I follow a lot of people. 1,878 as of this morning. I also don't engage in any other social media. Never have, never intend to. Pretty much every other social media domain is blocked at our firewall level. I only looked at twitter(as it was called at the time) in December of 2019, for the first time in my life, to try to get fast breaking COVID news, and have access to scientists who would be ahead of the knowledge curve.
I'm only really here for one reason. To get good info, synthesize it, and redistribute it, often in different words, when I think it'll be helpful. Despite some truly "delightful" DMs I've received recently, I have no ulterior motive. No one's forcing you to believe that, and I take it as a badge of honor to be blocked, so, knock yourself out if you're so inclined.
I'm asking everyone, particularly scientists, to be careful with your words. There's been palatable rising tensions here in 2024. Some of it has to do with science(H5N1, WHO airborne) some of it doesn't(politics), but it's real.
I have seen some truly awful H5N1 takes as things ramp up. Particularly this morning. Nuance matters. If you want to be a prognosticator, be clear. "I think" or "I believe" instead of launching into what you want to say.
Here's a few things I've seen that should be discussed carefully:
- Pasteurization is completely effective against H5N1.
Here's what the FDA says about that:
The FDA believes the pasteurization process is “very likely” to inactivate H5N1, though they acknowledged that no studies have been done to test that.
Here's someone who knows better:
“Daniel Perez, an influenza researcher at the University of Georgia, is doing his own test tube study of pasteurization of milk spiked with a different avian influenza virus. The fragile lipid envelope surrounding influenza viruses should make them vulnerable, he says. Still, he wonders whether the commonly used “high temperature, short time” pasteurization, which heats milk to about 72°C for 15 or 20 seconds, is enough to inactivate all the virus in a sample.”
- It's already spreading person to person across the US.
The only reference I can find that would lead to that conclusion would be this:
"Only one human case linked to cattle has been confirmed to date, and symptoms were limited to conjunctivitis, also known as pink eye. But Russo and many other vets have heard anecdotes about workers who have pink eye and other symptoms—including fever, cough, and lethargy—and do not want to be tested or seen by doctors. James Lowe, a researcher who specializes in pig influenza viruses, says policies for monitoring exposed people vary greatly between states. “I believe there are probably lots of human cases,” he says, noting that most likely are asymptomatic."
Or, perhaps in conjunction with this:
"The genetic sequence from the human case, which occurred on an unidentified farm in Texas, is sufficiently different from the cattle sequences that it can’t be easily linked to them, he said. The differences suggest that the individual was either infected in a separate event — maybe not via a cow, but through contact with infected wild birds — or that there might have been another line of viruses in cattle early on and it has since died out."
I don't want to belabor the point, and I don't want to call out anyone. I just felt the need, after scrolling through my timeline this morning, to point out that language matters. Be careful. Don't spread misinformation. If you want to prognosticate, go ahead, but be clear it's your opinion. Your magic internet points don't matter.
I've also been asked a lot whether we're in panic mode here, and if we're running off to the homestead.
No, not at this point. We, obviously, already take airborne precautions. Please don't forget about COVID.
Last night my wife and I did make the decision to stop using grocery store milk. We really only buy 2 gallons a month. It's not a big deal to us, so it seems like an easy thing to do. We use it to make kefir, and kefir can, under some circumstances, harbor and facilitate the growth of viruses from what I've read. So the kefir grains are going to stop being fed for the moment. Sorry kefir grains.
If I bought a lot of ground beef from the store would I be worried? Hard to tell since it's not something we do, but, I guess I'd be cooking it to a higher temperature, at least.
Know your egg substitutes.
Crises precipitate change. Don't be afraid to be flexible as circumstances change.
Otherwise, we're just keeping up to date and seeing what goes on.
@HelenBranswell on top of it again today. Lots of good tidbits in this one.
https://www.statnews.com/2024/04/24/h5n1-bird-flu-usda-orders-dairy-cow-testing/
"an animal to test negative for the virus before it can be moved across state lines"
"farms that move cattle across state lines and have animals that test positive for H5N1 or any influenza A virus will be required to open their books to investigators, so they can trace movement of cattle from infected herds"
"The order currently applies to lactating dairy cows but could be expanded if necessary"
"He sidestepped questions about where the positive milk samples were purchased and what percentage of samples contained traces of the virus when tested by PCR — polymerase chain reaction testing — saying that the agency has an analysis of its work that will be made public “very shortly.”"
"There was some support offered for the oft-repeated claim that pasteurization would kill the virus in milk from by Jeanne Marrazzo, the new NIAID director. She said that some NIAID-funded researchers had also found PCR-positive milk in samples bought from stores, but that when the researchers tried to grow virus from those samples, they could not.
“The results that those investigators got indicated that the PCR-positive material was not alive,” Marrazzo said, though she warned that work was done on a small number of samples and needs to be confirmed by the larger FDA effort."
"Watson confirmed that USDA has met some resistance from farmers who they’ve suspected of having infected cows. Farmers have been told they must discard any milk produced by cows that are infected with H5N1 virus, though it’s not clear if or how that recommendation is being enforced."
An article from today about the possibility of this H5N1 spread being similar to the spread of contagious mastitis in cows. It's from the perspective of the industry.
https://www.agri-pulse.com/articles/20994-usda-working-to-provide-answers-on-h5n1-in-dairy
I also read way more about contagious mastitis than I ever wanted to, but, if anyone is interested this article was a good review.
Presented without further comment.
https://www.nature.com/articles/s41577-019-0143-6
"The adaptive immune response to influenza virus infection is multifaceted and complex, involving antibody and cellular responses at both systemic and mucosal levels. Immune responses to natural infection with influenza virus in humans are relatively broad and long-lived, but influenza viruses can escape from these responses over time owing to their high mutation rates and antigenic flexibility."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291154/
"In summary, herd effects are assumed with influenza vaccine programmes, but there are few studies that quantify the herd effect of vaccination. We found low-level evidence supporting a herd effect of vaccination on influenza virus infection in contacts of vaccinated persons. Further rigorous studies are needed in order to better understand under which circumstances vaccination may prevent influenza and its complications in contacts."
I don't really have time today to do a deep dive write-up on these, as I often do for articles. However, if you're interested in the possibility of airborne transmission, where the science has been on this, and how far off the possibility has been(spoiler alert, 5 amino acid substitutions) these articles are a good starting point. I'm also putting them here so I can refer back to them in the future if needed.
"Influenza A viruses are transmitted via the air from the nasal respiratory epithelium of ferrets"
https://www.nature.com/articles/s41467-020-14626-0
"Airborne Transmission of Influenza A/H5N1 Virus Between Ferrets"
https://www.science.org/doi/10.1126/science.1213362
"The Potential for Respiratory Droplet–Transmissible A/H5N1 Influenza Virus to Evolve in a Mammalian Host"
https://www.science.org/doi/10.1126/science.1222526
"A comprehensive review of highly pathogenic avian influenza (HPAI) H5N1: An imminent threat at doorstep"
https://www.sciencedirect.com/science/article/pii/S1477893923000984
"The Role of Airborne Particles in the Epidemiology of Clade 2.3.4.4b H5N1 High Pathogenicity Avian Influenza Virus in Commercial Poultry Production Units"
https://www.mdpi.com/1999-4915/15/4/1002
"Influenza: Five questions on H5N1"(which I admittedly mostly found interesting because it extensively quotes Jeremy Farrar 11 years before he became the head of the WHO in 2023)
I'm going to dump a few more articles that I've been reading here today. These ones are specifically related to previous mammal to mammal spread of H5N1, presented roughly in chronological order starting in 2004.
"Avian Influenza H5N1 in Tigers and Leopards"
https://wwwnc.cdc.gov/eid/article/10/12/04-0759_article
"Probable Tiger-to-Tiger Transmission of Avian Influenza H5N1"
https://wwwnc.cdc.gov/eid/article/11/5/05-0007_article
(Transmission route not determined, but they had stopped being fed raw chicken)
"H5N1 pathogenesis studies in mammalian models"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858902/
(Interesting tidbit - "Notably, conjunctivitis and other ocular complications following influenza virus infection in humans are most frequently associated with the H7 subtype, but have been documented rarely during H5N1 virus infection (Belser et al., 2009a). Furthermore, the presence of SA on the corneal surface and linkage of ocular and respiratory tract tissues by the nasolacrimal ducts identifies the ocular system as both a potential site of replication as well as a route of entry to establish a respiratory infection (Kumlin et al., 2008). Although H5N1 viruses do not demonstrate a particular tropism for this tissue, ocular inoculation (with or without prior corneal scarification) of mice with H5N1 viruses resulted in a systemic infection, with infectious virus recovered from the lungs, brain, and eye of mice p.i. (Belser et al., 2009b; Sun et al., 2009). Selected H5N1 viruses were capable of mounting a lethal infection by this route, albeit with a 2–3 delay in mortality compared with i.n. inoculation (Belser et al., 2009b).")
"Highly pathogenic avian influenza A(H5N1) virus infection in farmed minks, Spain, October 2022"
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2023.28.3.2300001
"Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in New England Seals, United States"
https://wwwnc.cdc.gov/eid/article/29/4/22-1538_article
"Mass Mortality of Sea Lions Caused by Highly Pathogenic Avian Influenza A(H5N1) Virus"
https://wwwnc.cdc.gov/eid/article/29/12/23-0192_article
"Highly pathogenic avian influenza A (H5N1) in marine mammals and seabirds in Peru"
New H5N1 info today from stat, although not from Helen Branswell this time.
https://www.statnews.com/2024/04/25/h5n1-bird-flu-cows-outbreak-likely-widespread/
I think this paints a pretty good picture of where we're at, in terms of the extent of the outbreak in dairy herds.
"They collected 150 commercial milk products from around the Midwest, representing dairy processing plants in 10 different states, including some where herds have tested positive for H5N1. Genetic testing found viral RNA in 58 samples, he told STAT."
For me, personally, this is both good and bad news.
On the one hand, the continuing drip of information saying that this has been going on longer than we knew, and is pretty widespread, means that the milk is almost certainly safe. At least, not acutely bad. If, for instance, as I have seen speculated(not on Mastodon), 50% of people would die from drinking contaminated milk we'd know. Agreed? Let's put that idea away.
Small sample size, but:
"The team that produced that data — the St. Jude and OSU groups — told STAT that it has so far analyzed four samples of store-bought milk that had tested positive via PCR for H5N1 genetic material. “We’ve done the viral growth assays to see if we can recover any virus from them and we can’t,” Webby said."
On the other hand, every mammal infection is another chance for a dangerous mutation. Just 5 amino acids, right? We've, hopefully, learned this lesson from COVID variants.
Now, what does 39% of samples testing positive in this case mean? I don't know! My first thought was that there's 64,155 dairy farms in the US, so near 25,000 must have infections, but, I realized I was making two big assumptions. One, milk from the Midwest is representative of the whole supply. Two, 150 was a significant sample size.
The FDA is now saying their testing found ~20% positive, but no information on where those samples came from, or how many they tested. Come on FDA!
I think it does suggest it's a lot more widespread than we previously knew. If this is the case, I think it's important that we now have genetic evidence of bird to cow, and then back to bird. Beyond the movement of cattle, this would be a way that you could see rapid spread across the nation.
I think the fact that early cases were said to have yellowed, viscous milk perhaps slowed the response. It's time(past time) to move to more mandatory testing given the newer information of asymptomatic infections.
Statnews.com's update today with a few interesting tidbits again:
https://www.statnews.com/2024/04/26/h5n1-bird-flu-usda-cattle-testing-order-more-limited/
"farmers only have to test up to 30 animals in a given group. The guidance does not say how farmers should determine which 30 animals to test in larger groups that are being readied to be moved. The USDA did not respond to STAT’s questions about the rationale for the 30-animal cap."
"Under the new rules, cows that are to be moved between states must have samples collected and tested no more than a week prior to transport. A licensed or accredited veterinarian has to collect the samples — between 3 and 10 milliliters of milk per animal taken from each of the four teats. That’s very important, the USDA noted, because there have been reports of infected animals having virus in only one teat.
A strange feature of H5N1’s jump from birds into cows is that the virus seems to have developed an affinity for mammary tissue. Samples from sick cows show the highest levels of virus not in their noses but in their milk, suggesting that udders seem to be where H5N1 migrates to or infects."
"The USDA order does not apply to beef cattle or non-lactating dairy cattle, including calves, due to their lower risk profile, according to the guidance. But influenza researchers told STAT that not enough yet is known about the risks to non-lactating animals to leave them out."
34 herds in 9 states now confirmed:
https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/livestock
But almost certainly far more widespread.
"On Friday, the FDA issued an update saying that tests of several samples of retail powdered infant and toddler formula were negative, indicating no presence of H5N1 viral fragments or whole virus. It provided no details on the quantity tested."
"At this time, there have been no reported cases of H5N1-positive dairy cattle exhibiting any signs of neurological disease in the U.S."
Another interesting article from @HelenBranswell at StatNews today on the subject.
https://www.statnews.com/2024/04/29/bird-flu-raw-milk-h5n1-risk-us-cattle/
One, don't drink raw milk, and be wary of cheeses that use raw milk. I once had a roommate who was a head cheese maker, and knowing the process there I'm a little less worried about cheeses, but, I'm a big fan of the precautionary principle.
“Expect the unexpected. That’s the situation we deal with here.”
I think this was an interesting portion:
"But H5N1 has more tricks up its sleeve than seasonal flu viruses do; it can infect organs other than the lungs. Kuiken noted that the virus has been seen to move into the liver, the central nervous system and the brain, among other tissues. He saw the latter when he experimentally infected cats in the mid-2000s. Similar results were seen when baby goats were infected with the virus on a Minnesota farm in March. Ten of the kids died; necropsies on five of them showed virus in the brains and other organs.
Many of the animal species infected in the wild have been reported to sustain damage outside of the respiratory tract. It’s believed these animals — bears, raccoons, seals, foxes, and a raft of other mammals — became infected by eating sick or dead wild birds or poultry infected with the virus.
“So many, many species, they get a brain infection and brain disease, not a pulmonary disease,” Kuiken said. “In some cases the disease is missed because people are expecting pneumonia. If the animal is found dead, they don’t see the neurologic signs, and they forget to test the brain.”
Human infection with flu occurs when people breathe viruses emitted by others into their upper respiratory tracts. But the shared real estate of the top of the respiratory and gastric tracts make it impossible to rule out the possibility that ingestion of food or drink that contained high levels of viable H5N1 virus could trigger infection, scientists said.
Krammer said there are several mechanisms that could come into play. “You could get infection of cells in the upper respiratory tract that could go down and cause lower respiratory tract infection. There could be a route where it’s really going to the olfactory bulb,” he said, going from there to the brain. “And there’s the other option that it really makes it through the stomach … and then you start an infection from the mid gut.”
Krammer said he thought that last option was unlikely; he thinks stomach acids would inactivate the virus. But Kuiken doesn’t believe that’s necessarily true, referring to his study of H5N1 in cats. Milk acts as a buffer, he said. “It’s the perfect fluid for [virus] reaching the intestine in an infectious state.”
Maria Van Kerkhove, acting head of the WHO’s department of epidemic and pandemic preparedness, pointed to another outbreak, involving another virus and another animal species — the MERS coronavirus, which spreads to people from camels — as an example of where ingestion of virus-laced milk may have triggered infection of a respiratory disease. Some cases of MERS were traced to the drinking of raw camel’s milk, Van Kerkhove said, though she noted it wasn’t generally possible to tease out whether it was the drinking of the milk or the act of milking that led to the infections. (Influenza viruses and coronaviruses belong to different families.)"
I see some prominent people on Mastodon discussing the amazing speed at which bird flu has evolved from birds to mammals. Let's debunk.
"The first description of avian influenza (bird flu) dates to 1878 in northern Italy, when it was described as a contagious disease of poultry associated with high mortality, referred to as “fowl plague.” At the turn of the 20th century, it was determined that “fowl plague” was caused by a virus; however, it was not until 1955 that the virus was shown to be a type A influenza virus."
https://www.cdc.gov/flu/avianflu/timeline/avian-timeline-background.htm
Even just mammal to mammal spread was first scientifically documented 20 years ago.
https://wwwnc.cdc.gov/eid/article/10/12/04-0759_article
Just because you learned about something recently, it doesn't mean it just happened.
Separately, from a US-centric point of view, which is the view I think many people are taking this from, bird flu was first found in North America in 2021.
I have my suspicions about why mammal spread has been far more wide-spread in the last few years, but, I'm not sharing them as "fact" and I only wish others would do the same.
As pointed out by @HelenBranswell there's an early release of a paper from Iowa State with scientific details of the early part of this cattle H5N1 outbreak. To be quite honest, there's a lot in there that I can't really intelligently talk about as it's just out of my scientific comfort zone, but, I'm sure people who are more knowledgable will spring up to discuss it somewhere out there.
Some things I found interesting:
- From the cats in Texas that died "In total, >50% of the cats at that dairy became ill and died."
They were being fed milk from sick cows.
- "The HA sequences from the milk samples had 99.94% nucleotide identities with HA sequences from the cat tissues, resulting in a distinct subcluster comprising all 4 HA sequences, which clustered together with other H5N1 viruses belonging to clade 2.3.4.4b"
- "This case series differs from most previous reports of IAV infection in bovids, which indicated cattle were inapparently infected or resistant to infection (9). We describe an H5N1 strain of IAV in dairy cattle that resulted in apparent systemic illness, reduced milk production, and abundant virus shedding in milk. The magnitude of this finding is further emphasized by the high death rate (≈50%) of cats on farm premises that were fed raw colostrum and milk from affected cows; clinical disease and lesions developed that were consistent with previous reports of H5N1 infection in cats presumably derived from consuming infected wild birds (10–12). Although exposure to and consumption of dead wild birds cannot be completely ruled out for the cats described in this report, the known consumption of unpasteurized milk and colostrum from infected cows and the high amount of virus nucleic acid within the milk make milk and colostrum consumption a likely route of exposure. Therefore, our findings suggest cross-species mammal-to-mammal transmission of HPAI H5N1 virus and raise new concerns regarding the potential for virus spread within mammal populations."
- "Clinical IAV infection in cattle has been infrequently reported in the published literature. The first report occurred in Japan in 1949, where a short course of disease with pyrexia, anorexia, nasal discharge, pneumonia, and decreased lactation developed in cattle (17). In 1997, a similar condition occurred in dairy cows in southwest England leading to a sporadic drop in milk production (18), and IAV seroconversion was later associated with reduced milk yield and respiratory disease (19–21)."
- "An IAV-associated drop in milk production in dairy cattle appears to have occurred during >4 distinct periods and within 3 widely separated geographic areas: 1949 in Japan (17), 1997–1998 and 2005–2006 in Europe (19,21), and 2024 in the United States (this report). The sporadic occurrence of clinical disease in dairy cattle worldwide might be the result of changes in subclinical infection rates and the presence or absence of sufficient baseline IAV antibodies in cattle to prevent infection. Milk IgG, lactoferrin, and conglutinin have also been suggested as host factors that might reduce susceptibility of bovids to IAV infection (9). Contemporary estimates of the seroprevalence of IAV antibodies in US cattle are not well described in the published literature. One retrospective serologic survey in the United States in the late 1990s showed 27% of serum samples had positive antibody titers and 31% had low-positive titers for IAV H1 subtype-specific antigen in cattle with no evidence of clinical infections (24). Antibody titers for H5 subtype-specific antigen have not been reported in US cattle."
- "The genomic sequencing and subsequent analysis of clinical samples from both bovine and feline sources provided considerable insights. The HA and NA sequences derived from both bovine milk and cat tissue samples from different Texas farms had a notable degree of similarity. Those findings strongly suggest a shared origin for the viruses detected in the dairy cattle and cat tissues. Further research, case series investigations, and surveillance data are needed to better understand and inform measures to curtail the clinical effects, shedding, and spread of HPAI viruses among mammals. Although pasteurization of commercial milk mitigates risks for transmission to humans, a 2019 US consumer study showed that 4.4% of adults consumed raw milk >1 time during the previous year (29)"
(Is anyone monitoring these people, specifically?)
- "Ingestion of feed contaminated with feces from wild birds infected with HPAI virus is presumed to be the most likely initial source of infection in the dairy farms. Although the exact source of the virus is unknown, migratory birds (Anseriformes and Charadriiformes) are likely sources because the Texas panhandle region lies in the Central Flyway, and those birds are the main natural reservoir for avian influenza viruses (30)"
- "The mode of transmission among infected cattle is also unknown; however, horizontal transmission has been suggested because disease developed in resident cattle herds in Michigan, Idaho, and Ohio farms that received infected cattle from the affected regions, and those cattle tested positive for HPAI H5N1 (33)"
- "In conclusion, we showed that dairy cattle are susceptible to infection with HPAI H5N1 virus and can shed virus in milk and, therefore, might potentially transmit infection to other mammals via unpasteurized milk. A reduction in milk production and vague systemic illness were the most commonly reported clinical signs in affected cows, but neurologic signs and death rapidly developed in affected domestic cats. HPAI virus infection should be considered in dairy cattle when an unexpected and unexplained abrupt drop in feed intake and milk production occurs and for cats when rapid onset of neurologic signs and blindness develop. The recurring nature of global HPAI H5N1 virus outbreaks and detection of spillover events in a broad host range is concerning and suggests increasing virus adaptation in mammals. Surveillance of HPAI viruses in domestic production animals, including cattle, is needed to elucidate influenza virus evolution and ecology and prevent cross-species transmission."
There's a new article on StatNews today from @HelenBranswell with a Q&A format about what we know, and don't know, at this point about this outbreak.
https://www.statnews.com/2024/04/30/h5n1-bird-flu-virus-cows-and-risk-to-people/
Wear a mask makes an early appearance, so that's a plus. There's some discussion of asymptomatic and presymptomatic spread.
Some quotes of note:
- "The U.S. Department of Agriculture has said few tests from the respiratory tracts of infected cows have come back positive — and those that did showed there wasn’t a lot of virus present. But there is at least some evidence that H5N1 is on occasion getting deep into the respiratory tracts of cows."
- "While the contribution of respiratory transmission is still in question, there appears to be little doubt that a lot of spread is happening in milking parlors, where cows are strapped into the milking machines, and that in dairy cows, H5N1 seems to be primarily infecting mammary glands. The amount of virus in the udders of infected cows is off-the-charts high, making it easy to see how one cow’s infection soon becomes a herd’s problem."
- "Taylor noted another worry: H5N1, which is notorious for its ability to evolve, is being given a huge opportunity to adapt to bovine hosts. “The concern is if it becomes effective as a respiratory pathogen in cattle, it’s more likely to become effective as a respiratory pathogen in humans,” he said."
- "Sifford noted that cows in a herd without symptoms tested positive after cattle were moved into it from another herd whose remaining animals then went on to develop symptoms. The positive cows in the second herd haven’t developed symptoms, she said. “We are just getting underway with those studies to give us an idea of the opportunity for viremia either ahead of or after clinical signs,” she said. “So we should have more information about that in the coming weeks.”
One such study will be taking place in the high-containment laboratories at Kansas State University’s Center of Excellence for Emerging and Zoonotic Animal Diseases. Director Jürgen Richt said his group already has the necessary approvals and hopes to begin the research in mid-May."
- "Some uninfected cows will be housed with the infected animals to see whether they contract the virus, Richt said."
- "As to whether infected cows that have no symptoms are shedding virus in their milk, the evidence of viral traces in commercially purchased milk brings that question to the forefront. Farmers are supposed to discard milk from infected cows, which reportedly looks odd — yellowish and unusually thick. But PCR testing of commercially sold pasteurized milk has shown a substantial portion of samples were positive for RNA from H5N1, indicating the presence of either viral fragments or dead viruses. (The FDA said last week about one in five samples purchased in a cross-country survey tested positive.) So either some farmers aren’t following the recommendation, or some milk isn’t noticeably altered, or some cows that aren’t known to be sick are shedding the virus in their milk."
- "Kuiken is a bit pessimistic about whether, once the virus has found its way into a herd, transmission can be stopped: “You can’t not milk. And you probably can’t milk so well as to prevent cow-to-cow spread. I don’t think you can do it.” "
- "The CDC recommends that people working with or around cattle suspected or confirmed to be infected with H5N1 wear gloves, disposable fluid-resistant coveralls, vented safety goggles or a face shield, and an N95 respirator."
I would like to add to this that the CDC has recommendations for backyard flock owners since 2022 and I have yet to hear of anyone following it, even after bird flu has been found in their area. Recommendations, such as an N95, safety goggles and head to toe PPE, are pointless if no one follows them, or knows about them to begin with.
https://www.cdc.gov/flu/avianflu/h5/backyardflockowners.htm
- "Kuiken said the setup of many milking parlors is almost tailor-made to put workers in contact with viruses being shed in milk. That’s because there is typically a well — think of the area under the hoist in the garage where your car gets repaired — where workers are located while cows are being milked.
“So the milk worker is standing in a depressed area, and therefore his eyes are about at knee level — a little bit higher, maybe — with the cow. So very good for being inoculated, for eye infection,” he said."
- "Cook is also concerned about the possibility that the high pressure hoses that are used to spray down the parlors after milking may be aerosolizing virus that has fallen to the floor, making it easier for cows — and humans —to breathe in. He and other colleagues at the University of Wisconsin have begun deploying air monitoring devices into the milking parlors of affected farms to investigate the extent to which they can find genetic evidence of the virus in the air."
- "Farmers, who mostly haven’t been willing to have their cows tested, haven’t been keen to have their workers tested either."
Look, I know a lot of people are mad at the CDC about this, but, they can't raid farms and force people to test for a virus. I would sincerely like everyone who is calling for this to think it all the way through.
- "The World Health Organization appears to be concerned about the possibility of undetected human cases. Maria Van Kerkhove, acting head of the department of epidemic and pandemic preparedness, told STAT she’d like to see, among other things, studies looking for antibodies to H5N1 in the blood of farm workers and people who’ve been in contact with farm workers, to determine if there have been unreported cases and possibly even spread from those individuals to others."
People who don't want the CDC to test their workers for an active infection are really going to love the idea of the WHO coming in and testing their blood, right?
New article from StatNews again today, this time titled "Pasteurization inactivates H5N1 bird flu in milk, new FDA and academic studies confirm"
https://www.statnews.com/2024/05/01/bird-flu-pasteurization-inactivates-h5n1-in-milk/
I think the take home message in the article is:
"On Wednesday, the agency reported results from testing of a further 201 products, which included cottage cheese and sour cream, in addition to milk. Any PCR-positive samples were then injected into embryonated chicken eggs, to see whether any active virus could be grown — the gold standard test for assessing the viability of an influenza virus. None of the samples produced viable, replicating virus, Prater said."
"In addition, several samples of retail powdered infant formula as well as other powdered milk products. All PCR results from these products were negative. The agency did not disclose when it plans to make its full analysis, including which products were purchased from which states, available to the public."
"Bolstering the FDA’s data, academic researchers at the Ohio State University and St. Jude Children’s Research Hospital told STAT Tuesday night that their own study of 58 PCR-positive milk samples taken from Texas, Kansas, and eight other states in the Midwest also failed to turn up any evidence that H5N1 can survive the pasteurization process."
Catching up on my reading today and there's 4 new articles from StatNews.com that fit in this thread.
First, making the case for expanded wastewater surveillance:
https://www.statnews.com/2024/05/01/h5n1-bird-flu-hospital-wastewater-surveillance/
@HelenBranswell with another article about the USDA obfuscating data by labeling genomic sequences with simply "USA" and "2024":
https://www.statnews.com/2024/05/02/bird-flu-in-cows-h5n1-virus-changes-missing-data/
This one discusses a preprint
"The authors suggest the spillover event that started the spread in cattle may have happened in early December. The first detection that something was amiss with some cattle herds in the Texas panhandle dates to late January, but it took until March 25 before USDA confirmed the presence of H5N1 in a Texas herd."
https://www.biorxiv.org/content/10.1101/2024.05.01.591751v1.full.pdf+html
"Our genomic analysis
and epidemiological investigation showed that a reassortment event in wild bird populations preceded a5
single wild bird-to-cattle transmission episode. The movement of asymptomatic cattle has likely played a
role in the spread of HPAI within the United States dairy herd. Some molecular markers in virus populations
were detected at low frequency that may lead to changes in transmission efficiency and phenotype after evolution in dairy cattle. Continued transmission of H5N1 HPAI within dairy cattle increases the risk for
infection and subsequent spread of the virus to human populations."
The politics of public health is the topic of the next one, which is depressing:
https://www.statnews.com/2024/05/02/bird-flu-testing-dairy-state-politics-in-congress/
"Republican lawmakers have one big message on the avian flu outbreak in cows: Calm down."
No comment from me as I couldn't even get through it without having to take a walk.
And, finally, a little more info about the preprint paper from above and the recent data dump from the USDA:
""These data support a single introduction event from wild bird origin virus into cattle, likely followed by limited local circulation for approximately 4 months prior to confirmation by USDA,” the authors wrote."
"In the last few years, H5N1 has spread from wild birds to a variety of carnivorous mammals, including foxes, bears, and seals, but in each of those instances, the virus has hit a dead end. The outbreak in dairy cows represents one of the first times that this bird flu virus has demonstrated the ability to efficiently transmit between mammals, said Thomas Mettenleiter, a virologist who served as the director of the Friedrich Loeffler Institut — Germany’s leading animal disease research center — from 1996 until he stepped down last year. The other instance was a number of outbreaks at mink farms in Spain and Finland in 2022 and 2023, respectively."
Another article from @HelenBranswell today. This time with an interesting Q&A with the head of the CDC's influenza division.
https://www.statnews.com/2024/05/03/bird-flu-why-h5n1-keeping-awake-cdc-top-flu-scientist/
"It sounds like your team that was ready to go didn’t go. And it sounds like from what you’re telling me that CDC is very much in the back seat on this one. That it’s the states or local authorities who are running this.
They have the authority, right? CDC does not have the authority to go into a state. We have to have an invite from state public health.
Have any states invited CDC in?
No. Not officially yet. We’re speaking to these partners if not once a day, more than that."
"There has been a single human case in Texas. Has anybody done serology testing around that individual? That would be an obvious place to start, would it not?
I don’t know that that was consented to. You have to have consent from people to follow up. Certainly it was something that was on our radar for what we would like to have and request, but to my knowledge, serology was not performed. (A report on the case published Friday in the New England Journal of Medicine confirmed Dugan’s belief. The infected person and his contacts would not consent to have blood drawn.)"
After a peaceful weekend in the woods and some reflection, I decided I am not going to live blog all of the articles that come out about H5N1 any further. I think a lot of it is distraction. That said, I would still like to keep up on the science, and I'm sure other people would, too.
So here's a new story on an article discussing how cows might be a "mixing vessel" for influenza that digs into the receptor types. It "found that tissue from the mammary gland contains abundant receptors of the kind to which avian flu viruses like H5N1 can attach. But brain and respiratory tract tissues contained far fewer of this type of receptor."
https://www.statnews.com/2024/05/06/bird-flu-spread-study-of-h5n1-virus-infection-in-cows/
https://www.biorxiv.org/content/10.1101/2024.05.03.592326v1.full.pdf+html
"Human IAVs24 preferentially bind SA-α2,6 (human receptor), whereas avian IAVs have a preference for α2,325
(avian receptor). The avian receptor can further be divided into two receptors: IAVs isolated26 from chickens generally bind more tightly to SA-α2,3-Gal-β1,4 (chicken receptor), whereas27 IAVs isolated from duck to SA-α2,3-Gal-β1,3 (duck receptor). We found all receptors were28 expressed, to a different degree, in the mammary gland, respiratory tract, and cerebrum of beef29
and/or dairy cattle. The duck and human IAV receptors were widely expressed in the bovine30 mammary gland, whereas the chicken receptor dominated the respiratory tract. In general, only31 a low expression of IAV receptors was observed in the neurons of the cerebrum. These results32 provide a mechanistic rationale for the high levels of H5N1 virus reported in infected bovine33
milk and show cattle have the potential to act as a mixing vessel for novel IAV generation."
The paper has some salient, and interesting facts. It's always amazing to me what research comes out of these types of situations, and what assumptions that were made previously don't hold up to scrutiny.
"Here we evaluate the expression of IAV receptors in situ in the mammary gland, respiratory114 tract and cerebrum of cattle, which typically has been considered less susceptible to IAV115 infection5 . Strikingly, was the finding that both the human- (SA-α2,6) and the duck receptors116 (SA-α2,3-Gal-β1,3) were highly expressed in the mammary glands, whereas no expression of117 the chicken receptor (SA-α2,3-Gal-β1,4) was detected. A previous study showed that co-expression118 of both the human- and avian receptors can enhance the receptor binding of H5N1119 isolated from ducks (clade 2.1.1) in vitro23. Combined these findings support the hypothesis120 that the high viral load seen in milk from cows infected by HPAI H5N1 virus belonging to121 clade 2.3.4.4b are due to local viral replication, because these viruses have high affinity for this122 receptor24. Additionally, the avian receptor has been found to be highly expressed in the human123 cornea and conjunctiva25 which may explain the report that conjunctivitis was the dominating124 clinical sign of a person presumably infected by dairy cows in Texas 7."
"The transmission route(s) and the pathogenesis of H5N1 in cows remain unclear,126 and it’s not known if the virus enters the mammary gland by an ascending infection or127
systemically by the blood supply.
...
Suggestions by the USDA that only some udder quarters may be133 involved in infection does, however, argue against a viremic source27."
"The investigation of the IAV receptor distribution in the respiratory tract also135
revealed some novel findings. In the upper respiratory tract and upper part of the lower136 respiratory tract (trachea, bronchi, and bronchioles), the chicken receptor (SA-α2,3-Gal-β1,4)137 was expressed on the surface of the respiratory epithelium, whereas a lack of - or very limited138 expression - of the human and duck receptors was detected. This pattern is the opposite to what139 we found in the mammary gland. The lack of expression of the human receptor in the upper140 respiratory tract of cattle contrasts with findings in humans25,28 and swine22,25 and supports the141 perception that bovines are highly resistant to infection with influenza A viruses of human and142
swine origin when exposed by the respiratory route1,29. In the lung alveolar cells, however, all143 three receptors were abundantly expressed, similar to what has been found in pigs and144
humans22,25,28."
@BE I'm concerned about ranch run off, on vegetables. Like how we get E. Coli on romaine so often. Eggs, meat, you can cook well and be ok, at least AFAIK. Milk, if the virus is life in there, that's not good. But I'm already getting organic farm produce, not near ranches. 🤷🏼♀️
I've thought a bit about this for gardening and growing your own vegetables, at least. While I couldn't find a good study on H5N1, specifically, a 10% vinegar wash does inactivate H1N1.
A lot of people do wash veggies with vinegar solution already, so it seems like a good idea when possible given the possibility of wild bird feces anyway.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813869/
(Edited to add the paper 🙄 )
@BE I need to get that system going.
@BE Yes…sometimes ignorance is…no…not true. Thank you!
@BE Thank you for keeping on top of this issue. Wow…I feel bad for milk drinkers…not sure I would let my kids drink milk with this kind of uncertainty.
@BE Five subsitutions? FIVE??
Either God watches over fools and drunkards, or we're done for.
@BE It's a meaningless effort to look like they're taking reasonable measures, where all the data suggests that the barn is fully engulfed, the horses (cows) have bolted and they're at best half shutting the door. They need to be seen to be responding, so this is the ass covering shit we get.
@BE What we know is they tested in 38 states and found viral rna in 20% of samples taken. How many samples and what states are a big question and they're not being forthcoming. My guess is significantly more than the 9 currently acknowledged.
We also know that Ohio State's ad-hoc effort revealed 38% of sample in 10 states visited and that some of the states visited are not on the acknowledged list, but we don't know which states there either.
Absolutely. That info's in the thread above this latest one.
We also don't know about how milk transports around the country. I do know someone who purchases for a grocery chain and I reached out and she basically just said it's all algorithmically determined now and the milk in your store might come from your state or across the country at any given moment.
We simply don't have enough info to make firm conclusions, and that's a choice that's been made on purpose.
@BE I very much get the sense that there is an effort to minimize disclosure of what is known to the public. There is a lot of reassurance without data and reporters don't seem to be holding them to account by asking some very obvious questions.
@BE I've got a laundry list of unanswered questions at this point and in the absence of some real well evidenced statements, I'm going to be operating out of an abundance of caution.
I would say obfuscate in place of minimize, but otherwise, yeah. They, at least, were careful to say that the milk MIGHT not be safe, etc. What they're doing is obfuscating in deference to dairy and cattle farmers, I think.
"The USDA did not respond to STAT’s questions about the rationale for the 30-animal cap."
I get the feeling questions are being asked, but, they're under no obligation to answer them at this point.
@BE Which is why those questions should be posed publicly in articles written. Reporters are broadly speaking failing to hold the government to any sort of account on this matter.
This, imo, looks as bad to me as the way China acted at the beginning of the Covid pandemic.
Now apparently there's an announcement that the influenza virus lasts when it's frozen. 🤷
Since they got 1918 flu samples out of the frozen body in Alaska, why is this a surprise? 😆
We're in this loop with COVID stuff where things we knew years ago keep being reported as new. Probably where we're headed with flu info, too.
Yeah, it's not very reassuring from an institution standpoint. I mean they should know the basics.
It was interesting though because it does seem like the only confirmed touch cases that I can remember are cold chain cases. For covid I mean. I think there's about 5. Maybe there's one that isn't cold chain.
@BE @HelenBranswell drinking raw milk always seemed like a really bad idea!
I appreciate your clarity here, and am grateful for all the information and links you post. Thank you.
@BE Glad to follow you. Thank you for your posts! 🙂👍
@BE @HelenBranswell Thank you for the summary. We truly live in interesting times.
Also noteworthy, the #CatsOfMastodon are saddened by the news of their fallen compatriots… 🤍🕊️🤍
Regarding the 4.4% consuming raw milk, I wonder how they ask that question so that the general public understands it correctly.
Legitimate question!
@BE It’s always disturbing to see how toothless government agencies are against business. “We can’t force companies to NOT make people sick. We just have to keep asking them nicely as they continue to ignore us. It’s their right because profits over people in every instance.”
The other curious thing to me is how focused we are on milk and raw vs pasteurized, but I’ve seen nothing about poultry, beef, or other meats, nor eggs, cheese, or other animal byproducts. I might have missed it.
I don't think the poultry outlook has substantially changed since bird flu was first introduced to North America ~2021.
The USDA has started testing ground beef, but only in the 9 states officially recognized as having bird flu in dairy cows, from what I understand.
@BE So in your opinion, do you think any animal products are safe to consume? When I do a search, it sounds like officials say everything is fine as long as it’s commercially acquired or not from infected animals, but I don’t really trust that given the track record.
I've addressed this a little last week, but, I think it still stands today. It sucks, but, you're not wrong about the track record. You have to make your own decisions until a different track record is established.
We don't drink milk, but we did buy some to make kefir with every couple of weeks, and we quit doing that for now. That said, it should be safe if properly pasteurized.
We eat cheese and haven't stopped. I'm far from an expert, but, from what I know from personal experience cheese makers know if something is growing in their cheese and throwing off the chemistry, pH, etc.
We don't buy grocery store beef, so, I haven't given it too deep of thought. Off the top of my head, we've lived with bird flu theoretically infecting any given chicken for years now, and if cooked above 165 it should be safe. I would think the same applies to beef, but, I know we are a nation of medium/medium rare beef. Since there's really no science on infectious dose from eating infected meat it's hard to intelligently discuss.
If it were me, I might wait until we have some more information on that, specifically the USDA's ground beef testing. But that's easy for me to say when it doesn't affect us, personally. If you live on a beef diet you might have a different outlook on that.
@BE Meat is not much of a concern for me personally, but I worry for people I care about who are reluctant to give it up. I was more worried about eggs and cheese because I eat a lot of both, but that’s good to know about cheese making. Milk is easy to avoid, but products like sour cream use milk fat but are partially fermented. Do you know if this is similar to cheese in terms of the processor being able to tell if there’s an issue? Sorry, I ask because you seem knowledgeable.
I'm never offended by questions, although I'm definitely not an expert. Just someone with a science background who reads a lot, and used to have a head cheese maker roommate for years :)
I know you didn't really ask about eggs, but, you mentioned them. I put eggs and chicken in the same category for now, personally. I don't see any substantial change in their situation just because cows got H5N1. There's something like 430 billion birds in the world and 90 million cows in the US. It's not a huge reservoir overall, although, any new viral reservoir can lead to new and often unpredictable mutations.
Sour cream's a great question and I don't have a great answer beyond making sure it's made with pasteurized milk/cream.
I did read somewhere recently that a lot of Mexican-style soft cheeses are sometimes allowed to use unpasteurized milk. I haven't dug into the subject deeply, but, if that's true, I'd say the same thing about your cheese. Just make sure it's from pasteurized milk.
Somewhere in the thread above was a mention that something like 4% of people supposedly drink raw milk more than 1 time per year. If that's true, that would be something like 13 million people. That seems impossibly large to me, but, let's assume it's correct for the moment. If even 10% of them were currently sick with bird flu, that would be over a million people. I think we'd know. I'm not saying that there's no risk at all. Clearly, we've made some changes just to be on the safe side, but, to date, I don't see any evidence that there's a lot of people with bird flu, unless it's simply not distinguishable from COVID.
@BE Thanks for taking the time to answer. It’s interesting you mention Mexican cheeses because I believe I’ve seen a couple recalls mentioned in the past month or so due to listeria so I was already avoiding them. I’ve gotten both e-coli and salmonella in the past 6 years so I am cautious. It’s becoming increasingly difficult to eat anything safely anymore due to deregulation and lax enforcement.
That's the truth!
@BE That's good news.
Woot!!!
Not surviving the pasteurization process is not the same as being denatured via pasteurization. It would be a mistake to believe that 180F for 20 seconds inactives H5N1 just because the virus isn't viable in milk by the time it makes it to store shelves. The latter does not confirm the former.
@BE @HelenBranswell fun, isn't it! I have friends who are got farmers, they were not aware that it also had been found in a goat here in MN... And then in a few weeks all the county and state fairs start, with the potential to turn into super spreader events. And bringing different species together... Just calm down ... Right....
Yeah, I did wonder about particularly state fairs and whether everyone was just going to go ahead with them, and I'm sure the answer is yes.
@BE Thank you for all your information. We shall overcome…with facts…
Who am I following on this? @HelenBranswell has a string of great articles at statnews.com.
https://www.statnews.com/2024/04/05/bird-flu-cdc-urges-doctors-watch-for-h5n1-in-farm-workers/
https://www.statnews.com/2024/04/18/h5n1-bird-flu-scientists-want-usda-genetic-data-faster/
https://www.statnews.com/2024/04/21/usda-releases-h5n1-bird-flu-genetic-data-eagerly-awaited-by-scientists/
https://www.statnews.com/2024/04/23/h5n1-bird-flu-genetic-analysis/
https://www.statnews.com/2024/04/23/h5n1-bird-flu-virus-particles-in-pasteurized-milk-fda/
https://www.statnews.com/2024/04/24/h5n1-bird-flu-vaccine-preparedness/