Mary-Margaret Fill, MD, MPH

Day 8 of no power. Called 211 yesterday morning (took >1h to get through bc of busy signals). Provided my information. Radio silence for 24h ... Is Airbnb actually providing housing? Or just saying they are?

Day 8 with no power. Two young kids (4 & 7), a sweet senior dog (10.5) and their grown ups (physicians serving VUMC & the State of TN) are desperate to get back home. It's a simple repair of a severed line between 2 NES poles. @wsmv.com @thetnholler.bsky.social @freddieoconnell.bsky.social

Child dies from rare measles-related complication, LA County health officials say Health officials reported the death of a Los Angeles County child from a complication of measles infection acquired during infancy.

I’m so sorry to see this news from Los Angeles 💔

Subacute sclerosing panencephalitis (SSPE) is a progressive, almost uniformly fatal, neurological disorder caused by reactivation of the measles virus or an inappropriate immune response to the measles infection.

abc7.com/post/child-d...

Inside the Chaos at the C.D.C. A former senior official and two current employees describe the turmoil at the agency under R.F.K., Jr.,’s stewardship.

"The vast majority of [state health department] communicable-diseases budgets are paid for with C.D.C. dollars". In fact, ~80% of CDC's budget goes directly out the door to state, tribal, local and territorial health departments. @newyorker.com

www.newyorker.com/news/the-led...

RFK Jr. fires entire CDC vaccine advisory panel Health Secretary Robert F. Kennedy Jr. ousted all 17 members of a panel that advises the CDC on the safety, efficacy and clinical needs of vaccines.

Health Secretary Robert F. Kennedy Jr. ousted all 17 members of a panel that advises the CDC on the safety, efficacy and clinical needs of vaccines.

"Never doubt that a small group of thoughtful committed individuals can change the world. In fact, it's the only thing that ever has."
(Margaret Mead)

As we kick off the CSTE 2025 Annual Conference, I am immensely grateful to serve among these incredible STLT public health leaders.

Immensely grateful to Dr. McDonald (@milbankfund.bsky.social) and many others lending their voices to this critically important conversation.

In a new blog, Milbank Memorial Fund’s Morgan McDonald highlights the challenges and dangers of the abrupt termination of $11 billion in federal funds that occurred on March 24 and the mass layoffs at US Department of Health and Human Services that followed. www.milbank.org/2025/04/pray...

CDC's cruise ship inspectors laid off amid bad year for outbreaks The steep cuts to the cruise ship inspection team baffled officials in the program, which is not paid for by taxpayer dollars.

The CDC's cruise ship inspectors have been laid off, as well as agency's head epidemiologist for investigating cruise ship outbreaks

That baffled health officials since this program is paid for by cruise ship fees, not taxpayer dollars

www.cbsnews.com/news/cdc-cru...

And a few of the *many* impacts at the state and local levels:
- Minnesota: www.health.state.mn.us/news/pressre...
- Chicago: www.cbsnews.com/chicago/news...
- Texas: www.texastribune.org/2025/03/26/t...
- New Mexico: www.cnn.com/2025/04/07/h...

CDC is pulling back $11B in Covid funding sent to health departments across the U.S. “Now that the pandemic is over, the grants and cooperative agreements are no longer necessary," federal health authorities wrote to funding recipients this week.

More information on initial 'rescission' / clawback: www.nbcnews.com/health/healt...

RFK Jr. says he's "not familiar" with all health program cuts in exclusive interview Health and Human Services Secretary Robert F. Kennedy Jr. addressed health program cuts and the measles vaccine in his first network TV interview since joining the Trump administration.

These comments from Secretary Kennedy are quite disappointing. The abrupt clawback of $11B in federal funds allocated to state & local HDs has had dramatic negative impacts on public health capacity nationwide. A more cohesive approach between DOGE & HHS would be beneficial.

www.com/news/rfk-jr-...

50 canceled vaccination clinics, and other local impact from HHS cuts "Mass layoffs is not how you make America healthier," city and county health officials say in reaction to large-scale dismissals of federal health workers.

50 canceled vaccination clinics, and other local impact from HHS cuts: ‘Mass layoffs is not how you make America healthier,’ city and county health officials say www.statnews.com/2025/04/01/h... via @statnews.com

The CDC Has Been Gutted Thousands of CDC employees who worked on things like preventing HIV and lead poisoning have been told they were subject to a reduction in force. Experts say people will die.

NEW: Thousands of CDC employees who worked on things like preventing HIV and lead poisoning have been told they were subject to a reduction in force. Experts say people will die.

Hearing from all corners of HHS this morning about a total bloodletting — firings of scientists, analysts and many more as delayed RIFs take effect.

Many folks didn’t see early AM email and showed up, only to be turned away when badges didn’t work. Was sent this photo of long lines at one HHS site.

HHS starts layoffs of thousands of workers across its agencies Layoff notices began arriving early Tuesday for thousands of employees of HHS and its subsidiary agencies, with as many 10,000 workers potentially expected to be hit by the cuts.

Employees of #HHS and its agencies who are being fired — RIF'd — started to receive termination notices today starting at 5 am. Big swaths of the #CDC appear to have been cut. Developing story.
www.statnews.com/2025/04/01/h...

CDC is pulling back $11B in Covid funding sent to health departments across the U.S. “Now that the pandemic is over, the grants and cooperative agreements are no longer necessary," federal health authorities wrote to funding recipients this week.

“Now that the pandemic is over, the grants and cooperative agreements are no longer necessary," federal health authorities wrote to funding recipients this week.

Why Calgary reversed its decision on fluoride after 10 years After a decade without fluoride, Calgary had seen enough. The city’s reversal offers a critical perspective for communities debating the future of water fluoridation.

A few resources / links with additional details:

1. pmc.ncbi.nlm.nih.gov/articles/PMC...
2. www.npr.org/2024/12/13/n...
3. calgaryherald.com/news/fluorid...
4. www.dentistryiq.com/dentistry/re...

In 2011, the city of Calgary took fluoride out of their water. Children developed a higher rate of cavities (+ req'd treatments, i.e. general anesthesia) than in other communities.

Calgary is now in the process of putting fluoride *back* into their water supply.

Let's learn from other communities.

Trump administration yanks CDC flu vaccine campaign As flu rages, the Trump administration has pulled the plug on a Centers for Disease Control and Prevention flu immunization campaign that targeted high-risk groups, including pregnant women.

As flu rages, the Trump administration has pulled the plug on a Centers for Disease Control and Prevention flu immunization campaign that targeted high-risk groups, including pregnant women.

Raw pet food is recalled and warnings issued in two states after cats die of bird flu Pet owners cautioned after tests confirm Highly Pathogenic Avian Influenza (HPAI) in two cats living in different households.

Some lots of raw pet food sold in two states are being recalled after two indoor cats became ill with bird flu earlier this month and were euthanized due to the severity of their illnesses. https://cbsn.ws/41xxzzH

BREAKING: At least 8 injured after Delta plane crash landed at Toronto Pearson International Airport - CP24

While reports are that the EIS program has been spared, many other brilliant, dedicated, experienced public health professionals were terminated yesterday.

Our country is healthiest when we have a strong public health enterprise (from the federal to local levels).

bsky.app/profile/alex...

I had the great privilege of serving in the EIS Class of 2015, responding to dozens of disease outbreaks and novel health threats.

The program is a crowned jewel of U.S. public health and a model for other countries.

Cutting this program does not, in any way, make our country healthier.

68 children have died of influenza this season.
And I've heard anecdotes that busy children's hospitals are at capacity with available ECMO circuits to support children critically ill with influenza.
The *vast* majority of these children are unvaccinated.

Trump administration to fire thousands at health agencies The Trump administration is set to eliminate thousands of federal health care jobs Friday, targeting employees across agencies who were hired in the past one to two years.

#Breaking - Trump administration to fire thousands at health agencies. Employees across agencies who were hired in the past one to two years are being targeted

Observational research in epidemic settings: a roadmap to reform Observational studies are critical tools in clinical research and public health response, but challenges arise in ensuring the data produced by these studies are scientifically robust and socially val...

I am SO THRILLED to finally present our new paper on reforming observational studies in epidemic settings, published in @bmj.com BMJ Global Health.

gh.bmj.com/cgi/content/...

#Episky #Epidemiology #clinicalresearch #observational #IDSky

USDA milk testing shows different strain of H5N1 bird flu in Nevada dairy herds The USDA said four Nevada dairy herds were infected with an H5N1 bird flu strain that has circulated in wild birds, making prospects for containment in cows appear dim.

So there's a new development in the bird flu situation -the bird genotype of the virus (D1.1), which has, in the current panzootic, been responsible for all of the severe cases of H5N1 in humans- has been detected in 4 dairy herds in Nevada. Here's what that could mean:🧵

USDA milk testing shows different strain of H5N1 bird flu in Nevada dairy herds The USDA said four Nevada dairy herds were infected with an H5N1 bird flu strain that has circulated in wild birds, making prospects for containment in cows appear dim.

4 dairy herds in Nevada recently diagnosed with #H5N1 #birdflu were infected with a different version of the virus than has been spreading in cows elsewhere. Evidence of a second (at a minimum) spillover points to the challenge of stopping spread, experts say. www.statnews.com/2025/02/05/u...

Flu spikes Influenza-like illness hits a second peak

If you feel like everyone is sick right now, you are right. Flu is doing something unusual - outpatient visits just hit 7.0%, surpassing January's peak. substack.com/home/post/p-...