On Tuesday evening, April 29, the Navigating the Medical System Lecture Series hosted a comprehensive virtual program on viral respiratory illnesses at Congregation Etz Chaim. Dr. Mel Breite, the Founder and Director of the Lecture Series, opened the event with a warm welcome. Reflecting on his medical school days, he noted that polio was the primary concern at the time.
Dr. Glenn S. Turett, an Infectious Disease Physician at NewYork-Presbyterian Queens, began by addressing the widespread misinformation surrounding viral illnesses. His presentation focused on influenza, Covid-19, RSV, and measles. He explained that the flu claims 35,000 to 70,000 lives annually in the United States, and can trigger heart attacks, strokes, and worsen underlying respiratory conditions. To prevent these outcomes, he strongly recommended annual flu vaccinations for everyone six months and older.
Dr. Turett emphasized that the elderly face the most severe flu outcomes. The current vaccine protects against both Influenza A and Influenza B, and he advised getting vaccinated in October or before Thanksgiving. Vaccinating too early can cause immunity to wane before the peak flu season, which typically occurs in January and February but can extend through May. For those 65 and older, he recommended the high-dose flu vaccine for better protection.
Dr. Turett then clarified key medical terms. An endemic disease occurs regularly within a specific community or area, such as TB or malaria in Africa. An epidemic is a widespread outbreak of an infectious disease in a community at a particular time. A pandemic happens when an epidemic spreads globally, affecting a large population. During a pandemic, the disease spreads rapidly across all age groups, often outside the typical flu season, with simultaneous outbreaks worldwide and a high mortality rate. The critical factor in a pandemic is the emergence of a new virus, leaving the population without immunity and making everyone vulnerable to infection.
He provided a historical overview of flu pandemics. In 1580, an H1N1 flu virus emerged. The deadliest pandemic on record, the Spanish Flu of 1918-1919, claimed 50 to 100 million lives worldwide. Subsequent pandemics included the Asian Flu (H2N2), the Hong Kong Flu in 1968 (H3N2), which caused one million deaths, and the 2009 Swine Flu (H1N1), which resulted in 284,000 deaths globally. All 20th-century pandemics originated from avian sources, meaning they stemmed from birds.
Turning to the present, Dr. Turett discussed the current H5N1 Avian Flu, commonly known as bird flu, which is not easily transmissible between humans. He noted that Covid-19 demonstrated that pandemics are not always influenza-based. The ongoing bird flu outbreak, which began in 2022, initially affected wild birds and poultry before spreading to cattle, pigs, zoo animals, and humans. He reported 162 million poultry, 972 dairy herds, 12,000 wild birds, and 69 human cases. Dr. Turett reassured that properly cooked beef and poultry, as well as pasteurized milk, pose no risk of transmitting the virus. However, there is concern about potential genetic mutations that could make the virus more transmissible and virulent in humans.
Regarding Covid-19, Dr. Turett shared that mortality and hospitalization rates continue to decline, with “long Covid” cases now at 3.5%. He recommended vaccination for everyone six months and older, advising older adults to complete a primary series followed by boosters. He highlighted available Covid-19 vaccines, including Moderna, Pfizer, and Novavax.
Dr. Turett then addressed RSV, which leads to the highest ICU admission rates among respiratory viruses and poses the greatest risk for requiring invasive mechanical devices. In May 2023, the first RSV vaccines were approved for individuals over 65 or those at risk for upper respiratory diseases. Initially, three vaccines were available, but now the RSV vaccine is a single shot with no neurological side effects.
He also discussed measles, a highly contagious respiratory viral illness. Symptoms include fever, malaise, cough, coryza, conjunctivitis, and a characteristic rash. While typically self-limiting, measles can lead to severe complications like pneumonia and encephalitis. Before the measles vaccine, the disease caused two million deaths annually worldwide. The vaccine, introduced in 1963, has saved 57 million lives. Since 1989, children receive two doses to enhance effectiveness. Those born before 1957 are presumed immune, having likely contracted measles. Since 1971, the MMR (measles, mumps, rubella) vaccine has been standard for children.
Dr. Turett noted that declining global vaccination rates have led to a resurgence of natural measles cases. As of April 11, 2025, 712 cases were reported across 19 US states. Individuals vaccinated between 1963 and 1967 should receive one dose of the current vaccine and can check their antibody levels to determine if a second dose is needed. The measles vaccine has minimal side effects.
Vaccines don’t always prevent infection, Dr. Turett explained, but they can reduce the severity of illness. For flu treatment, antiviral medications like Tamiflu are effective if administered within 24 hours of symptom onset; after three days, they offer no benefit.
He briefly mentioned that adults should receive tetanus shots every 10 years, typically combined with diphtheria and pertussis vaccines, which babies also receive.
The session concluded with a lively Q&A session, providing attendees with further insights.
Thank you, Dr. Breite and Congregation Etz Chaim, for these informative sessions.
By Susie Garber
