@dremilyrsmith.bsky.social
Associate Professor @GWPublicHealth. Epidemiologist. #GlobalHealth. I study infection & nutrition in pregnancy. Advocate for evidence. Alumna @HarvardChanSPH @EmoryRollins. Lover of coffee, crosswords, & cooking with friends.
Was reminded today of this chat about evidence and covid from April 2020, organized by @whaleactually.com, with @anecdatally.bsky.social @sarahwieten.bsky.social @dremilyrsmith.bsky.social and Althouse the traitor (😘). Feels like about 4 million years ago.
www.metacausal.com/2020/04/30/c...
Congress rejected massive cuts to US science budgets for 2026, but much of the money still isn’t flowing to researchers.
The culprit? The White House Office of Management and Budget (OMB) is quietly slow-walking the release of funds. 🧵👇
The full results of the STOMP trial are now published in @nejm.org
Tecovirimat did not shorten time to symptom resolution or impact symptoms of clade II mpox. The findings are similar to PALM007 trial which found no beneficial effects of the drug for clade I mpox
www.nejm.org/doi/full/10....
8 more children died from influenza complications last week, according to CDC's FluView report, bringing the total to 60 pediatric deaths so far this season. The agency keeps tabs on childhood deaths caused by the flu, but doesn't recommend flu shots as a way to prevent infection👇
As if Nipah virus weren’t bad enough, some patients in Asia were coinfected with an emerging bat virus called Pteropine orthoreovirus (PRV).
Symptoms of PRV include fever, disorientation, abnormal gait, and difficulty breathing.
PRV seems to have traits that increase likelihood of zoonosis.
Proud to be one of so very many people who had the chance to learn from Dr. Foege. I admire that he was often leading with a call to action, asking each of us how we can contribute to a healthier world. Rest in peace, Dr. Foege.
WHO removing Us Flag
I realize I should articulate a professional opinion about the new dietary guidelines (I will). And also there are even more important things happening in the US right now.
But I have to get this off my chest… IMO the new food pyramid is bad graphic design! It’s both unclear and ugly, right?
The CDC changed the universal vaccine schedule & no longer recommends
Rotavirus
Hepatitis A & B
Meningitis
Influenza
RSV
I’ve cared for previously healthy kids who died from RSV, influenza and meningitis.
We all are going to be caring for a lot more now.
In our already overflowing hospitals
RFK Jr's HHS had a press call to announce they were — based on no new data — overhauling the childhood vaccine schedule. Senior officials at HHS answered questions but refused to go on the record, saying we could only attribute the quotes to "officials." www.washingtonpost.com/health/2026/...
Atlantic: Rotavirus Could Come Roaring Back—Very Soon
By Katherine J. Wu @theatlantic.com
bit.ly/3YWlGAS
The Centers for Medicare and Medicaid Services (CMS), run by Oz and his boss, RFK Jr., will no longer require physicians to report vaccination rates.
Instead, they plan to start having doctors report if they’ve discussed “alternative” vaccine schedules.
Areas with ⬆️ numbers of exemptions to vaccine requirements 🔜 have more disease 🦠
Wrapping up the last few bits and bobs for friends and colleagues. T minus six hours until holiday break!
And note that about one in five adults in Guinea Bissau have Hep B infection, with more than 90% having been exposed acc to a national sero survey. Such a high burden context! Where the birth dose could prevent so many pediatric infections.
👋 Breastfeeding & infant feeding expert here! All babies need safe, accessible nutrition. Most people already want to breastfeed and 84% start out doing so but can’t realize their goals. What we need are *policies* that make it possible to breastfeed for all who desire to do so and…
The decision by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention to downgrade its recommendations to protect infants from hepatitis B is a dangerous move that will harm children.
Click here to read AAP's full statement: bit.ly/3Y9ZQJT
A perfect time to reshare a few of these key studies that highlight the importance of universal birth dose of the hepatitis B vaccine.
Multistate infant botulism outbreak adds 8 more cases, 23 total
All 23 cases involve hospitalization.
www.cidrap.umn.edu/b...
🚨Dept. of Education proposes to exclude public health degrees from the “professional degree” category.
That means new public health experts could lose access to key higher ed resources, like loan limits & reimbursement.
A bold strategy to let infectious diseases win! 🦠
aspph.org/department-o...
“So the plan is to have a plan — eventually.” @rollingstone.com with the healthcare and US policy analysis we need.
👉 Bottom line: Acetaminophen is safe when used as needed and remains the first-line choice for pain and fever in pregnancy.
5️⃣ Other data doesn’t support this argument. US Tylenol use over time has been very stable over the past decade (Mansour 2024). And the claim that there is a new epidemic of autism isn’t right either—broader diagnostic criteria, improved screening explain much of the increase—not new exposures.
4️⃣ Studying medicines in pregnancy is tricky. Many studies can’t fully separate effects of Tylenol from the illness it’s used for, often missing dose, timing, or over-the-counter use (Wood. 2020). That’s why some papers suggest a link—but after careful review—experts agree evidence is not conclusive.
3️⃣ Large studies show no link. A Swedish study of 2.5 million children found no association between acetaminophen in pregnancy and autism, ADHD, or intellectual disability once family and health factors were considered (Ahlqvist et al. JAMA 2024).
2️⃣ Untreated illness is risky. Fever in pregnancy can raise risks of miscarriage, preterm birth, and birth defects. Pain itself can worsen blood pressure, anxiety, and depression. Treating these is important for both mother and baby.
1️⃣ Professional guidelines are clear. SMFM, ACOG, and RCOG all continue to recommend acetaminophen as the first option for pain and fever during pregnancy.
There are ongoing claims that acetaminophen (Tylenol) use in pregnancy causes autism. Here’s five things you should know 🧵
Nearly 1 in 5 Urinary Tract Infections Linked to Contaminated Meat
New study finds people in underserved neighborhoods face the highest risk of foodborne infections
Primary source study posted in thread
Excellent thread on the paper out this week in Nature suggesting COVID mRNA vaccines may support the immune system in responding to cancer ⬇️