Plague lab quarantine stirs pandemic fears; higher weight at dementia diagnosis tied to longer survival; young TikTok followers trust physician-influencers more than doctors — Morning Medical Update

Plague lab quarantine stirs pandemic fears

Russian officials cite pneumonia of unknown cause, and none of her contacts have shown symptoms.

A 28-year-old laboratory worker at the Irkutsk Anti-Plague Research Institute in Siberia died Oct. 2, and about 200 people who had contact with her were quarantined, Reuters reported. Russia's health watchdog, Rospotrebnadzor, said she had pneumonia of unknown origin and found no microorganisms linked to her work in her samples, though a governor in a neighboring region had earlier said she may have died of plague. Talk of a possible lab leak drew comparisons to COVID-19, but experts told The New York Times the risk would be limited even if plague were confirmed.

A World Health Organization spokesperson said Oct. 6 that all of her contacts have been identified and none have shown symptoms, rating the risk "moderate to low" for the Irkutsk area, "low" for the rest of Russia and "very low" for Europe. The State Department said it is monitoring the situation with the Centers for Disease Control and Prevention (CDC). According to the CDC, pneumonic plague is the only form that can spread between people, and the U.S. averages about seven human cases a year. Pneumonic plague is treatable with antibiotics, especially when started early.

Higher weight at dementia diagnosis tied to longer survival

The authors say weight may help predict survival, not that patients should gain it.

People who were overweight or obese when diagnosed with dementia had a lower risk of death than those at a normal weight, according to a study published Sept. 30 in the Journal of Alzheimer's Disease. Researchers used University of Michigan Health and Retirement Study data from 1998 through 2022 on 4,523 adults who developed dementia after enrolling. After adjusting for chronic conditions, smoking and demographics, mortality risk was 16% lower for those with a body mass index (BMI) of 25 to 29.9, 27% lower for a BMI of 30 to 34.9 and 22% lower for a BMI of 35 or higher.

The findings are observational. Because weight loss can begin up to a decade before diagnosis, the team tested for that and other sources of bias and found they did not explain the results. "This doesn't mean that patients with dementia should attempt to become overweight or obese," lead author Virginia Chang, an associate professor at NYU School of Global Public Health, said in a news release, adding that the findings support nutrition as a key factor in survival.

Young TikTok followers take physician-influencers at their word

Interviewees said the doctors they follow seem more helpful than their own.

None of 26 Generation Z TikTok users interviewed for a study in the Journal of Consumer Affairs had checked whether the physician-influencers they follow are licensed, relying instead on cues such as scrubs, stethoscopes and profile bios. Researchers at Virginia Commonwealth University and two other universities also analyzed 330 videos from 11 U.S. physicians with at least 100,000 followers each. Videos filmed in clinical settings drew more likes and views, and those featuring medical attire drew more comments.

Followers described the influencers as focused on prevention and their own physicians as more interested in repeat visits, and most did not see product mentions as advertising, even when the physician owned the product.

"What a physician-influencer recommends may carry more weight than what their own doctor tells them. That should give us pause," lead author Suzanne Makarem, Ph.D., said in a university news release. The qualitative findings do not establish cause. The authors noted that American Medical Association ethics guidance advises physicians to disclose financial interests when promoting products on social media.