La clasificación de U.S. News, publicada este martes, se basa en los resultados clínicos por los pacientes, la experiencia del paciente, la capacidad para atender condiciones médicas complejas además de una amplia variedad de indicadores relacionados con la calidad de la atención.

Para los pacientes internacionales, este reconocimiento confirma que Cedars-Sinai cumple con los más altos estándares de excelencia clínica, investigación e innovación, lo que brinda a los pacientes internacionales la confianza de recibir atención médica de primer nivel en una institución reconocida mundialmente.

“Ser reconocidos entre los mejores hospitales de Estados Unidos durante 11 años consecutivos refleja nuestro constante compromiso de ofrecer una atención clínica de excelencia y acceso a investigación transformadora”, afirmó el Dr. Heitham Hassoun, director ejecutivo de Cedars-Sinai International. “Seguiremos acercando la innovación y la excelencia clínica de Cedars-Sinai a nuestros pacientes, dondequiera que se encuentren”.

Los hospitales que integran el Cuadro de Honor son seleccionados por U.S. News con base en su desempeño sobresaliente en múltiples especialidades, procedimientos y tratamientos.

Diez especialidades de Cedars-Sinai fueron reconocidas entre los mejores programas clínicos de Estados Unidos. Tres de ellas se ubicaron entre las cinco mejores del país:

• Cardiología, Cirugía Cardíaca y Vascular
• Gastroenterología y Cirugía Gastrointestinal
• Ortopedia

También fueron reconocidas entre las mejores de Estados Unidos las siguientes especialidades: Cáncer; Diabetes y Endocrinología; Geriatría; Neurología y Neurocirugía; Obstetricia y Ginecología; Neumología, Cirugía Pulmonar; y Urología.

“Estos excelentes resultados son un reconocimiento al compromiso de los profesionales de la salud que trabajan cada día para impulsar nuestra misión de sanar, descubrir, educar y servir a la comunidad”, señaló el Dr. Peter L. Slavin, presidente y director ejecutivo de Cedars-Sinai Medical Center y Cedars-Sinai Health System. “Nos guía el compromiso permanente de mejorar la salud de nuestros pacientes, tanto en Los Ángeles como en todo el mundo”.

Cedars-Sinai Medical Center has been named to the Honor Roll for the 11th consecutive year. It also tied for #1 in California and Los Angeles.

Cedars-Sinai Health System affiliates Torrance Memorial Medical Center and Huntington Health also earned high state and local rankings. Torrance Memorial Medical Center ranked #7 in California and #4 in Los Angeles, while Huntington Health was #10 in California and #5 in Los Angeles.

“These strong results are a credit to the dedicated healthcare professionals and staff who work every day to advance our four-part mission of healing, discovery, education and community service,” said Peter L. Slavin, MD, president and CEO of Cedars-Sinai Medical Center and Cedars-Sinai Health System.

The U.S. News rankings, released Tuesday, are based on patient outcomes, patient experience, ability to handle complex medical conditions and a variety of other health-related measures.

U.S. News identified the nation’s top 20 hospitals for the Honor Roll based on their high rankings and ratings in multiple specialties, procedures and conditions.

The publication also ranked the top hospitals by clinical specialties in the U.S.

Ten Cedars-Sinai Medical Center specialties were ranked among the best in the nation, including three that ranked in the top five:

• Cardiology, Heart & Vascular Surgery (#4)
• Gastroenterology & GI Surgery (#3)
• Orthopedics (#5)

In addition to the above specialties, Pulmonology & Lung Surgery (#9) was ranked in the top 10 nationally.

Three specialties also were #1 in California (highest U.S. News ranking in the region):

• Cardiology, Heart & Vascular Surgery
• Gastroenterology & GI Surgery
• Orthopedics

Those three were #1 in Los Angeles along with Obstetrics & Gynecology.

Three Cedars-Sinai Health System affiliate hospital specialties also ranked nationally:

• Torrance Memorial Medical Center Orthopedics (#27)
• Torrance Memorial Medical Center Obstetrics & Gynecology (#44)
• Huntington Health Obstetrics & Gynecology (#33-tie)

Cedars-Sinai Marina Hospital ranked as “High-Performing” in Common Adult Procedures and Conditions, including Back Surgery, Diabetes, Heart Failure, Hip Fracture, Hip Replacement and Pneumonia.

Slavin said the strong rankings reflect Cedars-Sinai’s patient-care philosophy, even during a time of profound change in the healthcare industry.

“We are driven by an enduring commitment to improve the health of patients in Los Angeles and across the globe,” he said. “That is our most important priority.”

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Aunque la poliomielitis prácticamente dejó de ser una preocupación de salud pública en Estados Unidos, donde fue eliminada hace más de cuatro décadas, cepas del virus que causa la enfermedad aún circulan en algunas regiones de Europa, Asia y África. Mientras tanto, en Estados Unidos se han reportado recientemente brotes de sarampión en Pensilvania, Virginia y Utah, elevando el total de casos registrados durante 2026 a más de 2,220, una cifra que ya supera la del año pasado, según los Centros para el Control y la Prevención de Enfermedades (CDC).

"Más que nada, es un buen recordatorio de que mantener las vacunas al día es fundamental para viajar de forma segura y proteger la salud", afirmó el Dr. Michael Ben-Aderet, director asociado de Epidemiología Hospitalaria de Cedars-Sinai.

El equipo de Cedars-Sinai Noticias conversó con Ben-Aderet sobre lo que los viajeros deben saber acerca de la poliomielitis y el sarampión, y cómo protegerse este verano.

¿Dónde sigue existiendo la poliomielitis?

La poliomielitis es causada por un virus altamente contagioso que ha sido prácticamente eliminado en la mayor parte del mundo gracias a la vacunación. Las cepas salvajes del virus aún persisten en unos pocos países, entre ellos Afganistán y Pakistán, por lo que el riesgo para la mayoría de los viajeros internacionales es relativamente bajo, especialmente si están vacunados.

En los últimos años, alrededor de 30 países de África, Europa y Asia, incluidos el Reino Unido y Alemania, han detectado indicios de circulación del virus. Sin embargo, esto no significa necesariamente que existan brotes activos. Por ejemplo, las autoridades sanitarias del Reino Unido han encontrado el virus en muestras de aguas residuales, lo que probablemente indica la presencia de casos asintomáticos.

¿Cómo se transmite la poliomielitis?

El poliovirus suele propagarse cuando una persona infectada no se lava las manos después de usar el baño y contamina el agua, los alimentos u otras superficies que luego tocan otras personas.

Por lo general, provoca una enfermedad leve de la que la mayoría de las personas se recupera rápidamente. Lo que históricamente hizo temible a la poliomielitis es que un pequeño porcentaje de las infecciones puede progresar a parálisis, generalmente en las piernas y los pies, cuando el virus invade el sistema nervioso.

Por ello, la vacunación es tan importante. En las poblaciones con altas tasas de inmunización, prácticamente ha eliminado ese riesgo.

¿Qué tan grande es el riesgo para los viajeros internacionales?

Casi todas las personas en Estados Unidos recibieron la serie de vacunas contra la poliomielitis durante la infancia. Para quienes ya están vacunados, el riesgo es mínimo.

Los adultos mayores preocupados porque su inmunidad pueda haber disminuido con los años deberían considerar recibir una dosis de refuerzo antes de viajar a regiones donde aún existe la posibilidad de transmisión del virus.

La vacuna contra la poliomielitis tiene pocos efectos secundarios, por lo que el beneficio de aplicársela supera ampliamente cualquier riesgo. Aunque la protección máxima se alcanza aproximadamente cuatro semanas después de la vacunación, la respuesta inmunitaria comienza a desarrollarse desde los primeros días.

¿Dónde representa un riesgo el sarampión?

En muchos sentidos, el sarampión representa un riesgo más inmediato para los viajeros de verano, especialmente en lugares concurridos o espacios cerrados.

Es mucho más contagioso que la poliomielitis, ya que se transmite por partículas suspendidas en el aire que una persona infectada expulsa al toser o estornudar. Estas partículas pueden permanecer en el ambiente hasta dos horas después de que la persona haya abandonado el lugar.

Recientemente se han identificado grupos de casos en partes de California, Texas y Oklahoma. Además, los brotes más importantes se han reportado en India, Bangladesh, Yemen, México y Pakistán.

"Los brotes de sarampión están ocurriendo en múltiples países alrededor del mundo. Aunque se puede intentar evitar los lugares donde se sabe que existen brotes, la probabilidad de entrar en contacto con una persona infectada ha aumentado a medida que disminuyen las tasas de vacunación, y nunca se sabe cuándo puede ocurrir una exposición", explicó Ben-Aderet.

¿Qué tan protegidas están las personas vacunadas?

La mayoría de las personas que completaron su esquema de vacunación están protegidas de por vida.

Los adultos que no estén seguros de haber recibido las dos dosis de la vacuna triple viral (MMR), que protege contra sarampión, paperas (parotiditis) y rubéola, deberían considerar aplicarse al menos una dosis. Los adultos con mayor riesgo pueden requerir dos dosis, administradas con un intervalo mínimo de 28 días.

En el caso de los niños, se recomienda administrar dos dosis: la primera entre los 12 y 15 meses de edad y la segunda entre los 4 y 6 años. Los bebés de 6 a 11 meses que viajarán al extranjero deben recibir una dosis antes del viaje y completar posteriormente las dos dosis recomendadas después de cumplir su primer año de vida.

Siempre es recomendable revisar el historial de vacunación y consultar con el médico de atención primaria o con una clínica especializada en medicina del viajero entre cuatro y seis semanas antes de un viaje internacional.

Lea más en Cedars-Sinai Stories and Insights: 8 Consejos de Expertos Para Evitar Enfermarse Cuando Viaja

Although polio has largely receded from public health concerns in the U.S., where it was eliminated more than four decades ago, strains of the virus that causes the disease still circulate in parts of Europe, Asia and Africa. At home, measles outbreaks have recently been reported in Pennsylvania, Virginia and Utah, pushing the total number of cases in the U.S. during 2026 to more than 2,220—already more than last year’s count, according to the Centers for Disease Control and Prevention.

“More than anything, it’s a good reminder that staying up to date on vaccinations is critical to staying safe and healthy while traveling,” said Michael Ben-Aderet, MD, associate director of Hospital Epidemiology at Cedars-Sinai.

The Cedars-Sinai Newsroom spoke with Ben-Aderet about what travelers should know about polio and measles and how to stay safe this summer.

Where does polio still exist?

Polio is caused by a highly contagious virus that has essentially been eliminated from most of the world through vaccination. Wild strains still persist in a handful of countries, including Afghanistan and Pakistan, which means the vast majority of international travelers are at relatively low risk, particularly if they’ve been vaccinated. In recent years, roughly 30 countries in Africa, Europe and Asia, including the U.K. and Germany, have shown signs of the virus circulating. However, those signs are not necessarily tied to outbreaks. For example, public health officials in the U.K. have detected the virus in wastewater tests, which likely points to some degree of asymptomatic polio.

How does polio spread?

The poliovirus typically spreads when an infected person doesn’t wash their hands after using the restroom and contaminates water, food or other surfaces that others touch. It usually causes a mild illness that most people recover from quickly. What makes polio historically frightening is that a small percentage of infections can progress to paralysis, typically affecting the legs and feet, when the virus invades the nervous system. That’s why vaccination is so important. It has essentially eliminated that fear in populations where immunization rates are high.

How big of a threat is polio to international travelers?

Almost everyone in the U.S. received the polio vaccination series as a child. For vaccinated travelers, the risk is minimal. For older adults concerned that their immunity may have waned over the years, a booster is worth considering before visiting regions where polio transmission remains a possibility. The polio vaccine has minimal side effects, so there is little harm in getting the vaccine. You won’t receive the full benefit of immunity until four weeks after vaccination, but you’ll start receiving some protection immediately.

Where is measles a concern?

Measles is, in many ways, a more immediate risk to summer travelers, especially in crowded or enclosed spaces. It’s far more contagious, spreading through airborne particles from an infected person’s cough or sneeze, and it can stay in the air for up to two hours after that person leaves.

Recent clusters have emerged in parts of California, Texas and Oklahoma, and the largest outbreaks have been reported in India, Bangladesh, Yemen, Mexico and Pakistan. Measles outbreaks are happening in multiple countries throughout the world. You could try to avoid known measles outbreaks as you travel, but the chance of encountering someone with measles has risen as fewer people get vaccinated, and you don’t know when you’ll be exposed.

How protected are those who have been vaccinated?

Most fully vaccinated individuals are well protected for life. Adults who are uncertain whether they ever received the two doses of the MMR vaccine, which protects against measles, mumps and rubella, should consider getting at least one dose. Adults at high risk should consider two doses at least 28 days apart. Children are recommended to receive two doses: one at 12 to 15 months and one at 4 to 6 years old. Babies 6 to11 months old should get one dose before they travel and two more doses after their first birthday.

It’s always a good idea to check your vaccination records and to consult your primary care provider or a travel medicine clinic four to six weeks before traveling abroad.

Read more from Cedars-Sinai Stories and Insights: 8 Expert Tips to Avoid Getting Sick When You Travel

“Si tiene mascotas que pasan tiempo al aire libre, es importante tomar medidas para prevenir las pulgas, como el uso de productos de control de pulgas”, dijo el Dr. Jonathan Grein, director de Epidemiología Hospitalaria y profesor asociado en el Departamento de Medicina de Cedars-Sinai. “El tifus no suele poner en peligro la vida, pero si no se trata, puede provocar una enfermedad grave”.

El tifus transmitido por pulgas, también conocido como tifus murino, es causado por la bacteria Rickettsia typhi y se transmite a los humanos por pulgas infectadas.

De acuerdo al Departamento de Salud Pública del Condado de Los Ángeles, se reportó una cifra récord de 220 casos en 2025, continuando una tendencia ascendente constante observada desde 2010. En Cedars-Sinai, varios pacientes requirieron hospitalización por tifus transmitido por pulgas el año pasado.

“Si bien los casos tienden a alcanzar su punto máximo a fines del verano y principios del otoño, la expansión de los hábitats de la vida silvestre urbana y el clima más cálido probablemente estén contribuyendo al aumento de la transmisión durante todo el año, por lo que queremos que la gente esté informada”, dijo Grein.

El Newsroom de Cedars-Sinai habló con Grein sobre cómo se propaga el tifus transmitido por pulgas, sus síntomas, el tratamiento y las formas de prevenir la infección.

¿Cómo se contagia la gente de tifus transmitido por pulgas?

El tifus transmitido por pulgas circula principalmente entre ratas, zarigüeyas y gatos callejeros. Las pulgas que se alimentan de estos animales pueden infectarse y luego transmitir la bacteria a los humanos a través de picaduras de pulgas y heces de pulgas, que ingresan al cuerpo a través de pequeñas heridas en la piel o cuando se frotan en los ojos.

Las mascotas que pasan tiempo al aire libre pueden llevar pulgas infectadas al hogar, lo que aumenta el riesgo de exposición humana. Debido a que muchas pulgas pueden alimentarse de un solo animal infectado, la enfermedad puede propagarse y crecer rápidamente dentro de las poblaciones de animales y pulgas, lo que hace que los brotes sean más probables entre los humanos.

¿Es contagioso el tifus transmitido por pulgas?

No. La enfermedad no se transmite de persona a persona; la transmisión ocurre solo a través de pulgas infectadas.

¿Cuáles son los síntomas?

Los síntomas suelen ser similares a los de la gripe y pueden incluir fiebre, dolor de cabeza y dolores musculares. A veces, las personas desarrollan una erupción en el torso o la espalda aproximadamente una o dos semanas después de que comienzan los síntomas. Si bien muchos casos se resuelven por sí solos en aproximadamente una semana, se recomienda el tratamiento porque algunas personas pueden desarrollar complicaciones que afectan el cerebro y otros órganos.

¿Qué tan grave es el tifus?

El tifus transmitido por pulgas generalmente no pone en peligro la vida y suele ser fácil de tratar. Sin embargo, las personas que están embarazadas o tienen un sistema inmunitario comprometido enfrentan un mayor riesgo de enfermedad grave.

¿Es el tifus lo mismo que la tifoidea?

El tifus a veces se confunde con la fiebre tifoidea. Aunque los dos tienen nombres similares y síntomas que se superponen, son causados por patógenos muy diferentes y no están relacionados.

¿Cuándo debe uno consultar a un médico?

Cualquier persona que haya estado expuesta a las pulgas y desarrolle fiebre persistente, dolor de cabeza intenso y dolores musculares dentro de una a dos semanas debe buscar atención médica. Se utiliza un simple análisis de sangre para diagnosticar el tifus, y el tratamiento temprano ayuda a prevenir complicaciones.

¿Cómo se trata?

El tratamiento generalmente consiste en el antibiótico doxiciclina durante aproximadamente una semana. La mayoría de los pacientes responden rápidamente y los síntomas desaparecen poco después de comenzar el tratamiento.

¿Cómo puede la gente prevenir el tifus transmitido por pulgas?

La prevención se centra en minimizar la exposición a las pulgas. Mantenga a las mascotas con control de pulgas durante todo el año, evite el contacto con animales salvajes o callejeros, y manténgalos alejados de las áreas donde las mascotas viven o comen. Asegurar los botes de basura y controlar las poblaciones de roedores alrededor del hogar también puede ayudar a reducir la propagación de pulgas entre los animales y, en última instancia, a los humanos.

Lea más en Historias y Perspectivas de Cedars-Sinai: Manténgase Saludable Mientras Llega el Clima de Playa

Cedars-Sinai has unveiled the largest artwork in its extensive collection, and it’s located on the façade of the new Cedars-Sinai Marina Hospital, now under construction in Marina del Rey. Measuring 120 feet wide and 16 feet tall, the mural is the only mosaic in Cedars-Sinai’s collection.

It is also a solution to an unusual challenge.

“The side of one of the support buildings to the main tower was going to have a big blank wall facing the community,” said John T. Lange, curator of the Cedars-Sinai Art Collection. “We saw an opportunity to engage the community with this mural.”

Lange said Cedars-Sinai put out a call to local artists to propose artwork that could fill the massive 1,900-square-foot space on the side of the new hospital’s energy center. The goal was to select a design that would resonate with those who live and work in the area.

Hospital leaders, staff and community members reviewed the submissions, ultimately selecting a vibrant sunburst reflecting off water, designed by artist Jay Yan, who has spent the past decade sailing in the harbor off Marina del Rey.

“My favorite part of the day is the return home when you see the sunset on the water and that beautiful kind of half-sun sinking into the ocean, making the sky this kind of magenta, pink, dark blue shade,” Yan said, while seated at his desk in the cavernous studio he shares with other artists. “There is something just so beautiful about those colors that a digital camera just cannot capture. I was very inspired by trying to create that in tile.”

Yan found further inspiration in the colorful mosaics lining the underground walkways between terminals at Los Angeles International Airport, just a few miles south of the hospital.

“They are just absolutely spectacular and an icon of Los Angeles,” Yan said, gesturing to a photo of one of the mosaics pinned behind his desk.

Building the Sky, Tile by Tile

To re-create the vivid hues of the Marina sky, Yan worked with Cerámica Súro, a ceramics studio and factory in Guadalajara, Mexico, renowned among artists, designers and architects for its custom work. Over five visits, Yan selected colors from the studio’s vast library, working with a pigment specialist to refine the palette. The factory mass-produced tens of thousands of rectangular and curved tiles, glazing them on a giant conveyor belt.

“Making this piece from glazed tile means that the brightness and beauty of the color will last for decades despite exposure to weather and the salty Marina air,” Yan said.

With the help of computer software, Yan created tile patterns within the mural that are never repeated, grouping the bouncing sunrays into jigsaw panels glued to a fine netting to simplify installation. To make the half sun, the artisans produced large, curved ceramic plates, cutting them into wide slices.

The factory hand packed the plates and panels into custom boxes, shipping them to Los Angeles, where a skilled crew laid out large swaths of the mural in a warehouse.  

Finally, the crew hauled boxes of tile onto scaffolding 30 feet high to install the jigsaw pieces and plates on the hospital’s energy center.

Honoring Hospital Staff

The finished mural gives commuters a brilliant welcome as they exit the 90 Freeway, heading west on Mindanao Way.  

“As the sun rises from the east, it will hit the sun motif on the right side of the façade,” Yan said. “As the day goes on transitioning toward evening, the sun will shine on the other end of the mural, where the color of the tile will match the night sky.”

Yan named the mural “Tlaquepaque” after the neighborhood in Mexico where the tiles were made, to honor all the people who have worked on the piece—the artisans who mixed the pigments by hand, the women who assembled all the tiny pieces and the Los Angeles crew who installed the tiles—all of whom are from Guadalajara.

“I wanted to honor their labor while also recognizing all the people who labor at the hospital,” Yan said.

Healing Power of Art

While the nine-story hospital has been under construction, staff members and physicians driving or walking by the site have texted photos of the progress to Joanne Laguna-Kennedy, MSN, RN, vice president of Hospital Operations and chief operating officer of Cedars-Sinai Marina Hospital.

“They are so excited, and this massive new mural is going to instill so much pride,” Laguna-Kennedy said. “They’re going to see this piece on the way into work and think, ‘That’s my hospital.’”

Laguna-Kennedy is also looking forward to the paintings, prints, photography and sculptures that will fill the hospital’s hallways, waiting areas and patient rooms.

“When I was a nursing leader at Cedars-Sinai Medical Center, I used to take patients for walks to the artworks because they were everywhere,” she said. “I'm so excited that we will have that same opportunity here at the Marina campus as well. There is just such a healing component to artwork, and we are really fortunate to have such incredible artists sharing their masterpieces with us.”

She also sees the art—and especially the mural—as symbols of Cedars-Sinai’s enduring commitment to the local community.

Yan hopes the bright sun and its chromatic rays provide comfort to patients and their loved ones.

“When we come to the hospital, it's typically not our happiest day,” he said. “I want to bring some joy to people as they enter, to relieve some of the tension they feel and some of their fears when they step through the hospital’s doors.”

Read more from Cedars-Sinai Stories and Insights: The Healing Powers of Art

“Parece ser una cepa más agresiva y un problema más grave”, afirmó el Dr. Sam Torbati, copresidente y director médico del Servicio de Emergencias de Cedars-Sinai, en referencia a la influenza de este año. “No recuerdo que el año pasado hubiera tantos pacientes tan enfermos”. 

Torbati advirtió que aún es muy pronto en la temporada de influenza 2026 de Los Ángeles, sobre todo porque en Estados Unidos la influenza suele comenzar en la costa este y extenderse hacia el oeste. 

“Puede empeorar mucho”, afirmó.

Noticias de Cedars-Sinai habló con Torbati para saber por qué los pacientes se están enfermando tanto, cómo tratar la influenza y cómo evitar una enfermedad grave.

¿Quién necesita atención de urgencia por la influenza?

Estamos atendiendo a muchos pacientes mayores que viven solos, y si nadie los cuida y se enferman, nadie los atiende. Pueden pasar dos días en cama, deshidratándose y poniéndose en peligro.

También hay muchos pacientes con enfermedades crónicas que contraen la influenza y, dos o tres días después, están agotados. Cuando acuden al hospital, a veces están deshidratados, a veces tienen una infección bacteriana y a veces es solo la gripe en sí.

La influenza, en sí misma, puede causar problemas importantes a los pacientes. Puede hacer que se enfermen gravemente, que se sientan tan mal que no puedan mantenerse en pie, que se deshidraten y que sea necesaria la hospitalización para que se recuperen.

¿Qué tan grave ha sido la temporada de gripe hasta ahora este año?

Alrededor de la segunda semana de diciembre, comenzamos a ver a muchos pacientes con influenza llegar al Departamento de Emergencias. Ese pico en la actividad de la influenza se observó de forma similar en todo el condado. Estamos viendo pacientes —muy jóvenes, muy mayores— a todos los que se ven afectados por la influenza.

Anticipamos, basándonos en algunas de las predicciones del hemisferio sur, que íbamos a tener una temporada de influenza moderadamente grave.

¿Cuáles son los síntomas más comunes de la influenza en este momento?

En la fase inicial, normalmente observamos fiebre, dolor corporal, dolor óseo, secreción nasal y tos. La fiebre suele durar entre dos a cinco días. La fiebre tiende a desaparecer, pero luego nos quedamos con muchos síntomas persistentes. Algunos pacientes tienen tos que persiste durante un tiempo. Otros pueden tener congestión que puede durar un tiempo. Pero la media es de entre siete y diez días. Por lo tanto, si alguien enferma, debe esperar que le lleve ese tiempo volver a la normalidad, hasta sentirse al 100 %.

¿Cuál es la mejor manera de tratar la influenza?

Si usted es joven y está sano y tiene una infección viral con síntomas similares a los de la gripe, básicamente debe cuidarse. Si tiene mucha tos, tome medicamentos para la tos. Si tiene fiebre, tome Tylenol o Motrin. Descanse, aíslese y beba mucho líquido para no deshidratarse.

Para los pacientes que tienen dificultad para respirar, asma o problemas respiratorios, o para los pacientes de edad avanzada que desarrollan síntomas más graves, puede ser importante acudir al médico, principalmente para asegurarse de que no haya complicaciones.

Para los pacientes que tienen enfermedades médicas subyacentes —insuficiencia cardíaca, EPOC (enfermedad pulmonar obstructiva crónica), asma grave y pacientes trasplantados— cuanto más complejos sean sus antecedentes médicos y cuanto más enfermos se sientan, mayor será la probabilidad de que un hospital pueda ayudarlos, y de que acudir a la sala de emergencias sea beneficioso. En algunos casos, recetamos un medicamento antiviral llamado Tamiflu para reducir el riesgo de una enfermedad más grave, siempre y cuando el tratamiento pueda iniciarse lo suficientemente temprano.

¿Cuál es la mejor manera de evitar una enfermedad grave por influenza?

No es demasiado tarde para vacunarse. Y aunque las vacunas no son perfectas, ya que no previenen completamente la influenza, hay pruebas suficientes que demuestran que pueden reducir la gravedad de los síntomas.

Lea más en Historias y Perspectivas de Cedars-Sinai: Cuándo ir al Departamento de Emergencias por la Gripe

“It seems to be a more aggressive strain, and it seems to be a tougher problem,” Sam Torbati, MD, co-chair and medical director of the Cedars-Sinai Emergency Department, said of this year’s flu. “Last year, I don't recall this many patients becoming this ill.”  

Torbati cautioned that it's still very early in Los Angeles’ 2026 flu season, particularly because in the U.S., the flu tends to start along the East Coast and spread westward.  

“It may get much worse,” he said.

The Cedars-Sinai Newsroom spoke with Torbati to learn why patients are getting so sick, how to treat the flu and how to avoid a serious illness.

Who needs emergency care for the flu?

We're seeing a lot of older patients who live by themselves, and if somebody is not keeping an eye on them and they become sick, then no one is taking care of them. They could be lying in bed for two days getting very dehydrated and getting into trouble.

There are also many patients with chronic diseases who develop the flu, and two or three days later they're wiped out. When they come to the hospital, sometimes they’re dehydrated, sometimes they have a bacterial infection and sometimes it's just the flu itself.

The flu, in and of itself, can cause significant problems for patients. It can make them very sick, can make them very much out of it to the point that they can't stand, become dehydrated, and hospitalization becomes necessary to get them back on their feet.

How bad is flu season so far this year?

Around the second week of December, we started seeing a lot of influenza patients coming to the Emergency Department. That spike in flu activity was similarly seen throughout the county. We're seeing patients—the very young, the very old—everybody that gets affected by flu.

We did anticipate, based on some of the predictions from the southern hemisphere, that we were going to see a moderately severe flu season.

What are the most common flu symptoms right now?

In the early phase, we typically see fever, body ache, bone pain, runny nose, cough. The fever usually lasts anywhere from two to five days. Fever tends to stop, and then we end up having a lot of the lingering symptoms. Some patients have coughs that linger for a while. Some can have congestion that can linger for a while. But the average is a good seven to 10 days. So people should expect if they get sick, that it may take that long until they're back to normal, to the point that they feel 100%.

What is the best way to treat the flu?

If you're healthy and younger and you have a viral infection with flu-like symptoms, you basically need to take care of yourself. If you're coughing a lot, take cough medication. If you have a fever, take Tylenol or Motrin. Rest, isolate, drink a lot of fluids so you don't get dehydrated.

For patients who have shortness of breath, asthma or respiratory issues—or for older patients who are developing more severe symptoms—a doctor's visit may become important primarily to make sure that there isn't any complication.

For patients who have underlying medical illnesses—heart failure, COPD (chronic obstructive pulmonary disease), severe asthma, and transplant patients—the sicker and more complicated their medical history is, and the sicker they feel, the more likely it is that a hospital would be helpful, and coming into the ER would be helpful. For some patients, we will prescribe an antiviral called Tamiflu to reduce the risk of a more serious illness if the medication can be started early enough.

What is the best way to avoid a serious flu illness?

It's still not too late to get a vaccine. And although the vaccines are not perfect—they don't completely prevent flu—there is ample evidence to show that they can reduce the severity of what flu does.

Cedars-Sinai Stories and Insights: When to Go to the ER for the Flu

Cedars-Sinai experts recommend getting the flu shot starting in September before flu season begins as early as November. They say vaccination is the most powerful tool to avoid influenza-related hospitalizations or worse. As many as 130,000 people in the U.S. died from the flu last year, according to estimates from the Centers for Disease Control and Prevention.

“By getting the flu shot, you’re not only protecting yourself, you’re protecting your family and vulnerable members of the community who would suffer a more serious illness,” said Jonathan Grein, MD, director of Hospital Epidemiology at Cedars-Sinai and associate professor in the Department of Medicine.

Although vaccination is the best way to prevent the flu, Grein also recommends washing hands thoroughly and often, avoiding others who are sick, and wearing a mask when not feeling well to avoid spreading an illness to others.

The Cedars-Sinai Newsroom spoke with Grein and other Cedars-Sinai specialists about this year’s flu shot recommendations, how to manage flu symptoms and where to seek care during a flu illness.

Who Should Get the Flu Shot?

There are no significant changes to flu shot recommendations this year, Grein said. The vaccine is still advised for eligible adults, teens and children more than 6 months old, according to the Centers for Disease Control and Prevention. Those 65 and older are still encouraged to get a high-dose flu vaccine if available because it elicits a stronger immune response, and older adults’ immune systems weaken with age.

“If a high-dose flu shot is not available, older individuals should receive a standard dose, rather than skipping the shot,” Grein said. “It’s critical for older adults to protect themselves.”

Children 6 months to 8 years old who have never received a flu vaccine should receive two doses, spaced four weeks apart, said Priya Soni, MD, a pediatric infectious disease specialist at Cedars-Sinai Guerin Children’s.

“Ideally, parents should vaccinate their children before the end of October to ensure protection before peak flu season,” Soni said.

Cedars-Sinai primary care physicians and pediatricians are now offering flu shots to patients during scheduled visits. Patients who have been treated by a Cedars-Sinai primary care provider in the past 16 months can schedule a vaccination appointment through My CS-Link at locations in Beverly Hills, Marina del Rey, Santa Monica, Los Feliz, Playa Vista and Tarzana.

How to Treat Flu Symptoms

Like other upper respiratory infections, flu symptoms include nasal congestion, fever, body aches, cough, sore throat and fatigue. Most people with mild symptoms will improve at home with fluids, a pain reliever such as Tylenol and rest, Grein said. Those at high risk of more serious infection—older adults, immune-compromised individuals and others with chronic health conditions—should speak with their physician soon after symptoms appear to find out whether an antiviral medication like Tamiflu would be right for them.

Those with more severe symptoms—a very high fever, loss of appetite or inability to keep fluids down—should see their physician or visit urgent care, said Jonathan Weiner, MD, chair of the Cedars-Sinai Medical Group’s Department of Primary Care and Acute Care Medicine.

Life-threatening symptoms like difficulty breathing should immediately be addressed in the nearest emergency department.

Flu Treatment for Children

Mild flu symptoms in children look similar to those of an adult and will likewise improve with fluids, rest, and Tylenol or ibuprofen, Soni said. She cautioned against giving children aspirin because of the risk of contracting Reye’s syndrome, a rare but serious illness linked to aspirin. Higher-risk children might need an antiviral treatment prescribed by a physician.

Soni explained that children 2 and younger run a high risk of dehydration, so their parents should make sure they drink and eat enough. She also advised parents to watch for signs that their child’s symptoms might be escalating.

“If a child is struggling to breathe, or showing signs of severe fatigue, vomiting or dehydration, they should be seen promptly by their physician or in the emergency department,” Soni said.

Where to Get Care for the Flu

For children and adults with milder symptoms, a virtual visit through a mobile app like Cedars-Sinai Connect is a great first step to get reassurance or guidance on the best treatment options, Weiner said.

“A physician or other provider can see you, assess how sick you appear and determine if you need to be seen in person or if you can manage your illness at home,” said Weiner, who treats patients in person and via Cedars-Sinai Connect. “If we determine that you need to see your Cedars-Sinai primary care physician or you need to go to urgent care for your symptoms, your provider will see the notes from your virtual visit in your chart because we all share the same Cedars-Sinai medical record.”

If a flu test is needed to rule out other illnesses or for a Tamiflu prescription, Cedars-Sinai Connect providers can order one through a streamlined visit at one of Cedars-Sinai’s urgent care locations. Patients also can get an over-the-counter test at their local pharmacy. Weiner said it’s good to know if you have the flu so you can avoid spreading the illness to others. People are contagious a day before symptoms start and up until their fever has resolved and symptoms are improving—as long as five to seven days after getting sick.

If symptoms do not improve, other causes of upper respiratory tract infections need to be ruled out, which could require in-person treatment, Weiner said. He emphasized that an in-person appointment also is recommended for patients with underlying conditions, high fever, trouble keeping food and liquids down, and for anyone who is having trouble breathing.

Read more on the Cedars-Sinai Blog: Flu and RSV: How to Protect Yourself Now

Published on Medicare's Care Compare website, the ratings of one to five stars provide patients with a reliable way to compare hospitals' quality and performance. The ratings are based on 46 quality measurements from five categories: mortality, safety, readmissions after treatment of common conditions, patient experience, and timely and effective care.

Of the 2,891 U.S. hospitals rated, around 10% earned five stars.

“These results are thanks to the ongoing collaboration of our staff members to ensure that Cedars-Sinai delivers the highest-quality care to our patients,” said Sharon Isonaka, MD, chief value officer and vice president of Clinical Efficiency and Value at Cedars-Sinai.

Cedars-Sinai earned this year’s rating in part by sustaining strong performance in mortality measures that track rates of patient survival 30 days after hospitalization for serious medical conditions such as heart attack. Since CMS began tracking this data, the academic medical center’s mortality rates have remained among the best in the U.S. for patients being treated for conditions including:

• Heart failure
• Chronic obstructive pulmonary disease (COPD)
• Stroke

Lower rates of hospital-associated infections at Cedars-Sinai also contributed to the medical center’s high score, thanks to focused efforts targeting the prevention of catheter-associated urinary tract infections.

Cedars-Sinai also reduced the need for readmissions after discharge from the hospital for serious conditions like heart failure. The medical center likewise achieved a low unplanned readmission rate across the entire hospital, which is better than the national average. These achievements are the result of a yearslong effort by Cedars-Sinai to help vulnerable older adults safely return home and to the care of their physician after a hospital stay, whether it be for a common surgery or a serious medical condition.

Older adults who are at highest risk for readmission receive phone calls from specialized nurses, pharmacists or case managers from Cedars-Sinai to check their status, answer questions and ensure that follow-up appointments are scheduled. Staff members also can facilitate a timely follow-up visit if the patient’s condition worsens. This additional support helps ease the transition, which can be challenging for older adults who might become confused about which drugs they’re supposed to be taking or might be concerned about new symptoms they’re developing as they heal.

Cedars-Sinai Marina del Rey Hospital earned a four-star hospital rating for the second year in a row, thanks to sustained improvements in safety and timely and effective care. The work that led to this achievement includes:

• A collaboration among Emergency Department staff to reduce patient wait times
• A coordinated effort to identify sepsis infections and quickly intervene
• Development of an education program and infrastructure for infection control, reducing hospital-associated infections by identifying and addressing the root causes

“I am so proud of the many nurses, physicians and operational staff members who have strengthened our focus on patient safety and quality of care, contributing to these impressive results,” said Joanne Laguna-Kennedy, MSN, RN, vice president of Hospital Operations and chief operating officer of Cedars-Sinai Marina del Rey Hospital. “Their dedication will be invaluable as we prepare to move into our new, state-of-the-art hospital next year and to care for patients with more complex needs.”

Read more on the Cedars-Sinai Blog: Why You Should Consider Magnet Recognition in Your Care

The medical center also tied for #1 in California and Los Angeles.

The U.S. News rankings, released Tuesday, are based on patient outcomes, patient experience, technology, ability to handle complex medical conditions and a variety of other health-related measures.

U.S. News selects the top-performing hospitals for the Honor Roll based on their high rankings and ratings in multiple specialties, procedures and conditions.

Cedars-Sinai had 11 specialties ranked nationally in the hospital rankings. The specialty rankings mean Cedars-Sinai is among the top 50 hospitals in the nation in these specific clinical areas.

Three Cedars-Sinai specialties were ranked in the top five nationally:

• Gastroenterology & GI Surgery (#2)
• Orthopedics (#5)
• Pulmonology & Lung Surgery (#5)

Six specialties were ranked in the top 10 nationally. In addition to the three above, the list includes:

• Cardiology, Heart & Vascular Surgery (#6)
• Diabetes & Endocrinology (#9)
• Obstetrics & Gynecology (#8, tied)

Three specialties also were #1 in California (highest U.S. News ranking in the region):  

• Cardiology, Heart & Vascular Surgery
• Gastroenterology & GI Surgery
• Orthopedics

One specialty was ranked #1 in Los Angeles only (highest U.S. News ranking in the region):

• Obstetrics & Gynecology

Additionally, Cedars-Sinai Marina del Rey Hospital has been recognized with six “High Performing” designations from U.S. News & World Report for 2025–2026. This honor reflects the hospital’s strong commitment to delivering exceptional care across key specialties and conditions.

Cedars-Sinai affiliates Torrance Memorial Health and Huntington Health also earned high state and local rankings. Torrance Memorial Health ranked #8 in California and #3 in Los Angeles, while Huntington Health was #10 in California and #5 in Los Angeles.

The California Rehabilitation Institute—a partnership of Cedars-Sinai, UCLA Health and Select Medical—was the #24 rehabilitation hospital in the country. U.S. News evaluated 1,049 rehab hospitals and ranked the top 50 for their care of patients recovering from events such as stroke, traumatic brain injuries and severe burns.

“At Cedars-Sinai, we are fortunate to have passionate, talented healthcare professionals who work tirelessly to meet the needs of our patients and the community,” said Peter L. Slavin, MD, president and CEO of Cedars-Sinai Health System and the David and Meredith Kaplan Presidential Chair. “Their dedication is the reason our clinical programs are ranked among the top in the nation.”

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

of the highly infectious virus hepatitis A, most adults might not be doing the one, simple thing that can help keep them safe from the virus—washing their hands.

“Many adults do not routinely wash their hands after visiting public places where they come in contact with a wide variety of germs from hundreds, if not thousands, of strangers, or even after using the bathroom,” said infectious disease specialist Soniya Gandhi, MD, MPH, associate chief medical officer and senior vice president of Medical Affairs at Cedars-Sinai Medical Center.

In fact, almost half of adults in the U.S. (48%) do not to wash their hands after visiting a grocery store, restaurant or even a hospital, according to a recent survey from the National Foundation for Infectious Diseases. Estimated rates of hand-washing worldwide after using the toilet are even lower—only 19%, according to the Centers for Disease Control and Prevention.

In addition to getting vaccinated—the best way to prevent hepatitis A, according to physicians—thoroughly washing hands with soap and water before eating or preparing food and after using the bathroom is a key way people can protect themselves from the virus. The Cedars-Sinai Newsroom spoke with Gandhi about how hepatitis A spreads and why good hand hygiene is a critical tool for avoiding the virus and a host of other infectious diseases.

How is hepatitis A transmitted?

Hepatitis occurs when the liver becomes inflamed, and it’s most often caused by one of three viruses: hepatitis A, B or C. Each of these viruses spreads in different ways. Hepatitis A is present in the stool and blood of infected individuals and typically spreads through person-to-person contact or by eating or drinking contaminated food or drink. Food can become contaminated with the virus at any point before it’s eaten—when it’s growing, harvested, prepared or served.  

Why is hepatitis A so infectious?

An infected person can spread the virus—even before they feel sick—by not washing their hands after using the toilet and then touching food that another person later eats. Exposure to even a small amount of the virus can cause an infection, and the virus can survive on surfaces for up to a few months. Not all infected individuals experience symptoms, though adults are more likely to have symptoms than children, and symptoms can take anywhere from two to seven weeks to develop.

What are the signs and symptoms of a hepatitis A infection?

Because the liver processes nutrients, filters the blood and fights infections, symptoms of an infection will be related to the organ struggling to perform those functions. Signs of a hepatitis A illness can include dark urine, pale stools and jaundice—a yellowing of the skin and whites of the eyes—as well as common flu-like symptoms: fever, fatigue, nausea, vomiting and diarrhea. Infections are usually mild, lasting a few weeks to several months. But symptoms sometimes can last up to six months. In rare cases, hepatitis A can cause liver failure and even death.

How can you avoid hepatitis A?

Get vaccinated against the virus and practice good hand hygiene. We all learned about hand-washing and the use of hand sanitizer as a tool for stopping the spread of infectious diseases during the COVID-19 pandemic. But it’s astonishing how many people don’t wash their hands! And make sure you do it thoroughly. If you’re using soap and water, scrub your hands and work up a lather to create friction, which will help eliminate viral particles from your skin. Scrub for at least 20 seconds and dry hands completely because wet hands can more easily transmit germs. If water and soap isn’t available, use a hand sanitizer with at least 60% alcohol concentration. Apply enough to completely cover your hands and rub them together until they’re dry.

What is causing the current outbreak in Los Angeles?

The Los Angeles County Public Health Department reported a spike in hepatitis A infections and high levels of virus in local wastewater, which they monitor for viral pathogens. Although hepatitis A normally spreads among unhoused individuals who don’t have regular access to toilets or hand-washing, and among travelers returning from parts of the world with poor sanitation, this outbreak in Los Angeles is different. It is widespread in the community, and it’s not clear why.

How long does the vaccine for hepatitis A last?

Everyone is encouraged to get the hepatitis A vaccine as a child. It’s a two-dose series starting at 12 through 23 months for the first dose and 2 through 4 years for the second dose. The vaccine has been shown to last up to 20 years. If you’re uncertain whether you’ve been immunized or whether you still have immunity, check your health records or ask your healthcare provider to check your antibody levels.

What is the treatment for a hepatitis A infection?

There is no known treatment for hepatitis A. With supportive care—rest, eating healthy, getting plenty of fluids—the virus usually clears on its own in weeks to months.

Read more on the Cedars-Sinai Blog: Do You Need a Measles Booster? 

The U.S. healthcare system continues to face significant challenges, including rising costs, workforce shortages, inefficiencies and the growing complexity of patient care. Cedars-Sinai is launching the Digital Innovation Platform to address these challenges by developing and scaling healthcare solutions that are clinically effective, operationally scalable and financially sustainable.

“Cedars-Sinai is uniquely positioned to develop new and innovative ways to fix some of the most pressing problems in healthcare today, thanks to our focus on translational medicine and our ability to bring together leading-edge clinical care, research, AI and strategic industry relationships to benefit our patients,” said Peter L. Slavin, MD, president and CEO of Cedars-Sinai and the David and Meredith Kaplan Presidential Chair. “This bold approach and unique ecosystem will allow us to address healthcare challenges on a deeper level and move faster by collaborating with key partners to develop innovations that have been shown to work in real-world, clinical environments.”

Cedars-Sinai will leverage the scalable innovation model created by Redesign Health, a venture builder that has successfully launched more than 60 healthcare companies in the past seven years. Together, they will develop a sustainable innovation center by tapping the resources and network of an academic healthcare system. With this new platform, they hope to nurture a digital innovation ecosystem in Los Angeles to improve the delivery of high-value healthcare.

The Digital Innovation Platform will source external talent—healthcare business strategists, engineers, data scientists and others—who will leverage Cedars-Sinai’s internal clinical expertise and emerging technology to develop and scale new digital health solutions that address critical needs within the healthcare system. Cedars-Sinai is striving to identify solutions for personalized medicine, specialty care access, hospital workflow optimization, clinical decision support, and increased coordination among patients, providers and payers.

Cedars-Sinai clinicians, researchers and staff members will have the opportunity to participate in a new, structured entrepreneurship program to identify challenges in their everyday work that could be addressed through the Digital Innovation Platform. The program will focus on fostering a culture of entrepreneurship among staff members while providing guidance and mentorship to help them better recognize digital innovation opportunities. The newly formed companies will likewise benefit from the clinical expertise of Cedars-Sinai’s staff.

The Digital Innovation Platform will source experienced founders to lead the new companies, and Cedars-Sinai will be their first large-scale customer to validate solutions. Founders will gain access to an integrated data platform Cedars-Sinai is developing that uses deidentified, secure and synthetic data—artificial data that mimics real-world patterns. This enterprise tool will provide access to large, diverse datasets supplying critical infrastructure and insights. The data will facilitate the use of AI and other emerging technologies during the design of digital solutions while supporting development at every stage of company growth.

Founders will fine tune these digital solutions in a variety of real-world clinical settings at Cedars-Sinai, benefitting from the organization’s large network of providers, sites of care and strategic partnerships.

“We’re pleased to partner with Cedars-Sinai to launch transformative healthcare companies, combining our experience launching healthcare companies with their exceptional clinical expertise and longstanding dedication to driving innovation in healthcare,” said Brett Shaheen, founder and CEO of Redesign Health. “By harnessing Cedars-Sinai’s groundbreaking medical research, expansive provider network and clinical insights, we’re uniquely positioned to develop transformative businesses that not only address unmet needs but also shape the future of healthcare on a global scale.”

The partnership will lay the foundation for a sustainable model that brings together ideas, funding and clinical expertise to address some of healthcare’s most critical challenges through digital innovation.

“With the Digital Innovation Platform, we hope to catalyze a broader healthcare innovation ecosystem in Los Angeles—connecting universities, entrepreneurs, investors and other healthcare leaders to foster a thriving hub for digital health innovation,” Slavin said.

Read more on the Newsroom: AI Enhances Scoliosis Monitoring for Pediatric Patients

Officials from the Los Angeles County Department of Public Health reported that several cats tested positive for the bird flu, also called H5N1, after drinking raw milk. Shortly after, the officials reported the first confirmed local case of the illness in a human.

But how much of a threat does the bird flu actually pose to humans?

“This is not yet a threat to everyday people who are not in close contact with affected animals, such as dairy cattle, poultry and wild birds, and we have not seen any human-to-human transmission of the virus,” said Jonathan Grein, MD, director of Hospital Epidemiology at Cedars-Sinai and head of the medical center’s Special Pathogens Response Team, which can test for bird flu and treat the most severe cases.

Though most human cases of H5N1 in the U.S. have been mild since the virus first appeared in 1997, Grein cautioned that the bird flu can be severe and is still evolving.

“We’re concerned that this virus now spreads more readily across mammals—cattle in particular—and as this virus mutates and adapts, it has the potential to spread even more easily,” he said. “We must remain vigilant.”

The Cedars-Sinai Newsroom asked Grein what everyone should know about bird flu, including how to treat it and how to avoid getting sick.

How is bird flu different from seasonal flu?

They’re both from the same family of influenza viruses, but H5N1 binds to different cell receptors. They both cause similar symptoms—fever, sore throat, cough, muscle aches—but conjunctivitis appears to be more common with H5N1 patients who have had close contact with dairy cattle. Both viruses can cause mild illness or more severe forms like pneumonia, but these viruses behave differently. The flu generally follows more established seasonal patterns, whereas H5N1 is more unpredictable. We largely use the same antiviral—Tamiflu—to treat H5N1 as we do to treat seasonal influenza.

How can I know which type of flu I have?

There is no way to determine which virus you’ve contracted unless you get tested. As seasonal flu activity picks up, it will be really important to understand which virus you have. From a public health perspective, we need to understand what’s happening in the community. On a personal level, you’ll want to keep those around you safe, especially if you’ve contracted something beyond the typical seasonal flu.

Will my flu shot also protect me from H5N1?

The flu shot is our most powerful tool to protect yourself and those around you from seasonal influenza. But it likely does not confer protection against bird flu. Vaccines have been developed for H5N1, but they’re not widely available at this time, although some have been stored in a strategic national stockpile to be deployed in an emergency. Drugmakers are developing additional vaccines, and their development process would likely pick up if we began seeing H5N1 spread between humans.

How can I avoid bird flu?

Nearly all cases in humans have been in people who had close contact with dairy cattle, poultry or wild birds. Individuals who must be in contact with these animals should avoid cattle and birds if they appear sick. Also avoid drinking raw milk, which the virus can easily infect.

Read more from the Cedars-Sinai Blog: Flu and RSV—How to Protect Yourself Now

“The holidays can be incredibly hard, and they can highlight who and what we don't have in our lives at the moment,” said Cedars-Sinai Marina del Rey Hospital Chaplain Rev. Hannah M. Rhiza, MA, MDiv. “It's important to recognize that for each person on a journey through grief or sadness, there is no right or wrong way to engage with the festive season.”

Rhiza, who normally helps the hospital staff celebrate Christmas, Hanukkah and Kwanzaa with a festive spiritual care cart, added a new tradition this year: She hosted a “blue holiday” event for employees, complete with rock painting and ornament making while soothing music played in the background. Employees painted smooth rocks with words of encouragement or threaded colorful ribbons marked with feelings—like anger, love, fear—into clear ornaments. Participants loaded up on hot cocoa with tiny marshmallows and whipped cream while they snacked on cookies.

“It doesn’t have to be the typical holiday cheer,” Rhiza told her colleagues.

Letting go of what the holidays should look and feel like can be liberating, said Cedars-Sinai Medical Center Chaplain Rev. Peggy Kelley. People often compare their holiday experiences to others’, which can make them feel they’re missing out on the connections and love that might seem so abundant for others. “I encourage making space for self-compassion during a time that can feel dark,” Kelley said.

Cedars-Sinai Newsroom spoke with Rhiza about advice for coping during a “blue holiday” and how to support a loved one experiencing loss or sadness during the festive season.

What would you recommend for people coping with grief or sadness over the holidays?

Rhiza: Set realistic expectations for yourself this year. Acknowledge that it may look very different than the holiday seasons of the past. I encourage everybody to feel all the feelings. I think when people try to deny what they're feeling and what they're going through—grief or feeling blue during a season where it seems like everybody around you is festive—that can make things a lot harder. Surround yourself with people who you don't have to explain yourself to and ones that will be supportive.

What are tips for navigating holiday parties?

Rhiza: I recommend getting in contact with the host early. Find out the very last moment you can actually cancel your decision to go. With the best of intentions you may have accepted the offer to attend a party, but when the day comes, it might be an incredibly hard time for you. Or Plan B: Attend the party but can you bring a supportive friend with you to be a source of support for the night? And lastly, the time frame. You don't have to stay there the whole night. If you can possibly make an appearance and keep it at that, that might be just what you need to go. 

What kinds of self-care do you recommend?

Rhiza: I always lean toward comfort and creativity. Things like hot chocolate or pastries that remind you of the way that you had celebrated the holidays before, or something that is a source of comfort for you. Rock painting is a wonderful tool as well, to have that one little moment where you're not thinking of where you are right now, but you're able to focus on what is in front of you. Seek out solutions and resources that work for you from trusted sources. I find a lot of inspiration online from public health experts and organizations like the National Alliance on Mental Illness and the National Institute of Mental Health.

How can you support a loved one who’s grieving?

Rhiza: Be present. I don't think that there is enough credit or weight that's held on that, but it's incredibly powerful to be present, to listen, and to see your loved ones exactly where they are, meeting them where they are without judgment. Make sure they are taking care of themselves, and encourage self-care.

Read more on the Cedars-Sinai Blog: Social Anxiety—How to Navigate the Holiday Season

“It’s not just sniffles or cold-like symptoms. It can turn into pneumonia or an even more severe illness for older adults that can lead to hospitalization and, unfortunately, sometimes their demise,” said Leslie Ramirez, MD, a physician with Cedars-Sinai’s Senior Advantage program, which specializes in caring for medically complex Medicare Advantage patients 65 and older.

Because the body’s immune system weakens with age, Ramirez said, viruses like influenza can cause more serious illness in older adults. Once hospitalized, they’re at even higher risk for developing bedsores and skin infections from lack of movement. And unlike younger people whose condition rapidly improves once an illness passes, it can take weeks for older adults to regain their strength.

“If they’ve been in the hospital for a while, when they return home, they can struggle getting in and out of bed, getting to the bathroom or sitting down and standing up,” Ramirez said. “It complicates their care and increases the burden on the family members trying to help them.”

The Cedars-Sinai Newsroom talked with Ramirez about the most effective ways to help older adults avoid a hospital stay altogether.

What can cause an older adult with the flu to need hospital care?

The flu can trigger a huge inflammatory response in the lungs of older adults who may not be able to continue breathing on their own. They might need supplemental oxygen and fluids because we tend to eat and drink less when we’re ill. Dehydration can be very harmful in older patients, causing their blood pressure to drop, as well as respiratory distress.

Older adults also are more likely to have multiple chronic health issues—heart, lung and kidney conditions—and an influenza infection can make all of those worse.

If an older adult gets the flu, how can they avoid a severe illness?

They should contact their provider as soon as they experience flu-like symptoms—fever, chills, body aches, maybe a sore throat or diarrhea—or get tested for the flu at a nearby urgent care. With a confirmed diagnosis, patients might be eligible for Tamiflu, an antiviral treatment that can help shorten the length of illness and decrease severity. But the medication must be started within five days of symptom onset.

It's also important to rest and drink plenty of water. Chicken noodle soup or broth also can help with hydration. Acetaminophen can help reduce a fever, ibuprofen can ease body aches and over-the-counter cough suppressants can help ease a cough. But always check with a provider before taking a new drug to ensure it won’t interact with your current medications or chronic conditions.

Do you have any advice for caregivers or loved ones of older adults?

It’s important to identify flu symptoms early—a fever above 100.4 degrees, chills, fatigue, body aches, an itchy throat. If you notice that an older loved one with the flu is starting to become more lethargic, very weak or confused—they don’t know where they are or who they are, and they’re usually very aware of their surroundings—those are big flags that the severity of their illness is increasing. Take them to the emergency department or call their provider immediately.

If they start complaining that they haven’t gone to the restroom as much as they normally do, that could be a sign they’re not drinking enough, or their kidneys aren’t functioning well. If their cough worsens and they’re having difficulty breathing or they’re short of breath or they can’t walk to the bathroom—those are all red flags.

How can older adults avoid the flu?

Wash your hands, especially if you’re going to be eating or you’ve been in an environment that might not be clean. You might want to avoid crowded places like giant sporting events during flu season. I’m not advocating that people skip important life events like a wedding or gathering with family, but take precautions, such as masking or keeping your distance. Some people still choose not to shake hands.

And, of course, get the flu shot. The flu vaccine is available at local pharmacies and in our clinic at Cedars-Sinai. For those 65 and older, there is a high-dose flu shot because their immune system isn’t as reactive as it used to be, and they need a stronger dose to mount a successful immune response. Younger family members also should consider getting vaccinated to reduce their risk of contracting influenza and passing it on to their older relatives. But remember, it takes two weeks to become fully protected. Keep that in mind if you want to time your flu shot ahead of Thanksgiving, the holidays or major travel.

Read more on the Cedars-Sinai Blog: Care Coordination for the Sandwich Generation

Antibiotics are often prescribed for patients experiencing a respiratory illness. But when tests reveal that a virus—such as influenza—is causing the illness, antibiotics should be stopped, Cedars-Sinai investigators say. That’s because antibiotics are not meant to treat a viral illness; they are only effective against bacterial infections.

Some flu patients continue taking antibiotics out of concern that they will also develop a bacterial pneumonia—a common “secondary” infection often seen in vulnerable patients with influenza and a leading cause of death in flu patients.

A team of investigators led by Cedars-Sinai found that when influenza patients take antibiotics, the drugs disturb the gut’s fungal microbiome. This results in an increase in immune cells called eosinophils in the lungs that hinder the function of alveolar macrophages—important immune cells that clear out pathogens from the lungs.

This chain of events actually makes it more likely that a flu patient taking antibiotics will develop a bacterial pneumonia rather than avoid one. The investigators also showed that increased levels of eosinophils are associated with poor clinical outcomes and more systemic inflammation. The results of the experimental study were published in The Journal of Clinical Investigation. 

“We need to be aware that antibiotics are not innocuous and can have harmful side effects,” said the study’s corresponding author, Peter Chen, MD, the Medallion Chair in Molecular Medicine and the interim chair of the Department of Medicine at Cedars-Sinai. “To be clear: When a flu patient has a confirmed bacterial infection, you definitely need to prescribe antibiotics. But when there is no direct evidence of such an infection, antibiotics should not be prescribed because they will not help, and could, in fact, be harmful.”

To conduct the study, investigators examined laboratory mice that had been infected with influenza followed by a bacterial infection caused by MRSA (methicillin-resistant Staphylococcus aureus), one of the most common causes of a secondary bacterial pneumonia. One group of mice received antibiotics prior to the onset of a bacterial infection; the control group did not receive any medication.

Compared with the control group, those treated with antibiotics experienced greater weight loss and showed evidence of greater lung damage after MRSA infection. The mice that were given antibiotics also had higher levels of MRSA bacteria in their lungs and higher levels of immune cells (macrophages and eosinophils). In other words, this data suggests that antibiotic treatment during an influenza infection actually impaired the body’s efforts to clear the MRSA bacteria rather than helping the body heal.

The investigators also evaluated a cohort of influenza patients at Cedars-Sinai and critically ill patients at Northwestern University and the University of Pittsburgh. They found that eosinophils increase with antibiotic use and are associated with a higher length of stay and systemic inflammation.

“Altogether, this research demonstrates that prescribing antibiotics during influenza infections may do more harm than good. This research also sheds light on the role that eosinophils play in regulating lung immunity,” said co-author David Underhill, PhD, chair of the Department of Biomedical Sciences and the Janis and William Wetsman Family Chair in Inflammatory Bowel Disease. “These results also support clinical trials using eosinophil-depleting strategies as a therapy to improve outcomes in patients admitted with influenza and other viral illnesses.”

Additional authors include Marilia Sanches Santos Rizzo Zuttion, Tanyalak Parimon, Stephanie A. Bora, Changfu Yao, Katherine Lagree, Catherine A. Gao, Richard G. Wunderink, Georgios D. Kitsios, Alison Morris, Yingze Zhang, Bryan J. McVerry, Matthew E. Modes, Alberto M. Marchevsky, Barry R. Stripp, Christopher M. Soto, Ying Wang, Kimberly Merene, Silvia Cho, Blandine L. Victor, Ivan Vujkovic-Cvijin, Suman Gupta, Suzanne L. Cassel, Fayyaz S. Sutterwala and Suzanne Devkota.

This work was supported by grants from the NIH (TP: K08HL1411590; CAG: F32HL162377; RGW: U19AI135964, U01TR003528,P01HL154998, R01HL14988, and R01LM013337; GDK: R03HL162655; AM: R01HL163646, R01HL164177; BJM: P01HL114453; PC: R01HL159953, R01HL155759). This research was also supported by NIH National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number UL1TR001881.

Follow Cedars-Sinai Academic Medicine on LinkedIn for more on the latest basic science and clinical research from Cedars-Sinai.

Published on Medicare's Care Compare website, the ratings of one to five stars provide patients with a reliable way to compare hospitals' quality and performance. The ratings are based on 46 quality measurements from five categories: mortality, safety, readmissions after treatment of common conditions, patient experience, and timely and effective care.

Of the 2,847 U.S. hospitals rated, fewer than 14% earned five stars.

This year’s rating for Cedars-Sinai was driven by strong performance in mortality measures that track the rate of patient survival 30 days after hospitalization for common medical conditions. Since CMS began tracking this data, the academic medical center’s mortality rates have remained among the best in the U.S. for patients being treated for conditions including:

• Heart failure
• Chronic obstructive pulmonary disease
• Stroke

Cedars-Sinai also achieved a high rate of patient survival 30 days after hospitalization for treatment of heart attack or pneumonia.

The medical center likewise received high marks for reducing unnecessary readmissions among patients who had recently been in the hospital for common conditions and surgeries. These results are thanks to a major effort by Cedars-Sinai to help Medicare patients safely return back home after a hospital stay for a surgery, such as a hip replacement, or a medical condition, like heart failure.

“We put programs in place across the medical center that anticipate the common reasons for readmissions, proactively address these issues and ensure patients experience smooth transitions back to their life at home,” said Sharon Isonaka, MD, chief value officer and vice president of Clinical Efficiency and Value at Cedars-Sinai, which is the largest Medicare provider in California.

Depending on a Medicare patient’s medical condition and risk factors, Cedars-Sinai can provide extra support in a variety of ways. Staff members can schedule follow-up appointments for a patient before they leave the hospital. A care manager can call a patient soon after discharge to make sure they have everything they need to heal, troubleshooting any hurdles.

Taking the right medications the right way after a hospital stay can play a big role in determining an older patient’s ability to recover. Many older adults already take a long list of medications even before they arrive at a hospital for surgery or to treat a chronic issue. A Cedars-Sinai pharmacist can call these patients when they return home to review their updated list with them and ensure they understand when and how to take each medication.

The common thread with all of these tactics is taking a broader view of patients’ health, Isonaka said. Older adults, in particular, often have needs that stretch beyond the one thing that brought them to the hospital.

“If someone comes in for hip surgery and they have heart failure, we want to make sure that patient returns home still taking their heart failure medication,” Isonaka said. “We want to look beyond the condition that brought the patient in to ensure that they go home with their chronic health condition in the same state that it was before surgery.”

Thanks in part to these efforts, the overall readmission rate for all patients at Cedars-Sinai Medical Center dropped from 13.9% in 2019 to 11.5% in 2023. Initiatives to reduce readmissions among Medicare patients have been so successful, Cedars-Sinai is rolling out new similar programs in specialty areas including GI surgery and minimally invasive heart procedures.

“Readmissions are such an important measure of quality,” Isonaka said. “Anytime you can keep people healthy and in their own home, that’s a major success.”

Read more on the Cedars-Sinai Blog: Why You Should Consider Magnet Recognition in Your Care

That’s because global warming causes temperatures to rise which, in turn, expands the reach of insects carrying infectious diseases. Species of mosquitoes that thrive in warmer environments are finding newly hospitable homes in places where the climate is warming and the summer heat lingers longer. As a result, physicians in once mild parts of the U.S. are seeing increasing cases of mosquito-borne diseases, such as Zika virus, West Nile virus and now dengue fever. 

“Warmer weather means warmer pools of standing water, a friendlier environment for breeding mosquitos, especially without very cold winters to kill off the eggs and larvae,” said Kimberly Shriner, MD, medical director of Infection Prevention and Control at Huntington Health, an affiliate of Cedars-Sinai. “There is no question that we’re seeing more Aedes mosquitos—the species that carries dengue—because of hotter temperatures.”

Another cause: People are traveling more widely and frequently, said Michael Ben-Aderet, MD, associate medical director of Hospital Epidemiology at Cedars-Sinai. He explained that this increases the odds that a traveler returns home with a mosquito-borne infectious disease, gets bit by one of the many Aedes mosquitos now thriving in Southern California, and that bug carries that disease to someone else.

“Dengue is well known in tropical places like South America, Central America and Puerto Rico,” Ben-Aderet said. “We’ve always had dengue cases in Los Angeles linked to travel, but now we’re encountering patients who haven’t traveled at all—they’ve never left Los Angeles. These individuals were bitten by mosquitoes locally. This suggests that there are likely more mosquitoes carrying dengue that we haven’t detected yet, partly because we’re not testing frequently enough and many people with dengue don’t become very ill.”

He added that Southern California is a perfect environment for dengue transmission. “We have mosquitos, a big population and people are traveling more than ever before,” he said.

Breakbone Fever

The Aedes mosquitos that can spread dengue, as well as Zika virus, started showing up in Southern California about a dozen years ago. While most people are familiar with the ankle-biting tendency of these mosquitos, they’re likely less aware of dengue and the disease’s symptoms.

Dengue can cause a wide range of symptoms from none at all to very severe, Ben-Aderet said. It starts with a high fever and severe muscle pain, giving it the nickname “breakbone fever.”  Dengue often appears with a diffuse red rash that blanches, turning white or the color of one’s skin after pressing on the rash and releasing pressure. Patients can also experience gastrointestinal symptoms like nausea.

The second time someone gets dengue, it can be much worse, said Shriner, who has treated patients with disease during annual medical mission trips to Tanzania with a nonprofit that provides clinical care and medical education. Dengue is a hemorrhagic fever, like the Ebola virus, that can cause bleeding—in this case, bruises bloom under the skin from “leaky” blood vessels.

For mild cases, treatment is supportive care: fluids, rest and Tylenol. More severe cases might need intensive care in a hospital. Highly specialized vaccines exist, but they’re primarily intended to help children avoid a dangerous second infection in places like the Philippines where the disease is endemic.

Canary in the Coal Mine

For local physicians, the spread of tropical diseases in once milder climates means they must think more broadly when diagnosing a sick patient.

"Whenever I see a patient in today's world, I need to keep a very open mind about what they might have," Ben-Aderet said. He added that the sporadic dengue infections we’ve seen from area mosquitos indicate we don’t yet have a “reservoir,” a sustained source of infections to make dengue endemic to Los Angeles. But it could happen in the not-too-distant future, he said.

Shriner emphasized that she doesn’t want people to panic. “We should be worried more about COVID-19 and the flu,” she said.

Still, she cautioned that smaller, novel outbreaks—like the emergence of dengue in Los Angeles—are “canaries in the coal mine” sending a message that we need to pay attention.  

“We live in an interconnected world with a fragile climate that is changing,” Shriner said. “We want to approach this scientifically, compassionately and with humanity. All of us are at risk for these diseases; all of us need to find solutions together.”

Read more on the Cedars-Sinai Blog: Everything You Need to Know About Bug Bites

Flu shots are available now at Cedars-Sinai medical offices—even as much of the U.S. continues to cope with unusually high levels of COVID-19 infections from that virus’ summer surge.

Though COVID-19 tends to taper off in the autumn—when flu and RSV (respiratory syncytial virus) are beginning to set in—whether the U.S. will have a tough virus season is unpredictable at this point.

“Only one thing is certain,” said Jonathan Grein, MD, director of Hospital Epidemiology at Cedars-Sinai and associate professor in the Department of Medicine. “We will definitely see influenza, COVID-19 and RSV circulating at the same time this winter.”

The most important advice Grein has for surviving this year’s respiratory virus season: Get vaccinated.

“The flu shot is still our most powerful tool to avoid influenza-related hospitalizations and deaths and keep our community safe,” Grein said. “The flu is linked to tens of thousands of deaths every year in the U.S. in addition to hospitalizations and clinic visits.”

The Cedars-Sinai Newsroom spoke with Grein for more information on vaccines, where to get medical care and other helpful advice for getting through flu season.

If someone gets sick, how can they tell which virus they have, and does it matter?

It can be tricky to tell these three illnesses apart because the flu, COVID-19 and RSV all can share similar symptoms—nasal congestion, headaches, fatigue, muscle aches, sore throat, cough and fever, and shortness of breath in more severe cases. Vomiting and diarrhea also can occur with COVID-19 or the flu. Only loss of taste and smell is more specific to COVID-19, though that occurs less often than it did early in the pandemic.

It’s important to get tested quickly to determine which illness—or illnesses—are causing your symptoms. Depending on which virus you have, you might need to start a particular treatment soon after symptoms appeared. If you’re considered high-risk—an older adult, someone who is immune-compromised or has a chronic health condition—your provider might recommend Paxlovid if you have COVID-19 or Tamiflu if you have the flu. To have the most benefit, Paxlovid should be taken within five days of symptom onset and Tamiflu within 48 hours, so it’s important to act quickly.

Who should get vaccinated against the flu, COVID-19 and RSV?

We strongly encourage adults and children older than 6 months to get the flu and COVID-19 vaccines. Ideally, you would get the flu shot in September or October and the updated COVID-19 vaccine when it becomes available shortly. Remember that it takes a couple of weeks for your immune response to develop after getting a shot.

Cedars-Sinai primary care physicians and pediatricians are now offering flu shots to patients during scheduled visits. Patients who have been treated by a Cedars-Sinai primary care provider in the past 16 months can schedule a vaccination appointment through My CS-Link at locations in Beverly Hills, Marina del Rey, Santa Monica, Los Feliz, Playa Vista and Tarzana.

To make an appointment for a COVID-19 vaccination, visit the My Turn website from the California Department of Public Health.

We also now have an RSV vaccine for older adults, a shot for pregnant people and an immunization for babies. If you or a loved one is in one of these groups, we recommend speaking with your physician to determine if the immunization or the vaccines are appropriate. 

When should someone seek treatment for flu-like symptoms?

Most mild symptoms can be managed at home with supportive care—fluids, Tylenol, rest. A humidifier can help with congestion and a saline nasal rinse can help clear mucus. Little kids might also benefit from a nasal suction device.

If you’re not sure if your symptoms are more serious, a virtual appointment is an easy way to get an expert opinion. Cedars-Sinai Connect offers quick access to Cedars-Sinai providers—available 24/7 for urgent issues—for those in California, including kids aged 3 and older, Spanish-speaking adults and patients new to Cedars-Sinai. Individuals with immediate concerns that are not life threatening—prolonged dizziness, not tolerating food or fluids—should visit urgent care. If symptoms truly are life threatening—difficulty breathing, pain or pressure in the chest or abdomen—go to the nearest emergency department. 

How long is someone contagious after getting sick with a virus?

Every virus is a little different, but in general people start becoming infectious with a respiratory virus shortly before their symptoms start, and then remain infectious for several days afterward when their symptoms are improving. With the flu, you’re infectious a day before symptoms start and until after a fever has resolved and symptoms are improving, as long as five to seven days after getting sick. It’s helpful to think of infectiousness as more of a gradient than an on or off switch. It’s also not unexpected for a cough to linger for many days or weeks after you’ve recovered, but it does not always imply you’re infectious for that period of time.

Is there anything unusual about this year’s flu season?

We should keep a close eye on what happens with the “bird flu,” the avian influenza A(H5N1) virus. Multiple outbreaks in cattle and poultry since the spring have been connected to more than a dozen infections in humans in the U.S. Even if you don’t work on a farm, it’s still relevant information. Families tend to visit farms in the autumn, and raw milk—which is sold in some health food stores—is another potential risk factor.

The good news is that we haven’t seen any human-to-human transmission of H5N1 with these recent cases in the U.S., but public health authorities are watching these outbreaks closely. If you’re someone who has been in close contact with cattle or poultry—even if it’s at a petting zoo or county fair—and you develop flu-like symptoms, alert your physician about your exposure to animals. I’d recommend washing your hands after being in contact with these animals and avoiding raw milk.

Read more on the Cedars-Sinai Blog: Tips to Survive Peak Flu Season from a Cedars-Sinai Expert

“We've seen a bit of a seasonal pattern emerge where we've had an uptick in COVID in the summer and then another one in the winter—usually the winter one being more severe,” said Michael Ben-Aderet, MD, associate medical director of Hospital Epidemiology at Cedars-Sinai.

The western U.S. is riding the biggest wave. Wastewater data for the region shows the virus that causes COVID-19 jumping from moderate to high levels in late June. The area had seen minimal levels circulating as recently as mid-May.

The uptick has largely been driven by the so-called FLiRT variants of COVID-19, such as KP.3 and KP.2, newer strains of the virus that began spreading in the spring. To stay on top of this latest wave, the Cedars-Sinai Newsroom sat down with Ben-Aderet to learn more about the FLiRT variants and why COVID-19 spikes over the summer.

Why are we seeing a COVID-19 spike this summer?

This has been the case for a couple of years. Why that is, I don't think anyone truly understands. A lot of viruses are seasonal in nature. Some viruses are seasonal in summer; some are in winter. COVID-19 seems to be in both. Some of that has to do with the virus itself—the virology, how it spreads. And another aspect of it is human behavior: School being out, people being on vacation, people traveling, people mixing and doing more activities does play a role in that summer surge.

What are the FLiRT variants?

The FLiRT variants is just a technical term for the continued mutation of the Omicron variants of COVID-19. And for the last year or so, pretty much all the variants of COVID-19 that we've seen circulate in the United States have been variants of Omicron.

How are the FLiRT variants different from previous versions of the virus?

So the symptoms that we're seeing in patients that are infected with one of the FLiRT variants are the same symptoms that we've been seeing with COVID-19 all along. There's no sense that there's any increased severity with the FLiRT variants. We're still seeing the relatively mild disease that we've been seeing with COVID-19 over the past year. It's primarily an upper respiratory illness. So think fever, chills, cough, runny nose, stuffiness— similar to a cold, essentially. And sometimes gastrointestinal symptoms.

Are existing COVID-19 tests and treatments still effective with the new variants?

All available testing, both commercial and home testing, will still test against the FLiRT variants. Paxlovid is still widely available and still works very well. So there hasn't been any reduction in activity of Paxlovid, and it’s still recommended for high-risk individuals with COVID-19.

How can we avoid getting COVID-19 at this point?

Masks still work. Make sure to wear a good, well-fitting mask. They’ve been proven to help prevent the spread of COVID-19. If you haven't been vaccinated, vaccines are still available, and it's really best to be up to date on your vaccinations. Avoid being around others who are sick. If you are exposed or if you're sick, stay home if you don’t need to go out.

Read more on the Cedars-Sinai Blog: Long COVID—What to Know

Parents of children 3 to 17 years old can now access Cedars-Sinai healthcare providers for urgent issues, including cough, cold, flu or rash.

• Parents can choose on-demand visits 24/7 or a scheduled visit 7 a.m.-9 p.m. on weekdays and 8 a.m.-4 p.m. on weekends for their sick child.
• A child’s existing pediatrician is kept in the loop through the Cedars-Sinai electronic health record.

Spanish-speaking adults and parents of children 3 and older can now choose a Spanish-language app experience.

• Spanish-speaking healthcare providers are available for scheduled visits 7 a.m.-9 p.m. on weekdays and 8 a.m.-4 p.m. on weekends.
• Translators can support patients seeking on-demand care 24/7 if a Spanish-speaking provider is not available.
• Spanish-speaking adults can access primary care in their preferred language to manage chronic conditions, such as high blood pressure, anxiety, depression and obesity.

“Cedars-Sinai Connect has already helped thousands of new and existing patients easily access the high-quality care for which Cedars-Sinai is known, from home,” said Jill Martin, executive vice president of Cedars-Sinai Medical Network. “The platform is helping us extend that opportunity to even more people throughout California who are coming to Cedars-Sinai for convenient acute or chronic care. These patients also gain access to our broad network of specialists through referrals when appropriate.”

The new care options for children and Spanish speakers build on Cedars-Sinai Connect’s initial success. Since the platform launched in fall 2023, it has helped more than 8,000 patients from San Diego to Sacramento access Cedars-Sinai care through more than 10,500 virtual visits.

“Patients have come to rely on Cedars-Sinai Connect as a convenient way to access Cedars-Sinai expert care and a comprehensive primary care experience,” said Caroline Goldzweig, MD, chief medical officer of Cedars-Sinai Medical Network. “Our unique hybrid model not only offers high-quality virtual care, but it is fully integrated into a top-tier academic health system, making it easier to coordinate care and share a patient’s health records with all of their providers.” 

Cedars-Sinai Connect harnesses AI technology developed by K Health to reduce administrative burdens such as data entry, freeing doctors to focus more time on patient care. K Health helps patients manage their acute, chronic and preventive care needs through its platform that harnesses medical knowledge and real patient experiences.

“Cedars-Sinai Connect is one of the first integrated clinical care apps of its kind that is successfully using technology and care model innovation to address significant pain points—particularly access and quality—in healthcare in the U.S.,” said Ran Shaul, co-founder and chief product officer of K Health. “By combining K Health’s virtual care model with Cedars-Sinai’s high-quality clinical care, our partnership gives Cedars-Sinai greater digital capability while expanding access to expert care across California.”

Martin added that with pediatric care and Spanish-speaking doctors now available, “Cedars-Sinai Connect is furthering our collective goals of tying together in-person and virtual care, reducing wait times and addressing primary care needs for as many Californians as possible, helping Cedars-Sinai advance health equity.” 

Read more on the Cedars-Sinai Blog: Women’s Heart Health | The Virtues of a Virtual Second Opinion

Building on decades of local experience, Congress Orthopaedic Associates Inc. and Risser Orthopaedic Group will continue to offer high-quality, personalized and coordinated care to patients.

The two groups have formed one comprehensive practice that will strengthen a shared commitment by Cedars-Sinai and Huntington Health, an affiliate of Cedars-Sinai, to enhance the wellbeing of patients across the region. The practices’ combined 29 specialists and support staff serve patients at locations in Pasadena and Arcadia.

“We are proud to welcome two of the most trusted orthopaedic practices in the San Gabriel Valley to Cedars-Sinai, expanding our ability to provide comprehensive orthopedic services to the local community through Huntington Health,” said Jill Martin, executive vice president of Cedars-Sinai Medical Network.

Huntington Health will continue as the primary hospital to admit and provide high-quality orthopedic services—including total joint replacements and spine surgery—to Congress and Risser patients, as it has done for years.

“By working even more closely with these two outstanding practices, we can offer members of the community an even better, more coordinated experience throughout their care journey,” said Lori J. Morgan, MD, MBA, president and CEO of Huntington Health. “We look forward to continuing to support these groups in providing high-quality orthopedic care in the San Gabriel Valley.”

The specialists at Congress and Risser offer expert care in general orthopedics and specialty areas, including knee, ankle, foot and hip, hand and wrist, shoulder and elbow, and neck and spine, as well as joint replacement, sports medicine, occupational medicine and orthopedic oncology. Physicians and staff provide a wide range of innovative treatment options, including noninvasive approaches and minimally invasive surgery. They also offer advanced diagnostic imaging and rehabilitation services such as physical therapy.

Congress is a well-known medical name in the area, where it has served patients for more than 60 years. It now has offices in Pasadena and Arcadia.

“For more than six decades, Congress Orthopaedic Associates has been dedicated to offering high-quality patient care, leading-edge research and comprehensive patient education,” said William M. Costigan, MD, director of the Congress Associates Center for Spinal Surgery and Study. “We look forward to furthering that commitment through our new relationship with Cedars-Sinai and Huntington Health.”

Risser’s history in Pasadena dates to the 1930s, when its founder, Joseph C. Risser, MD, began providing orthopedic care in the community. Risser’s current leaders said they look forward to enhancing services for communities that have long come to rely on the group for high-quality orthopedic care.

“Providing expert care close to where patients work and live in the San Gabriel Valley helps support the best outcomes for our patients,” said Daniel Laster, MD, medical director of Risser Orthopaedic Group. “Our patients have been at the center of all that we do, and we look forward to caring for them for many years to come.”

Cranes standing 200 feet tall hoist giant beams from trucks arriving daily with fresh supplies of steel. Piece by piece, the beams are lowered into place, framing the profile of the new nine-story community hospital that is expected to be ready for patients in 2026.

“What we see today are the steel columns and beams that form the structure for the hospital and the floors of the hospital; we're seeing it literally come out of the ground,” said Zeke Triana, AIA, vice president of Facilities Planning, Design and Construction at Cedars-Sinai. “It brings me a lot of joy because I've been involved with the planning of this since Day 1.”

The new building will replace the current two-story hospital that has been serving the community for more than 50 years. The new hospital will have an expanded emergency department, additional private patient rooms, state-of-the-art operating rooms, cardiac catheterization and gastroenterology labs, and interventional procedure suites to treat patients with complex needs, such as treatments for strokes and other image-guided interventions.

The design plan reflects the natural environment of the marina. Different colored glass on the hospital’s façade will create subtle waves. Those curves and colors will flow into the lobby where a large staircase will guide visitors up to a surgical waiting area. Large windows will bathe the interior in natural light and make the hospital easier to navigate on the higher floors, Triana said.

“When you get up to the patient areas and the elevator opens, on one side you will have views of the marina, on the other side you will have views of the hills, and it'll be just a wonderful patient experience for everyone,” Triana said.

Hospital staff members have been eagerly watching the progress next door from the current hospital.

“They’re looking forward to everything from new top-of-the-line equipment to new linens—it’s a whole new care environment,” said Courtnay Caufield, DNP, RN, chief nursing officer of Cedars-Sinai Marina del Rey Hospital. “The care team members have been talking about not only the ability to deliver exceptional care, but they also are looking forward to the warm and open environment for themselves. We will have so much more space, including calm places to walk and take breaks, to get outside and appreciate the fresh air.”

At the construction site, workers bolt and weld beams and columns into place and prepare the tower for the mechanical systems—air vents and pipes—that will be hidden away behind ceilings and walls. Next, they’ll pour the concrete floors, and the glass façade will follow shortly after.

“As we've been practicing at our current facility every day, the nurses look up and see another steel beam or a level every day, and it’s saying, ‘This is really happening—we are moving,’” Caufield said. “This wonderful creation of a space that provides the ability to provide the care that our community deserves—we're all so excited—and it grows one beam closer every day.”

Read more about care at Cedar-Sinai Marina del Rey Hospital from Cedars-Sinai Magazine: How to Choose a Weight Loss Path

Based on results from new clinical trials, the Centers for Disease Control and Prevention (CDC) recently issued proposed guidelines for using doxycycline to reduce the risk of a chlamydia or syphilis—and possibly gonorrhea—infection among sexually active adults. Experts say new preventive approaches are critical to control the widening STI epidemic, fueled in part by the disruption in healthcare services during the height of the COVID-19 pandemic.

“Even before COVID started, we had seen a significant increase in STDs [sexually transmitted diseases], both internationally and here locally in California,” said Christopher Foltz, MD, an infectious disease specialist at Cedars-Sinai. “Syphilis has been climbing at the highest rate with a significant increase among pregnant women and men who have sex with men.” 

Growing Problem

Syphilis cases among men who have sex with men rose 7% from 2020 to 2021, according to the CDC. Syphilis rates among women jumped 55.3% from 2020 to 2021, and 217.4% from 2017 to 2021, which has led to the birth of more babies with the disease.

People with syphilis often don’t have symptoms, Foltz said, and when they finally visit a doctor, they may have been infected for months—or even years—without knowing it. Undiagnosed long-term infections can lead to permanent complications, including blindness and permanent neurologic damage.

“That's what we're trying to prevent—these kinds of catastrophic long-term complications from undiagnosed STIs,” Foltz said. “If we can prevent infections with a relatively safe and easy-to-take antibiotic, the overall number of new infections will ultimately decrease.”

Old Drug, New Use

Doxycycline has long been a go-to treatment for acne, skin infections, illnesses spread by tics and pneumonia. The drug had been on the radar of physicians treating STIs for years, but previous clinical trials hadn’t shown it would be effective as a preventive therapy. Physicians have become increasingly hesitant to prescribe antibiotics when they’re not needed amid a rise in antibiotic-resistant bugs.

“Bacteria can figure out how to avoid being killed by antibiotics,” explained clinical pharmacist Greg Marks, PharmD, coordinator of the Antimicrobial Stewardship program at Cedars-Sinai Medical Center, which closely tracks the use of antibiotics in the hospital. “In general, the more we use antibiotics, the more concerned we are about resistance.”

But new trial results showed doxycycline could be an effective new tool to limit the spread of syphilis and chlamydia if taken as a single 200-milligram dose within 72 hours after unprotected sex, Marks said. Using doxycycline to prevent gonorrhea showed some promise but yielded mixed results.

Only one dose of the antibiotic is necessary in a three-day period to help avoid these bacterial infections, even if having sex with multiple partners. The strategy, dubbed “Doxy on Demand” or “Doxy-PEP” (post-exposure prophylaxis), is similar to taking the morning-after pill to prevent pregnancy after unprotected sex. But this new treatment isn’t a reason to ditch condoms.

“This by no means is a way to offset the use of condoms,” Foltz cautioned. “We absolutely encourage condom use to prevent against other STDs and HIV [human immunodeficiency virus] as an added barrier of protection for prevention.”

Foltz said the people most likely to benefit from this new strategy are those who have had STDs recently, those taking HIV medications or medications to prevent the spread of HIV, and members of the LGBTQ+ community, which tends to experience higher rates of certain STIs.

Pregnant women should generally avoid the drug, Marks said, as well as people allergic to tetracyclines, a class of antibiotics. He and Foltz encouraged patients to speak with a physician about whether doxycycline might be right for them.

“If you're actively having sex and not using condoms 100% of the time, which is the reality out there, this strategy could be appropriate for you,” Foltz said. “It comes down to each person’s individual risk level, something that you should discuss with your physician.”

Read more on the Cedars-Sinai Blog: Gaining Ground on HIV/AIDS

Through the new virtual healthcare option Cedars-Sinai Connect, healthcare professionals are available 24/7 for urgent issues, and same-day appointments are accessible for primary care—reducing wait times for those seeking medical attention.

“Cedars-Sinai Connect is a natural extension of the high-quality care Cedars-Sinai already provides to patients in person,” said Jill Martin, executive vice president of Cedars-Sinai Medical Network. “What could be more convenient than getting the care you need when you need it—in the palm of your hand—in your home or office?”

The new mobile app harnesses AI technology developed by K Health that empowers physicians by reducing the burdens of clinical intake and data entry, allowing doctors to focus more on patient care. K Health helps patients manage their acute, chronic and preventive care needs through a platform that harnesses medical knowledge and real patient experiences. K Health and Cedars-Sinai developed Cedars-Sinai Connect through a new joint venture.

The partnership gives new and existing patients expanded treatment options for a broad range of medical conditions from a dedicated team of virtual care providers. The app’s chat feature gathers health details and symptoms from patients to help assess their medical concerns and  presents that information to a clinician for review. This streamlines the intake process so providers can focus more on patient care. After the guided intake, patients can choose to connect with a clinician for an appointment via video call.

Cedars-Sinai Connect will accept all forms of insurance that Cedars-Sinai takes, including employer-provided plans.

“Patient care plans and visit information are integrated into the Cedars-Sinai health record, making it easy for patients to move between online and in-person care in a coordinated way, and for patients to access our broader network of specialists when needed,” said Caroline Goldzweig, MD, chief medical officer of Cedars-Sinai Medical Network. “This new platform will help us expand and enhance care for patients across California.”

K Health’s founders said the partnership with Cedars-Sinai will give patients greater access to world-class medical expertise, empowering people to take charge of their health by choosing when and where they get care.

“We’re excited to work with Cedars-Sinai, an esteemed institution that shares our vision to provide people with unfettered access to exceptional medical care around the clock,” said Ran Shaul, the company’s co-founder and chief product officer. “By fusing K Health’s technology with Cedars-Sinai’s renowned care, we are advancing primary care delivery by extending essential services to a wider spectrum of people in need while alleviating physician burnout.”

Read more on the Cedars-Sinai Blog: Virtual Second Opinion | Here’s What to Know

Flu season started early in the Southern Hemisphere, which typically gives experts some clues as to what we’ll experience here in the U.S. To avoid getting caught off guard, it’s important to get the flu shot in September or October, said infectious disease specialist Soniya Gandhi, MD, MPH, associate chief medical officer at Cedars-Sinai.

“Even a typical flu season can be deadly and can cause significant hospitalization,” Gandhi said, pointing to 58,000 deaths in the U.S. and more than half a million hospitalizations—all caused by last year’s flu. “We should do what we can to protect ourselves—and others—with the best tool we have: the flu vaccine.”

Cedars-Sinai primary care physicians and pediatricians are now offering flu shots to patients during regularly scheduled visits. Patients who have been treated by a Cedars-Sinai primary care provider in the past 16 months can schedule a vaccination appointment online through My CS-Link at clinics in Beverly Hills, Marina del Rey, Santa Monica, Los Feliz, Playa Vista and Tarzana.

In addition to the flu, COVID-19 and the respiratory syncytial virus (RSV) could again spike at the same time, triggering a “tripledemic,” Gandhi said. Last year, that same triple punch filled emergency departments across the country and strained children’s hospitals with young patients, who are vulnerable to RSV—a virus that can be serious, if not deadly, for infants and older adults.

But there’s a silver lining this year. In addition to the flu vaccine, new RSV shots are available for babies and adults over 60, and a new COVID-19 booster is coming this fall.

“These new shots and vaccines could really help protect us and our community during the upcoming season,” Gandhi said. “We need to preserve capacity in hospitals for those patients who really need that care.”

Help for Youngest and Oldest

RSV causes mild cold-like symptoms in most people, but it’s the leading cause for hospitalization among infants in the U.S. In babies, the virus can cause mild illness or it can cause dangerous inflammation in a child’s tiny airways.

“There's really no way to predict how your child would do even if they're completely healthy,” said Priya Soni, MD, a pediatric infectious disease specialist at Cedars-Sinai Guerin Children’s. “If they do end up having a horrible course with RSV, they will likely need to be hospitalized for oxygen support, fluids and other supportive measures.”

Most children in the U.S. will be infected with RSV within the first year of their life, and almost all infants will have been exposed to the virus by the time they're 2 years old.

But parents of infants have a new way to protect their children. The U.S. Food and Drug Administration (FDA) recently approved an immunization—a monoclonal antibody treatment called nirsevimab-alip (Beyfortus)—that can be given as a single-dose shot to newborns and infants during their first RSV season. Children up to 19 months old who remain vulnerable to severe disease in their second RSV season also can get the shot.

Soni said she “100%” recommends the immunization because of strong clinical trials that yielded positive results.

The FDA also recently approved a Pfizer RSV vaccine for women who are 32-36 weeks pregnant to protect their infants at birth. The same vaccine also was approved for adults 60 and older, as was another vaccine from pharmaceutical company GSK.

For older adults, the Centers for Disease Control and Prevention (CDC) recommended these new vaccines only for those who are at highest risk of severe RSV, such as patients with asthma, diabetes or heart failure. Although both vaccines are considered safe, a very small number of cases of Guillain-Barre syndrome—a condition in which a person’s immune system attacks their peripheral nerves—were reported after vaccination.

More data is needed to determine whether these episodes may have been unrelated to the vaccine, according to the CDC. But the significant risk RSV poses to some older adults could outweigh the very low risk of developing potential side effects.

Sonja Rosen, MD, section chief of Geriatric Medicine at Cedars-Sinai, said that for now,  she recommends the RSV vaccine for older patients with lung disease, or for those who are otherwise immunosuppressed and therefore at higher risk for severe illness. “Patients should speak with their physician and make an informed decision about whether this shot is right for them,” Rosen said.

New Twist on the COVID-19 Booster

The new COVID-19 booster has been updated to include a sub-variant of Omicron called XBB, which was the predominant strain at the time the shot was approved by the FDA this summer.  The vaccine should provide protection from all the strains circulating in the U.S. right now, Gandhi said.

Thanks to the new booster, antiviral medications like Paxlovid and at-home tests, Gandhi is grateful that “we're in a very different position in 2023.” She encouraged the public to take advantage of the booster when it becomes available this fall, to keep themselves and their loved ones safe, especially when gathering throughout the fall and winter holidays.

“We know immunity wanes after the administration of the booster and that many individuals may not have had a booster for quite some time,” Gandhi said. “I think it will be incredibly important, particularly in those populations that are vulnerable to COVID illness, hospitalization and potentially even death, to ensure that they get the updated booster in a timely fashion.”

She said it’s safe to get the COVID-19 and flu vaccines together. For older adults who determine with their physician that the RSV shot is right for them, they should get that immunization alone and two weeks apart from the other vaccines, if possible, Gandhi said. 

Read more on the Cedars-Sinai Blog: Flu—When to Go to the ER

Of the 3,076 U.S. hospitals rated, fewer than 16% earned five stars. The ratings are based on 46 quality measurements from five categories: mortality, safety, readmissions after treatment of common conditions, patient experience, and timely and effective care.

Found on Medicare's Care Compare website, the ratings of one to five stars provide patients with a simple way to compare hospitals' quality and performance. 

This year’s rating for Cedars-Sinai was driven by strong performance in mortality measures that track the rate of patient survival 30 days after hospitalization for common conditions such as heart failure, chronic obstructive pulmonary disease (COPD) and stroke. Since CMS began tracking this data, the academic medical center’s mortality rates have remained among the lowest in the U.S. Cedars-Sinai also achieved a high rate of patient survival 30 days after hospitalization for heart attack.

Cedars-Sinai received high marks for other measures, including:

• Low rate of emergency department visits after outpatient chemotherapy
• Low rate of unplanned hospital visits after outpatient surgery
• High rate of COVID-19 vaccination among healthcare personnel
• High overall rating of the hospital by patients

“Cedars-Sinai’s focus on increasing quality of care, safety and avoiding unnecessary readmissions all contributed to this year’s strong performance,” said Sharon Isonaka, MD, chief value officer and vice president of Clinical Efficiency and Value at Cedars-Sinai. “Among efforts in these areas are new enhanced care programs we created to help Medicare patients recover safely at home after a hospitalization for many common conditions and surgeries.” 

Before leaving the hospital, patients enrolled in these programs are visited by expert nurse practitioners who explain the post-discharge care plan. Once home, the patients receive an outreach call or visit a specialized clinic to help reinforce discharge instructions and prevent readmission to the hospital. Patients also receive a thorough medication review from clinical pharmacists as well as support from a case manager for 90 days to ensure that they are able to follow their care plan. 

“We want to give our patients the care they need when they need it,” Isonaka said. “Sometimes that means thinking beyond the hospital and setting them up for success when they return home.”

Read more on the Cedars-Sinai Blog: Why You Should Consider Magnet Recognition in Your Care

The U.S. News rankings, released Tuesday, are based on patient outcomes, patient experience, technology, reputation (according to surveyed physicians) and a variety of other health-related measures.

Departing from previous practice, U.S. News announced its top Honor Roll hospitals but did not rank them in order as in the past.  This year, U.S. News selected 22 hospitals for the Honor Roll based on their high rankings in multiple specialties and other factors. The digital media company also ranked clinical specialties nationally but did not provide numerical rankings at the state and local levels. Based on data, however, many of Cedars-Sinai’s clinical specialties were the best in California and Los Angeles.

Five Cedars-Sinai specialties ranked #1 in California (highest U.S. News ranking in the state):

• Cardiology, Heart & Vascular Surgery
• Gastroenterology & GI Surgery
• Orthopedics
• Pulmonology & Lung Surgery
• Urology

Each of these specialties also ranked #1 in Los Angeles (highest U.S. News ranking in the county), along with Neurology & Neurosurgery and Obstetrics & Gynecology.

In total, Cedars-Sinai had 11 specialties ranked nationally. This means that Cedars-Sinai is among the top hospitals in the nation in those clinical areas (nationwide rankings are provided in parentheses):

• Cardiology, Heart & Vascular Surgery (#2)
• Gastroenterology & GI Surgery (#2)
• Orthopedics (#2)
• Pulmonology & Lung Surgery (#2)
• Neurology & Neurosurgery (#5)
• Urology (#5)
• Diabetes & Endocrinology (#7, tied)
• Obstetrics & Gynecology (#7)
• Geriatrics (#8)
• Cancer (#14)
• Ear, Nose & Throat (#19)

Six of these specialties ranked among the Top Five in the nation—and four ranked as #2:

• Cardiology, Heart & Vascular Surgery (#2)
• Gastroenterology & GI Surgery (#2)
• Orthopedics (#2)
• Pulmonology & Lung Surgery (#2)
• Neurology & Neurosurgery (#5)
• Urology (#5) 

“The recognition of Cedars-Sinai and our clinical specialties is a reflection of our remarkable physicians, nurses and staff members, who provide our patients with compassionate, high-quality care every day,” said Thomas M. Priselac, president and CEO of Cedars-Sinai. “I am humbled by the commitment of our devoted staff, who work tirelessly to serve our patients with the excellent care they need and deserve.”

Read more on the Cedars-Sinai Blog: Virtual Second Opinion—Here’s What to Know

Although the names of these infections are almost identical—and their symptoms are very similar—they are completely different diseases. To clear up any confusion, we asked Jonathan D. Grein, MD, director of Hospital Epidemiology at Cedars-Sinai, to explain how these diseases compare to each other.

How does typhus differ from typhoid fever? 

Both diseases are infections, but they're caused by different types of bacteria that are spread in different ways. The kind of typhus we tend to see in the U.S. is spread by fleas that catch the disease from rats and opossums. Typhoid fever is spread through food that's come into contact with fecal bacteria. For example, a food worker might use the restroom, not wash their hands and then contaminate the food they're handling, which infects the person eating it.

What are the symptoms? 

The clinical symptoms can be very similar: fever, muscle aches, headache and, possibly, a rash on the trunk or back.

How can someone tell the difference between the two diseases? 

Symptoms like diarrhea or constipation are more commonly seen with typhoid fever than with typhus. A physician can make a diagnosis using different types of blood tests.

Why are the names so similar? 

People thought they were the same disease until the 1800s, when a physician determined that they were different infections.

How common are these infections? 

Los Angeles County sees an average of about 50 flea-borne typhus cases each year, except in 2018 when an outbreak caused that number to double. Typhoid fever, on the other hand, is less common in the U.S. It often manifests after a patient has traveled to Asia or India. The California Department of Public Health gets reports of about 75 cases of typhoid fever in the state each year.

How are these diseases treated? 

Fortunately, both infections are treatable. They each respond to different types of antibiotics.

How can people avoid catching these infections? 

You can reduce your risk of getting flea-borne typhus by avoiding contact with fleas. For example, make sure your pets are treated with flea protection. Also, keep rodents away from your home and workplace. You can avoid typhoid fever by getting vaccinated and carefully choosing what you eat or drink when you travel to countries where typhoid fever is more common. Speak with your doctor before you travel to see if a typhoid vaccine is appropriate. Stick to bottled water and fully cooked food or fruits and vegetables that must be peeled. Washing your hands also is important.

What should people do if they develop symptoms of these diseases? 

Contact your physician if you develop any of the symptoms like fever, muscle aches, headache and a rash on the trunk or back. Make sure you tell your healthcare provider if you've been traveling recently. A complete travel history could be critical to getting the right diagnosis.

Read more on the Cedars-Sinai blog: Typhus: What You Need to Know