Latest news with #LaraJohnson
CNN
27-03-2025
- Health
- CNN
Some measles patients in West Texas show signs of vitamin A toxicity, doctors say, raising concerns about misinformation
Doctors treating people hospitalized as part of a measles outbreak in Texas and New Mexico have also found themselves facing another problem: vitamin A toxicity. At Covenant Children's Hospital in Lubbock, near the outbreak's epicenter, several patients have been found to have abnormal liver function on routine lab tests, a probable sign that they've taken too much of the vitamin, according to Dr. Lara Johnson, pediatric hospitalist and chief medical officer for Covenant Health-Lubbock Service Area. The hospitalized children with the toxicity were all unvaccinated. US Health and Human Services Secretary Robert F. Kennedy has centered his response to the outbreak on vitamin A, even suggesting in a Fox News interview that it could work 'as a prophylaxis.' But overuse of vitamin A can have serious health consequences, and there is no evidence that it can prevent measles. The only way to prevent infection with the measles virus is through the measles-mumps-rubella (MMR) vaccine, which is 97% effective against measles after two doses. Kennedy has said that he does 'encourage' vaccination but that it is a 'personal choice.' 'If people have the mistaken impression that you have an either-or choice of MMR vaccine or vitamin A, you're going to get a lot of kids unnecessarily infected with measles. That's a problem, especially during an epidemic,' said Dr. Peter Hotez, co-director of the Texas Children's Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at the Baylor College of Medicine. 'And second, you have this unregulated medicine in terms of doses being given and potential toxicities.' In specific doses taken under the care of a physician, vitamin A can play a role in treatment for measles. That's why the World Health Organization and US Centers for Disease Control and Prevention recommend it in serious cases. But the patients who were reported to have toxicity were probably not taking the vitamin under the supervision of a physician, Johnson said. Vitamin A is most useful for measles support in people who have a specific deficiency, and studies suggesting its use mainly draw on evidence from low-income countries where that deficiency is common. The patients in West Texas are generally well-nourished, said Dr. Lesley Motheral, a pediatrician in Lubbock, so experts say it's unclear how beneficial the vitamin might be in this setting. Vitamin A has an important role in immunity and vision. It's fat-soluble, so when someone takes too much, it can accumulate in organs like the liver. Excess vitamin A can cause dry skin and eyes, blurry vision, bone thinning, skin irritation, liver damage and other serious issues. In pregnant women, excess vitamin A can lead to birth defects. Patients with toxicity can receive supportive care like fluids for low blood pressure or moisturizers for dry skin and eyes, Motheral said. But more serious damage will need to be evaluated and given further management. 'Recovery for patients with acute toxicity can be rapid when the vitamin is discontinued,' she said. 'Chronic toxicity can affect bones, brain and of course the liver. … Sadly, some of the more serious problems with vitamin A toxicity are not always reversible.' The Council for Responsible Nutrition, a trade association for dietary supplement and functional food manufacturers, issued a statement Wednesday warning parents against using high doses of vitamin A to try to keep their children from getting measles. 'While vitamin A plays an important role in supporting overall immune function, research hasn't established its effectiveness in preventing measles infection. CRN is concerned about reports of high-dose vitamin A being used inappropriately, especially in children,' the statement says. Johnson said she has seen people who were taking vitamin A for measles treatment as well as for prevention. She doesn't know exactly where these patients heard that they should be taking a lot of vitamin A, she said, but the approach is heavily discussed on social media. 'It's coming out of the health and wellness … influencer industry that downplays the importance of vaccines and tries to promote various spectacular cures like ivermectin or hydroxychloroquine or vitamin A,' Hotez said. Ivermectin, a deworming medication, and hydroxychloroquine, an anti-malarial drug, were both incorrectly touted as treatments for the Covid-19 pandemic but resulted in many poison control reports and an estimated $200 million in unnecessary spending. Experts worry that the drug misinformation so rampant during Covid could mirror rhetoric about vitamin A for measles prevention. In his Fox News interview, Kennedy endorsed an unconventional treatment regimen for measles including a steroid, an antibiotic and cod liver oil, which is rich in vitamin A. He praised two West Texas doctors who he said were using this remedy on their patients and had seen 'almost miraculous and instantaneous recovery.' The antibiotic, clarithromycin, could be an attempt to prevent secondary bacterial infections like pneumonia, but evidence for that is limited. Budesonide is a steroid with a variety of uses, but it's not clear whether or how it might help someone with measles. The measles outbreak has now affected at least 379 people across Texas, New Mexico and Oklahoma. Kansas has reported 23 measles cases, and officials said Wednesday that they may also be linked to the outbreak.
Yahoo
27-03-2025
- Health
- Yahoo
Some measles patients in West Texas show signs of vitamin A toxicity, doctors say, raising concerns about misinformation
Doctors treating people hospitalized as part of a measles outbreak in Texas and New Mexico have also found themselves facing another problem: vitamin A toxicity. At Covenant Children's Hospital in Lubbock, near the outbreak's epicenter, several patients have been found to have abnormal liver function on routine lab tests, a probable sign that they've taken too much of the vitamin, according to Dr. Lara Johnson, pediatric hospitalist and chief medical officer for Covenant Health-Lubbock Service Area. The hospitalized children with the toxicity were all unvaccinated. US Health and Human Services Secretary Robert F. Kennedy has centered his response to the outbreak on vitamin A, even suggesting in a Fox News interview that it could work 'as a prophylaxis.' But overuse of vitamin A can have serious health consequences, and there is no evidence that it can prevent measles. The only way to prevent infection with the measles virus is through the measles-mumps-rubella (MMR) vaccine, which is 97% effective against measles after two doses. Kennedy has said that he does 'encourage' vaccination but that it is a 'personal choice.' 'If people have the mistaken impression that you have an either-or choice of MMR vaccine or vitamin A, you're going to get a lot of kids unnecessarily infected with measles. That's a problem, especially during an epidemic,' said Dr. Peter Hotez, co-director of the Texas Children's Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at the Baylor College of Medicine. 'And second, you have this unregulated medicine in terms of doses being given and potential toxicities.' In specific doses taken under the care of a physician, vitamin A can play a role in treatment for measles. That's why the World Health Organization and US Centers for Disease Control and Prevention recommend it in serious cases. But the patients who were reported to have toxicity were probably not taking the vitamin under the supervision of a physician, Johnson said. Vitamin A is most useful for measles support in people who have a specific deficiency, and studies suggesting its use mainly draw on evidence from low-income countries where that deficiency is common. The patients in West Texas are generally well-nourished, said Dr. Lesley Motheral, a pediatrician in Lubbock, so experts say it's unclear how beneficial the vitamin might be in this setting. Vitamin A has an important role in immunity and vision. It's fat-soluble, so when someone takes too much, it can accumulate in organs like the liver. Excess vitamin A can cause dry skin and eyes, blurry vision, bone thinning, skin irritation, liver damage and other serious issues. In pregnant women, excess vitamin A can lead to birth defects. Patients with toxicity can receive supportive care like fluids for low blood pressure or moisturizers for dry skin and eyes, Motheral said. But more serious damage will need to be evaluated and given further management. 'Recovery for patients with acute toxicity can be rapid when the vitamin is discontinued,' she said. 'Chronic toxicity can affect bones, brain and of course the liver. … Sadly, some of the more serious problems with vitamin A toxicity are not always reversible.' The Council for Responsible Nutrition, a trade association for dietary supplement and functional food manufacturers, issued a statement Wednesday warning parents against using high doses of vitamin A to try to keep their children from getting measles. 'While vitamin A plays an important role in supporting overall immune function, research hasn't established its effectiveness in preventing measles infection. CRN is concerned about reports of high-dose vitamin A being used inappropriately, especially in children,' the statement says. Johnson said she has seen people who were taking vitamin A for measles treatment as well as for prevention. She doesn't know exactly where these patients heard that they should be taking a lot of vitamin A, she said, but the approach is heavily discussed on social media. 'It's coming out of the health and wellness … influencer industry that downplays the importance of vaccines and tries to promote various spectacular cures like ivermectin or hydroxychloroquine or vitamin A,' Hotez said. Ivermectin, a deworming medication, and hydroxychloroquine, an anti-malarial drug, were both incorrectly touted as treatments for the Covid-19 pandemic but resulted in many poison control reports and an estimated $200 million in unnecessary spending. Experts worry that the drug misinformation so rampant during Covid could mirror rhetoric about vitamin A for measles prevention. In his Fox News interview, Kennedy endorsed an unconventional treatment regimen for measles including a steroid, an antibiotic and cod liver oil, which is rich in vitamin A. He praised two West Texas doctors who he said were using this remedy on their patients and had seen 'almost miraculous and instantaneous recovery.' The antibiotic, clarithromycin, could be an attempt to prevent secondary bacterial infections like pneumonia, but evidence for that is limited. Budesonide is a steroid with a variety of uses, but it's not clear whether or how it might help someone with measles. The measles outbreak has now affected at least 379 people across Texas, New Mexico and Oklahoma. Kansas has reported 23 measles cases, and officials said Wednesday that they may also be linked to the outbreak.
CNN
27-03-2025
- Health
- CNN
Some measles patients in West Texas show signs of vitamin A toxicity, doctors say, raising concerns about misinformation
Doctors treating people hospitalized as part of a measles outbreak in Texas and New Mexico have also found themselves facing another problem: vitamin A toxicity. At Covenant Children's Hospital in Lubbock, near the outbreak's epicenter, several patients have been found to have abnormal liver function on routine lab tests, a probable sign that they've taken too much of the vitamin, according to Dr. Lara Johnson, pediatric hospitalist and chief medical officer for Covenant Health-Lubbock Service Area. The hospitalized children with the toxicity were all unvaccinated. US Health and Human Services Secretary Robert F. Kennedy has centered his response to the outbreak on vitamin A, even suggesting in a Fox News interview that it could work 'as a prophylaxis.' But overuse of vitamin A can have serious health consequences, and there is no evidence that it can prevent measles. The only way to prevent infection with the measles virus is through the measles-mumps-rubella (MMR) vaccine, which is 97% effective against measles after two doses. Kennedy has said that he does 'encourage' vaccination but that it is a 'personal choice.' 'If people have the mistaken impression that you have an either-or choice of MMR vaccine or vitamin A, you're going to get a lot of kids unnecessarily infected with measles. That's a problem, especially during an epidemic,' said Dr. Peter Hotez, co-director of the Texas Children's Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at the Baylor College of Medicine. 'And second, you have this unregulated medicine in terms of doses being given and potential toxicities.' In specific doses taken under the care of a physician, vitamin A can play a role in treatment for measles. That's why the World Health Organization and US Centers for Disease Control and Prevention recommend it in serious cases. But the patients who were reported to have toxicity were probably not taking the vitamin under the supervision of a physician, Johnson said. Vitamin A is most useful for measles support in people who have a specific deficiency, and studies suggesting its use mainly draw on evidence from low-income countries where that deficiency is common. The patients in West Texas are generally well-nourished, said Dr. Lesley Motheral, a pediatrician in Lubbock, so experts say it's unclear how beneficial the vitamin might be in this setting. Vitamin A has an important role in immunity and vision. It's fat-soluble, so when someone takes too much, it can accumulate in organs like the liver. Excess vitamin A can cause dry skin and eyes, blurry vision, bone thinning, skin irritation, liver damage and other serious issues. In pregnant women, excess vitamin A can lead to birth defects. Patients with toxicity can receive supportive care like fluids for low blood pressure or moisturizers for dry skin and eyes, Motheral said. But more serious damage will need to be evaluated and given further management. 'Recovery for patients with acute toxicity can be rapid when the vitamin is discontinued,' she said. 'Chronic toxicity can affect bones, brain and of course the liver. … Sadly, some of the more serious problems with vitamin A toxicity are not always reversible.' The Council for Responsible Nutrition, a trade association for dietary supplement and functional food manufacturers, issued a statement Wednesday warning parents against using high doses of vitamin A to try to keep their children from getting measles. 'While vitamin A plays an important role in supporting overall immune function, research hasn't established its effectiveness in preventing measles infection. CRN is concerned about reports of high-dose vitamin A being used inappropriately, especially in children,' the statement says. Johnson said she has seen people who were taking vitamin A for measles treatment as well as for prevention. She doesn't know exactly where these patients heard that they should be taking a lot of vitamin A, she said, but the approach is heavily discussed on social media. 'It's coming out of the health and wellness … influencer industry that downplays the importance of vaccines and tries to promote various spectacular cures like ivermectin or hydroxychloroquine or vitamin A,' Hotez said. Ivermectin, a deworming medication, and hydroxychloroquine, an anti-malarial drug, were both incorrectly touted as treatments for the Covid-19 pandemic but resulted in many poison control reports and an estimated $200 million in unnecessary spending. Experts worry that the drug misinformation so rampant during Covid could mirror rhetoric about vitamin A for measles prevention. In his Fox News interview, Kennedy endorsed an unconventional treatment regimen for measles including a steroid, an antibiotic and cod liver oil, which is rich in vitamin A. He praised two West Texas doctors who he said were using this remedy on their patients and had seen 'almost miraculous and instantaneous recovery.' The antibiotic, clarithromycin, could be an attempt to prevent secondary bacterial infections like pneumonia, but evidence for that is limited. Budesonide is a steroid with a variety of uses, but it's not clear whether or how it might help someone with measles. The measles outbreak has now affected at least 379 people across Texas, New Mexico and Oklahoma. Kansas has reported 23 measles cases, and officials said Wednesday that they may also be linked to the outbreak.
CBS News
03-03-2025
- Health
- CBS News
Your questions on measles, symptoms and the MMR vaccine, answered by experts
Measles is still making headlines in 2025, prompting questions about the life-threatening disease and how to prevent it. Here's what to know. Measles outbreak The largest measles outbreak so far this year has been in West Texas, where more than 140 people have been infected since late January. State and local health officials say the Texas outbreak is primarily affecting children and teenagers, nearly all of whom were unvaccinated. In late February, a child died of measles after being hospitalized in that outbreak. State and local health officials said the patient who died was an unvaccinated school-aged child, but did not release their name or other details. Measles cases have also been reported in a number of other states, including across the state line New Mexico, and in New Jersey, Georgia, California, Rhode Island, Kentucky and Alaska. How deadly is measles? Without vaccination, measles can be dangerous or even deadly. While most people's symptoms improve, 1 in 5 unvaccinated people who catch measles will be hospitalized, 1 out of every 1,000 will develop brain swelling that can lead to brain damage, and up to 3 of every 1,000 will die. The measles virus is airborne and extremely contagious. Before the first measles vaccine became available in the 1960s, almost everyone would catch it at some point during childhood, and between 400 and 500 Americans — mostly children — died every year from measles. Measles symptoms Symptoms typically begin about seven to 14 days after a person is exposed to the measles virus. The Centers for Disease Control and Prevention notes that the initial symptoms may appear similar to those of many other common viral illnesses, including: Fever Cough Runny nose Red eyes Another characteristic sign is a rash that begins to develop a few days later. A patient's fever may spike to 104 degrees Fahrenheit or higher, the CDC says. In some cases, serious complications can develop, including pneumonia or encephalitis, a swelling of the brain. Encephalitis may lead to convulsions and can cause deafness or leave a child with a lifelong intellectual disability, health officials warn. As many as 1 out of every 20 children with measles will develop pneumonia, which the CDC says is the most common cause of death from measles in young children. "The predominant issues that we talk about, and that have led patients to be admitted to the hospital, are those respiratory issues, and so that is a frequent cause of death," Dr. Lara Johnson, the chief medical officer at Covenant Children's Hospital in Lubbock, Texas, said at a news conference on Feb. 26. At the time, she said, the hospital had seen about 20 patients admitted with confirmed measles cases, including several who needed intensive care. "There are also neurological issues that can happen acutely — encephalitis, swelling of the brain, blindness, other issues along that line that can also be a part of acute measles," Johnson said. She added, "There are lots of childhood rashes and fevers, and as parents, we all know that our kids get these here and there. This is not that. This is a much more serious illness that has much greater risk of serious complications." Measles rash Several days after the first symptoms begin, characteristic tiny white spots develop inside the mouth, and a facial rash spreads to the rest of the body. On "CBS Mornings," Dr. Céline Gounder, CBS News medical contributor and editor-at-large for public health at KFF Health News, described the rash as a "flat, blotchy red rash." Why is there a measles outbreak? With safe, effective vaccines available, experts are pointing to lower vaccination rates as a reason why we're seeing these increasing cases. Health officials confirmed that nearly all of the patients in the Texas outbreak were unvaccinated. "It is troubling, because this was completely preventable," Dr. Amesh Adalja, an infectious disease physician and senior scholar at Johns Hopkins, recently told CBS News. "What we're seeing is, one of the places in Texas — it has the lowest vaccination rates, the highest school exemption rates from measles vaccination — having a measles outbreak, including hospitalizations of individuals who've been infected with measles." Measles vaccine While measles is one of the most contagious infectious diseases, doctors and public health officials say the vaccine is safe and highly effective. It is normally given in two doses as part of the combination measles-mumps-rubella (MMR) vaccine, which has been used for decades. But nationwide, at least 10 states have seen childhood vaccination rates decline, jeopardizing communities' herd immunity from widespread outbreaks. Like Texas, some Florida schools — such as an elementary school in Broward County last year — have seen measles outbreaks. The vaccination rate for Florida kindergartners has fallen to 88.1%, according to the CDC, the lowest in decades. Health and Human Services Secretary Robert F. Kennedy Jr., who has a history as a vaccine skeptic, voiced support for the measles vaccine in early March. Kennedy said he was "deeply concerned about the recent measles outbreak" in an opinion piece published by Fox News. "Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons," he wrote. When do you get the measles vaccine? The American Academy of Pediatrics recommends children get vaccinated with two doses of the MMR vaccine, with their first dose between the ages of 12 to 15 months. "That's after the antibodies you get from your mom, through the placenta and through breast milk, have faded away, so that the vaccine will actually work — so there's a logic to when we vaccinate," Gounder explained. Then the second dose is recommended at about 4 to 6 years of age. One dose is 93% effective against measles and the recommended two doses is 97% effective, research shows. The vaccine also protects against mumps and rubella, also known as German measles, which are caused by different viruses. Studies have also shown that the MMR vaccine, which was first introduced in 1971, may be given safely and effectively in combination with other vaccines. But according to recent KFF polling, about 17% of parents say they have skipped or delayed a vaccine dose for their children. "This is up from about 10% just two years ago. So we're really seeing a lot of exemptions [and] concerns about vaccination that are not warranted," Gounder said. How long does the measles vaccine last? For most people, the MMR vaccine will protect you for life, Gounder said. "If somebody is fully vaccinated against measles and has a normal immune system, they don't need to worry about measles," said Adalja. "You're not going to be at risk for contracting measles because the vaccine the vaccine is very, very effective." Who should get a measles booster? While most people have protection that lasts for life after getting vaccinated in early childhood, people born after 1957 but vaccinated before 1968 should consider a booster shot, Gounder said. "That group is unlikely to have robust immunity from infection, because at that point in time, they were using less effective vaccines," she said. There are also other people who could potentially benefit from getting a booster, she added, including those working in health care, overseas or in places where there is an active measles outbreak. If you're unsure if or when you were vaccinated against the measles, start by tracking down your vaccination records if possible, Gounder advised. But, if you can't find those records, there is "no harm in getting an extra dose," she said, adding that no blood test confirmation is needed. "That's actually what we would advise to do, as opposed to getting a blood test to see if there are antibodies — just get a booster if you're in doubt," she said.
Yahoo
01-03-2025
- Health
- Yahoo
What to know about vitamin A and the measles
More than one month into a major measles outbreak in western Texas that has sickened 146 people and killed one school-age child, the Centers for Disease Control and Prevention released its first public statement and it highlighted a therapy that has raised some eyebrows among infectious disease experts. 'Measles does not have a specific antiviral treatment,' read the statement, which was posted only on X on Thursday night. 'Supportive care, including vitamin A administration under the direction of a physician, may be appropriate.' Dr. Lara Johnson, a pediatrician and the chief medical officer at Covenant Children's Hospital in Lubbock, Texas, where measles patients from the current outbreak are being treated, didn't comment on whether the hospital is using vitamin A. 'We can't comment specifically about the care of our patients; however, our physicians have followed recommended treatment protocols for patients with measles,' Johnson said. Vitamin A is involved in many functions in the body including vision, growth and immunity. For years, it's been used for severe measles cases in children in developing countries, where vitamin deficiencies are common. In those cases, studies have found it can reduce complications and the risk of death, though it's not seen as a cure for the disease. It's also been recommended by the American Academy of Pediatrics and the World Health Organization in children hospitalized with measles. 'Virtually, all the studies have been done in resource-limited countries where it does seem to show a significant beneficial effect, and also in those countries, it's been shown that children with lower levels of vitamin A tend to have more severe measles,' said Dr. Camille Sabella, director of pediatric infectious diseases at Cleveland Clinic Children's, who added that he welcomed the CDC's support of vitamin A. Vitamin A is less commonly used for measles cases in the U.S., according to the National Foundation for Infectious Diseases. Doctors say one reason may be that most Americans have enough vitamin A in their diet. 'I think the big caveat of all of this is that there's a significantly higher rate of vitamin A deficiency in developing countries,' said Dr. Alexandra Yonts, infectious disease specialist at Children's National Hospital in Washington, D.C. 'So it is less clear whether there is any benefit in populations like in the U.S. and other developed countries.' Dr. Bernard Camins, medical director for infection prevention at the Mount Sinai Health System in New York, agrees that it's unclear if vitamin A would have the same benefits in the U.S. but says there's little harm in giving it at appropriate doses. 'I don't think that it's necessarily dangerous to give it, especially if you give it the right dose and if used in the right setting,' Camins said. 'It's just something doctors will prescribe if someone comes down with measles to help survive.' But, he added, vitamin A isn't effective for preventing measles. 'What I'm really worried about is what happened with Covid,' he said, when some people 'were just taking anti-parasitic agents or whatever, instead of the vaccine.' Getting that message wrong is a major concern of doctors. Anti-vaccine influencers and organizations, including new Health Secretary Robert F. Kennedy Jr., have for years rallied around vitamin A as protection against and treatment for measles. During outbreaks, anti-vaccine groups have organized drives to fundraise and send vitamin A to affected communities. 'There are examples of other outbreaks where that falsehood has spread through communities, the idea that vitamin A can be used as an alternative to MMR vaccination, and that is not the case,' said Dr. David Higgins, a pediatrician and preventive medicine specialist at the University of Colorado Anschutz Medical Campus. 'What I would have loved to see added in the CDC's statement is that vitamin A is never an alternative to MMR vaccination for measles prevention,' Higgins said. 'I think that clarity is really, really important.' Adding to the concern is that vitamin A is toxic at high levels. It's a fat-soluble vitamin, so it's stored in the body instead of released through urine. The more you take, the more it accumulates in organs like the liver. 'You actually can overdose and have toxicity for vitamin A,' Yonts said, adding that she would only use it in rare cases if she knows a patient is deficient or is severely ill and hospitalized. Pregnant women with measles who aren't taking a multivitamin may also benefit from the vitamin. The WHO, CDC and AAP all provide specific dosing recommendations for measles cases based on age and say it should only be given for two days. 'So that's why only using it in these extreme circumstances for a dose or two, and not doing what I'm afraid is going to happen in these communities, which is, 'Oh, well, we'll just go out there and start taking high doses of vitamin A every day to keep the measles away,'' Yonts said. 'This can actually result in negative outcomes and illness for those kids, because you do accumulate the vitamin in your body.' This article was originally published on
