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.

Presented without further comment.

nature.com/articles/s41577-019

"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."

ncbi.nlm.nih.gov/pmc/articles/

"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"

nature.com/articles/s41467-020

"Airborne Transmission of Influenza A/H5N1 Virus Between Ferrets"

science.org/doi/10.1126/scienc

"The Potential for Respiratory Droplet–Transmissible A/H5N1 Influenza Virus to Evolve in a Mammalian Host"

science.org/doi/10.1126/scienc

"A comprehensive review of highly pathogenic avian influenza (HPAI) H5N1: An imminent threat at doorstep"

sciencedirect.com/science/arti

"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"

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)

nature.com/articles/486456a

Follow

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"

wwwnc.cdc.gov/eid/article/10/1

"Probable Tiger-to-Tiger Transmission of Avian Influenza H5N1"

wwwnc.cdc.gov/eid/article/11/5

(Transmission route not determined, but they had stopped being fed raw chicken)

"H5N1 pathogenesis studies in mammalian models"

ncbi.nlm.nih.gov/pmc/articles/

(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"

eurosurveillance.org/content/1

"Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in New England Seals, United States"

wwwnc.cdc.gov/eid/article/29/4

"Mass Mortality of Sea Lions Caused by Highly Pathogenic Avian Influenza A(H5N1) Virus"

wwwnc.cdc.gov/eid/article/29/1

"Highly pathogenic avian influenza A (H5N1) in marine mammals and seabirds in Peru"

nature.com/articles/s41467-023

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