BK. Titanji
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boghuma.bsky.social
BK. Titanji
@boghuma.bsky.social
Physician Scientist MDPhD
Infectious Diseases
Academic Medicine
Global Health
Science Communicator
Posts are my opinions, not my employer's and not medical advice
I bet on myself and double down
https://substack.com/@bktitanji
Pinned
I think I shall just pin this post because ....👀
Here are 5 top things I'll be watching closely in global public health in 2025:

1. H5N1 outbreak trajectory
2. Impact of RFK Jr. on infectious dz control and vaccines in the US.
3. The mpox outbreak in Africa
4. Expanded access to Lenacapavir for HIV PrEP.
5. The US withdrawal from the WHO.
I never tire of seeing the amazing success of HPV vaccination. We are seeing the elimination of a leading oncogenic virus pathogen in real time
(Source: GAVI)
www.gavi.org/vaccineswork...
November 18, 2025 at 3:03 PM
It is scary how frequently we encounter these extremely multi-drug resistant gram(-) organisms in routine clinical practice these days. This Providencia isolate is resistant to everything we tested it against (including salvage drugs not shown)
Antimicrobial resistance is a very real threat.
November 17, 2025 at 11:54 PM
Because most weeks in 2025 have felt like a con.
November 17, 2025 at 3:46 AM
This video of a pregnant Black woman in labor being actively ignored by a triage nurse has made the rounds. The lack of empathy on display is a reality every Black woman has experienced in some form when dealing w the healthcare system. Nothing shields us from it.
www.instagram.com/reel/DRFwBfY...
Birgit Umaigba on Instagram: "If you need a real-life example of how Black women’s pain is dismissed, ignored and minimized, look no further. This is a classic example of anti-Black racism rooted in a...
A pregnant woman's harrowing experience at Dallas Regional Medical Center is a stark reminder of the systemic issues in our healthcare system. The mother, left unattended for over 30 minutes, delivers...
www.instagram.com
November 16, 2025 at 7:54 PM
The suspected outbreak of a hemorrhagic vial illness in Ethiopia has now been confirmed to Marburg Virus Disease. So far 9 cases have been identified in a part of the country that shares a border with Sudan.
apnews.com/article/ethi...
Ethiopia confirms first Marburg outbreak as WHO lauds country's fast action
Ethiopia has confirmed its first Marburg outbreak after nine cases were identified in the southern region of the country that borders South Sudan.
apnews.com
November 14, 2025 at 9:30 PM
Thanks for all the amazing questions. As always, I was challenged (thank God for pubmed), but it gives me a lot of joy to share info with you.
The thread is now officially closed but I'll do it again next month. You can review for cool questions and my answers.
It's that time again.
For the next 24 hours, drop any infectious disease and/or vaccine-related questions below in response to this post, and I will do my best to answer them. Responses are for information only and are NOT medical advice.
#AskAnIDDoc November 2025 edition.
a man is standing in a kitchen drinking from a cup and talking about flu season .
ALT: a man is standing in a kitchen drinking from a cup and talking about flu season .
media.tenor.com
November 14, 2025 at 1:48 PM
Let’s talk about why I am increasingly uneasy about the upcoming flu season. A new H3N2 influenza variant has been emerging globally, and it carries mutations linked to immune escape i.e the virus’s ability to bypass some of our pre-existing immunity. 🧵
utppublishing.com/doi/10.3138/...
Emergence of seasonal influenza A(H3N2) variants with immune escape potential warrants enhanced molecular and epidemiological surveillance for the 2025–2026 season | Journal of the Association of Medical Microbiology and Infectious Disease Canada
Background: All of the major antigenic changes in influenza A(H3N2) viruses since 1968 have involved mutations at just nine amino acid positions, called cluster transition sites, surrounding the receptor binding region of the hemagglutinin surface protein. During the northern hemisphere (NH) 2024–2025 influenza season, A(H3N2) variants emerged with multiple parallel substitutions affecting cluster transition sites 135, 145, 158 and/or 189, with implications for the 2025–2026 season. Methods: Using >24,000 global A(H3) sequences between September 2024 and August 2025, we assess the nature and frequency of amino acid mutations among emerging NH and southern hemisphere (SH) A(H3N2) variants relative to the 2024–2025 subclade J and updated 2025–2026 subclade J.2 vaccine reference strains. We contextualize based upon historic amino acid variation among >210,000 global A(H3) sequences since 1968 and publicly available antigenic characterization data relative to 2024–2025 and 2025–2026 vaccine reference strains Results: Virtually all circulating A(H3N2) viruses in 2024–2025 were subclade J.2. In Europe, about one-third had cluster transition site mutations, mostly T135A with S145N. In North America, more than two-thirds had cluster transition site mutations, including T135K or S145N, with late-season increase in doubly mutated J.2.3 (N158K + K189R) and J.2.5 (S145N + N158K) subclades. The SH 2025 season showed increase in J.2.3 and emergence of J.2.4 (T135K + K189R) including a further drifted J.2.4.1 variant with additional N158D and other mutations, recently renamed subclade K. A substantial proportion of J.2.3 and J.2.4 viruses are antigenically distinct from the 2025–2026 influenza vaccine. Conclusion: Influenza A(H3N2) variants with a combination of cluster transition site mutations emerged during the NH 2024–2025 season. A further drifted and vaccine-mismatched variant now called subclade K arose during the SH 2025 season and is projected to predominate among A(H3N2) viruses for the NH 2025–2026 season. While mismatched vaccines may still provide protection, enhanced genetic, antigenic and epidemiological (eg, vaccine effectiveness) monitoring are warranted to inform risk assessment and response.
utppublishing.com
November 14, 2025 at 12:02 PM
It's that time again.
For the next 24 hours, drop any infectious disease and/or vaccine-related questions below in response to this post, and I will do my best to answer them. Responses are for information only and are NOT medical advice.
#AskAnIDDoc November 2025 edition.
a man is standing in a kitchen drinking from a cup and talking about flu season .
ALT: a man is standing in a kitchen drinking from a cup and talking about flu season .
media.tenor.com
November 13, 2025 at 1:25 PM
Oh dear, a friend forwarded this piece to her co-worker who is planning an office potluck this week and they are now contemplating if it is wise to proceed 😂. She has shared the article to all who have signed up to bring foods .
I didn't mean to sow fear and chaos, just provide information.😊😅
It’s officially potluck season withoffice parties galore. 🦃🥘 If, like me, you harbor an irrational fear of food poisoning, I’ve got you covered. Here’s your ID doctor–approved guide to surviving the season’s buffets w/out ending up in the ER.
🧤🍽️💀
open.substack.com/pub/bktitanj...
An ID Doctor’s Guide to Surviving Holiday Potlucks Food Poisoning Free
Because nothing says “festive” like avoiding an impromptu Norovirus outbreak.
open.substack.com
November 11, 2025 at 8:59 PM
Really great article by Dr. Craig Spencer who bravely attended the CHD anti-vaxxer meeting last week. He makes the case for the need for pro-vaccine public health practitioners to peek behind the curtain to understand the movement in order to better counter it.
www.statnews.com/2025/11/11/c...
I’m a physician who went to the anti-vaccine movement’s biggest gathering. More of my colleagues should too
A pro-vaccine physician went to the anti-vaccine movement’s biggest gathering. He warns that public health must learn what it’s up against.
www.statnews.com
November 11, 2025 at 8:38 PM
Reposted by BK. Titanji
It’s officially potluck season withoffice parties galore. 🦃🥘 If, like me, you harbor an irrational fear of food poisoning, I’ve got you covered. Here’s your ID doctor–approved guide to surviving the season’s buffets w/out ending up in the ER.
🧤🍽️💀
open.substack.com/pub/bktitanj...
An ID Doctor’s Guide to Surviving Holiday Potlucks Food Poisoning Free
Because nothing says “festive” like avoiding an impromptu Norovirus outbreak.
open.substack.com
November 10, 2025 at 3:05 PM
Losing #measles elimination status as predicted is the result of vaccines being a victim of their incredible success. It quite sad that people will need to experience the suffering inflicted by an infection like measles in order to remember why elimination was remains something to strive for.
As expected, Canada has lost its measles-free status because of the long-running outbreak there. With it goes the #measles elimination status of the entire zone of the Americas, the only division of the #WHO to ever have achieved measles elimination. www.statnews.com/2025/11/10/m...
Canada loses measles elimination status — as does the entire Americas region
Canada has formally lost its measles elimination status, the country’s public health agency announced, triggering the loss of that status throughout all of the Americas.
www.statnews.com
November 10, 2025 at 10:02 PM
A bigot lost at the Supreme Court today. Cheers to love, equality, and every happily married gay couple. May the bigoted losers itch where they can’t scratch. 🌈
www.nbcnews.com/politics/sup...
Supreme Court rejects long-shot effort to overturn same-sex marriage ruling
The court turned away an appeal filed by Kim Davis, a former county clerk in Kentucky who was sued after refusing to issue a marriage license to a gay couple.
www.nbcnews.com
November 10, 2025 at 8:39 PM
It’s officially potluck season withoffice parties galore. 🦃🥘 If, like me, you harbor an irrational fear of food poisoning, I’ve got you covered. Here’s your ID doctor–approved guide to surviving the season’s buffets w/out ending up in the ER.
🧤🍽️💀
open.substack.com/pub/bktitanj...
An ID Doctor’s Guide to Surviving Holiday Potlucks Food Poisoning Free
Because nothing says “festive” like avoiding an impromptu Norovirus outbreak.
open.substack.com
November 10, 2025 at 3:05 PM
A fascinating new Lancet ID paper offers the strongest comparative evidence yet between infection-induced and vaccine-induced immunity against mpox. The study followed people for up to 2 years after infection with monkeypox virus or vaccination with MVA-BN. #IDsky
www.thelancet.com/journals/lan...
Long-term consequences of monkeypox virus infection or modified vaccinia virus Ankara vaccination in Belgium (MPX-COHORT and POQS-FU-PLUS): a 24-month prospective and retrospective cohort study
Individuals previously infected with MPXV show strong and durable immunological memory lasting up to 2 years after infection, in contrast to the less robust and shorter-lived response observed after M...
www.thelancet.com
November 9, 2025 at 1:15 PM
Not all heroes wear capes. What a brave and compassionate human being. The war in Sudan has killed 150,000 people and displaced 12 million. This orthopedic surgeon has not fled but continued to provide medical assistance under impossible conditions.
www.npr.org/sections/goa...
Doctor in Sudan wins $1 million prize for his extraordinary courage: 'It is my duty'
Dr. Jamal Eltaeb of Sudan has been awarded the Aurora Prize for Awakening Humanity. He says, "Every day we work in the impossible conditions with barely enough to keep people alive."
www.npr.org
November 9, 2025 at 10:00 AM
From winning the nobel prize for co-discovering the structure of DNA to becoming a pariah for his rank racist views towards Black people and overt sexism towards women. One can only hope before his death that he found time to reflect and change for better.
www.npr.org/2025/11/07/n...
James Watson, who co-discovered the structure of DNA, has died at age 97
James Watson, who co-discovered the structure of DNA has died at age 97. He was a scientific superstar until he made racist remarks that made him an outcast.
www.npr.org
November 8, 2025 at 2:16 AM
Elon Musk just secured a $1 trillion payout.
This same man helped dismantle USAID - an agency that cost ~$23 billion a year and saved millions of lives. Its collapse is projected to cause 14 million preventable deaths by 2030.
That is his real legacy.
www.bloomberg.com/news/article...
Tesla Shareholders Approve $1 Trillion Pay Package for Musk
Elon Musk responded in kind to Tesla Inc. investors approving his $1 trillion compensation package, making a series of extravagant predictions about what the company will be capable of in the years to...
www.bloomberg.com
November 7, 2025 at 12:29 PM
The travesty is complete.
The million dollar question is can he survive a 7 year term at the age of 92, and if he does will he run for a 9th term at 99?
Only time will tell if and when Cameroon will gain its liberation from authoritarian rule.
www.bbc.com/news/article...
Paul Biya sworn in for eighth term as Cameroon's president
Paul Biya has been in power since 1982 - the opposition says the election was rigged.
www.bbc.com
November 7, 2025 at 11:57 AM
I think I know what I am having for dinner tonight - A footlong sandwich from #subway 😋
November 6, 2025 at 9:44 PM
As reflected in the price of a dozen free range eggs being back to costing 10.99$
www.npr.org/sections/sho...
Bird flu surges among poultry amid a scaled back federal response
Migrating wild birds are spreading the virus to domesticated flocks, increasing the risk of eventually seeing a human outbreak. Scientists are troubled by the muted federal response.
www.npr.org
November 6, 2025 at 6:21 PM
If you read and watch one thing today it should be this pice accompanying @agawande.bsky.social documentary.
"As of November 5th, it estimated that U.S.A.I.D.’s dismantling has already caused the deaths of six hundred thousand people, two-thirds of them children."
www.newyorker.com/culture/the-...
The Shutdown of U.S.A.I.D. Has Already Killed Hundreds of Thousands
The short documentary “Rovina’s Choice” tells the story of what goes when aid goes.
www.newyorker.com
November 6, 2025 at 5:18 PM
The thing about being a woman and navigating the world, is that you are never safe from being sexually harassed by strangers even if you are a freaking head of state.
www.bbc.com/news/article...
Mexico president to seek charges after being groped on street
Claudia Sheinbaum says she is pressing charges because "a line must be drawn" against the harassment of Mexican women.
www.bbc.com
November 6, 2025 at 12:30 PM
A new NEJM study reports results from a phase 1 trial of a Lassa virus vaccine, a recombinant vesicular stomatitis virus vector engineered to express the Lassa glycoprotein (the same platform as the approved Ebola vaccine, ERVEBO). It was safe and immunogenic.
www.nejm.org/doi/full/10....
Safety and Immunogenicity of an rVSV Lassa Fever Vaccine Candidate | NEJM
No vaccine is currently available for Lassa fever, a viral hemorrhagic disease that is estimated to cause thousands of deaths each year in western Africa. A replication-competent recombinant vesicu...
www.nejm.org
November 6, 2025 at 12:12 PM
Word of the day!
November 5, 2025 at 11:20 AM