapid COVID-19 testing before meeting particularly susceptible loved ones is another layer of safeguarding. Additionally, the FDA recently approved combined flu and COVID-19 tests, and free COVID-19 test kits remain available through federal initiatives. 

CNN: Are there additional strategies for preventing illness during the holidays? 

Wen: Vigilant hygiene practices, such as frequent handwashing with soap and water, are essential. Hosts might consider asking symptomatic guests to refrain from attending gatherings to protect others. 

Finally, remember the significance of connection and joy during the holidays. Isolation and loneliness can adversely impact immunity, whereas shared moments with loved ones enhance emotional and physical well-being. Despite the season’s challenges, fostering togetherness is a gift to both body and soul. 

In contemporary society, lamenting exhaustion has become almost ritualistic. Yet, for a subset of individuals, profound fatigue is merely one harrowing symptom of a malady whose prominence surged in the shadow of the COVID-19 pandemic.

This disease, known as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), profoundly disrupts daily existence. While ME/CFS is not a novel disorder, its emergence in the aftermath of COVID-19 infections—often under the umbrella of long COVID—has shed light on its debilitating nature. Long COVID describes lingering symptoms persisting for months, if not years, post-infection, according to salon.com.

A significant proportion of long COVID sufferers exhibit symptoms mirroring those of ME/CFS or receive formal diagnoses of the condition. However, akin to the enigmatic character of long COVID, ME/CFS remains an enigma in medical research. This perplexity is compounded by the disease’s longstanding neglect within scientific circles—a neglect attributed to biases both societal and systemic. Historically, the condition has been marginalized, partly due to its predominance among women and its misleading association with unrelenting fatigue—a symptom that belies the illness’s multifaceted complexity.

Misconceptions and Misnomers

The nomenclature “chronic fatigue syndrome” trivializes the reality of the condition. “Chronic fatigue” inadequately encapsulates the lived experience of sufferers, diminishing the gravity of their struggles, as elucidated by Professor Chris Ponting of the University of Edinburgh. Co-leader of the DecodeME study—the world’s most extensive ME/CFS research initiative—Ponting emphasizes the disease’s gendered prevalence. “The majority of those afflicted are women, with a ratio of five to one when compared to men,” he explained. “Moreover, ME/CFS is more likely to strike individuals of advanced age,” as per salon.com.

According to the Centers for Disease Control and Prevention (CDC), ME/CFS severely impairs both physical and cognitive function. Patients endure incapacitating exhaustion, cognitive fog, and an inability to perform basic tasks, such as bathing or preparing meals. There is neither a definitive cure nor a standardized diagnostic protocol for the condition.

Systemic Neglect and Societal Oversight

Ponting highlights a troubling disconnect between policymakers—often young, healthy males—and the predominantly older female demographic afflicted by ME/CFS. This dissonance perpetuates ignorance about the disease’s devastating impact despite its prevalence, affecting approximately one in every 200 people.

A particularly confounding aspect of ME/CFS lies in its counterintuitive relationship with physical activity. Unlike the conventional wisdom extolling exercise as universally beneficial, exertion can exacerbate symptoms for ME/CFS patients. This phenomenon, known as post-exertional disease, undermines health, diminishes quality of life, and further restricts mobility, according to salon.com.

The Search for Answers

The precise biological mechanisms underpinning ME/CFS remain elusive. The prevailing hypothesis suggests an interplay between immune dysfunction and genetic predisposition, often triggered by viral infections. Ponting noted, “Many patients develop the condition following an illness, which may indicate mitochondrial dysfunction—the cellular ‘batteries’ may be compromised.”

DecodeME, an ambitious genetic study, seeks to unravel these mysteries by examining DNA variations among ME/CFS sufferers. Researchers hope such insights will illuminate the disease’s roots and guide future investigations.

Personal Accounts and Coping Strategies

Dr. Charles Shepherd, a UK-based medical advisor to the ME Association, recounts his journey with ME/CFS following a severe bout of chickenpox. Despite being a physician, Shepherd was mystified by his persistent symptoms, which included profound exhaustion and post-exertional malaise. His struggle to obtain a diagnosis, spanning two years, underscores the medical community’s limited understanding of the disorder, as claimed by salon.com.

Shepherd describes his experience as paradoxically fortunate, as he has managed to mitigate symptoms through energy pacing—a strategy involving meticulous management of physical and mental exertion. While this approach offers some relief, the prognosis remains grim; fewer than 10 percent of patients achieve full recovery.

Looking Ahead

Ponting remains cautiously optimistic about the potential breakthroughs emerging from the DecodeME initiative. “Our research will illuminate the path forward, identifying avenues for further study,” he stated. “However, the development of effective treatments remains a distant prospect.”

For the countless individuals grappling with ME/CFS, the quest for answers continues—a testament to resilience amidst adversity. Through rigorous research and heightened awareness, hope endures that this debilitating condition will one day be met with understanding, compassion, and, ultimately, effective remedies.

United States: Researchers have uncovered a disconcerting revelation about the H5N1 strain of avian influenza currently afflicting US dairy herds. The virus requires only one genetic adjustment to effectively bind to human upper respiratory cells. This pivotal discovery, unveiled in Science, delineates a streamlined pathway for the virus to enhance human transmissibility, heightening the specter of a potential pandemic if such a mutation proliferates in the wild. 

Avian flu viruses rely on surface proteins to adhere to specific cell receptors, enabling cellular infiltration. While bird and human receptors differ, this disparity is nuanced, according to James Paulson, a co-author of the study and biochemist at Scripps Research. “For H5N1 to spark a human pandemic, it must alter its receptor specificity from avian to human,” he explained. Remarkably, researchers found that this transformation demands only a solitary mutation, according to scientificamerican.com.

The H5N1 clade fueling the current outbreak first emerged in North America in 2021, affecting a spectrum of species, from wild birds and marine mammals to terrestrial animals like bears and foxes. Its recent leap to dairy cows has intensified scrutiny. 

Though human infections linked to these outbreaks remain infrequent and predominantly mild, they occur chiefly among individuals with high exposure, such as farm workers. Crucially, the virus has yet to display the ability to spread between humans—a barrier rooted in its receptor-binding preferences. 

Jenna Guthmiller, an immunologist at the University of Colorado Anschutz Medical Campus, who was not part of the research, noted, “If the virus enhances its affinity for human receptors, it could pave the way for human-to-human transmission, which poses significant risks.” 

The study focused on hemagglutinin, a surface protein integral to the virus’s ability to attach to host cell receptors and initiate infection. Employing genetic sequences from a Texas case is remarkably subtle, according to James Paulson, a biochemist at Scripps Research and co-author of the study. “For a new pandemic H5N1 virus, we know it has to switch receptor specificity from avian-type to human-type. So what will it take?” Paulson and his team found that this transition required just a single mutation, a surprising and troubling finding, as per scientificamerican.com.

The Mutation at Position 226

The researchers focused on hemagglutinin, a surface protein of H5N1 that facilitates receptor binding. By introducing mutations into the genetic sequence of hemagglutinin, they identified a single change at the 226th amino acid that enabled the virus to switch its binding preference from bird receptors to human upper respiratory tract receptors.

Previous pandemics, such as the 1918 and 2009 influenza outbreaks, typically required multiple mutations for this adaptation. The H5N1 virus could achieve this shift with a single mutation, which signals its potential for rapid evolution, according to Ian Wilson, a structural biologist at Scripps.

Implications for Human Transmission

H5N1 has been circulating in North America since 2021, impacting a wide range of animal species and recently emerging in US dairy herds. While human cases remain rare and primarily linked to direct contact with infected animals, this mutation could increase the risk of human-to-human transmission. Jenna Guthmiller, an immunologist at the University of Colorado, warned, “The better the virus becomes at binding to human receptors, the more likely it is to spread between people,” according to scientificamerican.com.

Viruses that bind more effectively to the upper respiratory tract, such as this mutated H5N1, can spread more easily through coughing or sneezing, posing a greater public health risk. However, receptor binding is just one piece of the puzzle. The virus must also replicate efficiently in human cells to become truly transmissible.

Lessons from a Recent Case

The study’s findings resonate with recent events. In Canada, a teenager hospitalized with severe bird flu symptoms was infected with an H5N1 strain carrying two mutations, including one at position 226. While it’s unclear if these mutations directly contributed to the severity of the illness, they underscore the virus’s potential to adapt to human hosts.

Preparing for a Pandemic Threat

While the current risk of widespread H5N1 transmission remains low, the study highlights critical areas for surveillance and research. By identifying key mutations, scientists can better monitor the virus’s evolution and anticipate its pandemic potential, according to scientificamerican.com.

As Paulson cautioned, “The magic that we hope doesn’t happen is that all the right factors come together to enable the first human-to-human transmission. That’s when we face the risk of a pandemic.”

This research serves as a call to remain vigilant, ensuring preparedness in the face of an ever-evolving threat.