A Second Vaccine against Pneumonia Recommended for Seniors

If you're over 65, there’s a new vaccine you should know about. But before I explain the vaccine, let me introduce you to the bacterium that the vaccine protects you from. The little blue ovals in the above picture are Streptococcus pneumoniae bacteria. You might have guessed by its name that S. pneumoniae is a leading cause of pneumonia, and you'd be right. Pneumonia is an infection of the lungs, usually manifested by fever, productive cough, and shortness of breath. Pn...

Sorting Out the Different Flu Vaccines

The best way to avoid the flu is spending the months from fall until spring in a solitary bunker, communicating with other people only electronically. The second best way is getting the flu vaccine. The Centers for Disease Control and Prevention (CDC) recommends the flu vaccine for everyone over 6 months who doesn't have a specific contraindication to it. Because of the increasing number of different flu vaccines that are now available, this post highlights the three most commonly used fl...

All Ashkenazi Jewish Women Should be Tested for BRCA

Mutations in two genes called BRCA1 and BRCA2 greatly increase the risk of breast and ovarian cancer. Last year I wrote about Angelina Jolie’s discovery that she carries a harmful BRCA1 mutation and her decision to have preventive double mastectomy. In the general population mutations in these genes are quite rare, but among Ashkenazi Jews these mutations are much more prevalent. One in 40 Ashkenazi Jews carries a mutat...

A Small Step Towards An Artificial Pancreas

Patients with type 1 diabetes (T1D) are forced to spend much of their time obsessing about their blood sugar and insulin doses. The state of the art in treatment of T1D is an insulin pump that delivers insulin and a continuous glucose monitor that displays the glucose level and sounds alarms for values that are too low or too high. (See here for a refresher on the differences between type 1 and type 2 diabetes.) Currently, p...

Nearing a Cure for Hepatitis C

In the contest to get a creative name, few pathogens have done worse than hepatitis C. In the 1970s there were two known viruses that caused hepatitis – liver inflammation. You might have already guessed that these two viruses were called hepatitis A and hepatitis B. It was known at that time that people sometimes developed hepatitis after blood transfusions and that the majority of those patients tested negative for hepatitis A and B. A new pathogen was hypothesized and called non-A-non-B h...

Return of the Spirochete


"Example is the school of mankind, and they will learn at no other." – Edmund Burke

Syphilis has been around at least since Europeans arrived in the Western Hemisphere. It’s a sexually transmitted disease caused by Treponema pallidum, a member of a group of corkscrew-shaped bacteria called spirochetes. Sometimes it causes no symptoms at all, but typically it initially causes a painless sore on the mouth or genitals. Later it can cause a rash. Untrea...

There Has Never Been a Better Time to Have Diabetes

The danger of diabetes is not only the immediate risk of very high blood sugar. Diabetes also has many dreaded long-term complications. (In this post I am referring to both type 1 and type 2 diabetes mellitus. For an explanation of the differences between these two very different diseases see the first half of this post.) Diabetes greatly increases the risk of stroke, heart attack, and amputation. In the US it is the leadin...

What We Don’t Know About Eating Fat

Most humans have spent most of human history nearly starving to death. So it’s no surprise that we spend a lot of time thinking about food. And it’s no surprise that food has acquired cultural, social, and religious significance in almost every society. Because food is so important, and because it’s nearly impossible for us not to ascribe powerful effects to anything important to us, every society imbues special health properties to various foods. From believing that some foods are aphrod...

The New Uncertainty about Mammograms

“I’d like to be tested for every kind of cancer.” All primary care doctors have heard this request. Our answer is an explanation that we can’t. Understanding this explanation is important before we get to the most recent study about mammograms. We don’t test for all kinds of cancers for an important reason. The outcome of most cancers don’t depend on when they are diagnosed. This may come as a surprise to many, since we’ve all heard the message of the importance of ear...