Inside Outbreaks: E. coli, Bird Flu, Diphtheria, and Cats with COVID — What They Reveal About Our Fragile Public Health Systems

In this episode of Thermometer HQ, Dr. Jay Varma and Dr. Jon Epstein unpack a whirlwind of infectious disease stories that illustrate how our global health systems—human, animal, and environmental—are intertwined. From raw-milk cheese in the Pacific Northwest to feline COVID infections in New York City, the through-line is clear: vigilance, vaccination, and science-based response save lives.

Why Now Is the Time to Vaccinate Against COVID and Flu

As the flu and COVID seasons overlap, Dr. Varma and Dr. Epstein remind us that mid-to-late fall is the perfect window for protection. Both hosts emphasize that updated COVID vaccines cover the current dominant variants and that vaccination remains the most effective way to prevent severe illness, long COVID, and heart complications. “The most effective way to boost our immune system,” Dr. Varma stresses, “is not supplements or vitamins—but vaccines.”

In an era of pandemic fatigue and misinformation, these reminders matter. The same public health infrastructure that delivers vaccines also tracks outbreaks—and as government shutdowns disrupt surveillance systems, even the best medical tools lose power without data.

Raw-Milk Cheese and the Return of Shiga Toxin E. coli

The episode’s first outbreak story brings us to Washington and Oregon, where a cluster of Shiga toxin–producing E. coli infections was linked to aged raw-milk cheese from Twin Sisters Creamery. The bacteria sickened three people, including a child under two, and at least one case was severe enough to require hospitalization.

Dr. Epstein explains why pasteurization remains vital: “Any raw or undercooked food carries a risk of bacterial infection. Pasteurization—heat-treating food—reduces that risk dramatically.” Shiga toxin–producing strains can cause hemolytic uremic syndrome (HUS), a form of kidney failure that hits children hardest.

Equally important, Dr. Varma cautions against a common instinct: “Antibiotics can actually make some E. coli infections worse by increasing toxin release.” Diagnosis and supportive care—not antibiotics—are key. The silver lining? The system worked. Outbreak detection linked just three cases before more people got sick—a small but crucial public health win.

Avian Influenza: Turkey Trouble Ahead

Next, the conversation turns to the resurgence of highly pathogenic avian influenza across U.S. poultry farms. In the past month alone, 6 million birds have been affected across 62 flocks, including a major outbreak in Minnesota’s turkey industry. For Americans planning Thanksgiving dinner, this could mean higher prices and tighter supply.

Industrial-scale farming magnifies the problem. As Dr. Epstein notes, “Once flu gets into a poultry flock, it spreads like wildfire.” Depopulation—the mass culling of infected flocks—remains the only containment tool, creating both ethical and economic consequences. The episode highlights how modern agriculture’s centralization, while efficient, also makes it uniquely vulnerable to infectious disease.

Diphtheria and the Cost of Falling Vaccination Rates

Shifting overseas, Dr. Varma spotlights expanding diphtheria outbreaks across Somalia, Sudan, Yemen, and Chad—regions where conflict, displacement, and collapsing immunization programs have left millions unprotected. The bacterial infection produces a toxin that can suffocate victims or damage the heart, yet it’s easily preventable through routine vaccination.

Dr. Varma connects these global crises to trends at home. U.S. kindergarten vaccination rates for diphtheria and other diseases have dropped from 95% to 92% in just a few years—a small dip that could have large consequences. “Eighty-five percent is the danger zone,” he warns. Below that, outbreaks of vaccine-preventable diseases become inevitable.

The episode underscores a larger message: declining public trust in vaccination is a global issue. Policies that complicate vaccine schedules or discourage combination shots (like the DTaP vaccine for diphtheria, tetanus, and pertussis) risk reversing decades of progress.

Ebola: A Victory for African Public Health

In contrast to the grim diphtheria picture, there’s good news from the Democratic Republic of Congo. The latest Ebola outbreak is nearing official closure after 42 days without new cases. Ring vaccination, local surveillance, and community engagement—much of it led by African experts—drove this success.

Dr. Varma calls it a “testament to African leadership and self-sufficiency,” while also warning that U.S. funding cuts threaten such progress. The lesson is clear: investment in surveillance and rapid response capacity works—and withdrawal of support undermines global safety.

Monkey Misinformation and the Mississippi Macaque Crash

A bizarre story from Mississippi illustrates the tension between science, media, and fear. After a truck carrying research macaques crashed, early reports falsely claimed the animals carried hepatitis, herpes, and COVID. Authorities euthanized several and warned residents of a potential zoonotic threat.

Dr. Epstein clarifies: the monkeys were specific-pathogen-free animals, not infected with any human diseases. “This was a tragic accident, but also a reminder of how misinformation spreads faster than facts,” he says. Public panic, he adds, often obscures legitimate animal welfare and biosafety concerns.

Cats and COVID: Lessons in One Health

The episode ends with a topic that hits close to home—literally. A Cornell University study found that many New York City cats—mostly indoor pets—had antibodies to SARS-CoV-2 during the first pandemic wave, suggesting human-to-cat transmission. Fortunately, most cats showed no symptoms.

Dr. Varma and Dr. Epstein use this as a case study in One Health, the idea that human, animal, and environmental health are inseparable. While there’s no COVID vaccine for cats, owners who test positive should minimize close contact until recovery. “We share our homes and microbes,” says Dr. Varma. “Protecting our pets is part of protecting ourselves.”

There’s a silver lining for cat lovers: research on COVID antivirals has yielded treatments for feline infectious peritonitis (FIP), once considered a fatal disease. Science that protects humans, it turns out, can save animals too.

In an era of polarized politics and fragmented health systems, this week’s Inside Outbreaks reinforces a timeless truth: science works when we let it. From foodborne E. coli to feline COVID, these stories are connected by the same thread—data, vaccines, and trust in public health.

👉 Watch the full episode on YouTube: https://youtu.be/THeRTrOUTrM