Seems we may have learned little from the COVID pandemic , and no doubt the anti-vaxers,anti-mandaters,conspiricists will come out from under their rocks again.From WAPO today:
" ...New this a.m.: Federal agencies with competing interests are slowing the country’s ability to track and control an outbreak of highly virulent bird flu that is infecting U.S. cows for the first time, our colleagues Lena H. Sun and Rachel Roubein report.
Some officials and experts are expressing frustration that more livestock herds aren’t being tested for avian flu, and that when testing occurs, the results aren’t shared quickly or with enough detail. They point, in particular, to a failure to provide more information publicly about how the H5N1 virus is spreading in cows and the safety of the milk supply.
Until yesterday, testing dairy herds was voluntary and limited to cows with certain symptoms. With growing evidence that the virus is more widespread than feared among cows, the Biden administration ordered all lactating dairy cows to be screened for bird flu before moving across state lines, starting Monday.
Flashback: For some, the response echoes the early days of the coronavirus outbreak in 2020 and similar communication missteps at the start of the pandemic. These experts fear that the delays could allow the pathogen to move unchecked — and potentially acquire the genetic machinery needed to spread swiftly among people.
The view from the White House: A senior administration official said there have been “no competing interests.” The White House’s Office of Pandemic Preparedness and Response Policy is coordinating the outbreak response with relevant agencies “that are working quickly and methodically...”
Not mentioned ion this article, 2 human dairy workers have been infected, and concerns are the virus could also spread to the nation's pork and beef animals, gaining mutation experience to also move on more easily to humans. Already, remnants of pathogen have been found in milk at numerous grocery stores in the US (the FDA has instituted more widespread testing and it's not clear yet whether pastuerization has rendered the remants safe ), and the World is woefully short of capacity to develop vaccine for the diease which apparently has a high mortality risk.
From STAT News yesterday:
"...To date, the USDA has reported that 33 herds in eight states have tested positive for H5N1, though a recent analysis of genetic sequences that the USDA released on Sunday suggests that the virus is more widespread than has been recognized to date. Given the size of the U.S. milk supply, the finding of evidence of virus in milk products on store shelves also suggests there have been more infections than have been detected or at least reported.
Related: H5N1 bird flu virus particles found in pasteurized milk but FDA says commercial milk supply appears safe.
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. And evidence that milk containing virus has made its way into the milk supply suggests either some farmers have ignored the advice, or asymptomatic infected cows may be emit viruses in their milk.
“There has been a little bit of reluctance from some of the producers to allow us to gather information from their farms. That has been improving here more recently,” he said, suggesting the federal order should also increase USDA’s access.
“With the federal order going into place, this is going to really help us address any gaps that might exist in terms of … knowing what’s happening with the cattle,” Watson said.
Likewise, Nirav Shah, the CDC’s principal deputy director, acknowledged there has been some difficulty in investigating the health of workers on some farms where H5N1 has been detected.....
The unsettling reality of H5N1 bird flu circulating in dairy cow herds in multiple parts of the United States is raising anxiety levels about whether this dangerous virus, which has haunted the sleep of people who worry about influenza pandemics for more than 20 years, could be on a path to acquiring the ability to easily infect people.
To be clear, there is no evidence that this is currently the case — the sole confirmed human case reported in Texas three weeks ago was in a farm worker who had contact with cattle. There is no way to predict if the virus will acquire the capacity to spread between people, or when and under what conditions it would make that fateful leap if it does.
But the first signs that H5N1 — or any new flu virus — was starting to spread from person to person would trigger a race to produce massive amounts of vaccine to try to mitigate the damage a flu pandemic might be expected to cause. While the 2009 H1N1 pandemic is estimated to have killed about a quarter-million people worldwide — severe flu seasons sometimes kill more — the 1918 Spanish flu pandemic is believed to have killed between 50 million and 100 million people, many times more than Covid-19.
The good news: The world makes a lot of flu vaccine and has been doing it for decades. Regulatory agencies have well-oiled systems to allow manufacturers to update the viruses the vaccines target without having to seek new licenses. The United States even has some H5 vaccine in a stockpile that it believes would offer protection against the version of the H5N1 virus infecting dairy cattle, though there would not be nearly enough doses for the entire country.
The bad news: The current global production capacity isn’t close to adequate to vaccinate a large portion of the world’s population in the first year of a pandemic. And batches of flu vaccine, often (though not always) produced in hen’s eggs, take months to produce..."
Bird-flu ? What me worry ?
Re: Bird-flu ? What me worry ?
STAT News today:
EXCLUSIVE
Early tests of H5N1 prevalence in milk suggest U.S. bird flu outbreak in cows is widespread
By Megan Molteni April 25, 2024
Andrew Bowman, a veterinary epidemiologist at Ohio State University, had a hunch. He had been struck by the huge amounts of H5N1 virus he’d seen in milk from cows infected with the bird flu and thought that at least some virus was getting off of farms and going downstream — onto store shelves.
He knew the Food and Drug Administration was working on its own national survey of the milk supply. But he was impatient. So he and a graduate student went on a road trip: 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.
The researchers expect additional lab studies currently underway to show that those samples don’t contain live virus with the capability to cause human infections, meaning that the risk of pasteurized milk to consumer health is still very low. But the prevalence of viral genetic material in the products they sampled suggest that the H5N1 outbreak is likely far more widespread in dairy cows than official counts indicate. So far, the U.S. Department of Agriculture has reported 33 herds in eight states have tested positive for H5N1.
“The fact that you can go into a supermarket and 30% to 40% of those samples test positive, that suggests there’s more of the virus around than is currently being recognized,” said Richard Webby, an influenza virologist who has been analyzing the samples at St. Jude’s Children’s Research Hospital in Memphis, Tenn., where he heads the WHO Collaborating Center for Studies on the Ecology of Influenza in Animals.
Earlier this week, the FDA announced that its effort had found evidence of the H5N1 virus in samples of milk purchased from store shelves, but it provided no detailed results. On Thursday, during an online symposium hosted by the Association of State and Territorial Health Officials, the FDA disclosed a high-level readout from the agency’s investigation. Results returned Thursday morning showed PCR-positive milk in 20% of samples, “maybe with some preponderance for areas with known herds,” said Donald Prater, acting director of the FDA’s Center for Food Safety and Applied Nutrition. He did not say how many samples the FDA had analyzed or from what geographic area.
The testing by PCR — polymerase chain reaction — turned up only genetic traces of the virus, not evidence that it’s alive or infectious.
The FDA has been adamant that H5N1, which is heat-sensitive, is very likely killed through the process of pasteurization.
The agency is still assessing those samples for viral viability by attempting to grow virus from milk found to contain RNA from H5N1. The FDA plans to release results of those studies in the coming days. On Wednesday, Jeanne Marrazzo, the new director of the National Institute of Allergy and Infectious Diseases, told reporters that a team of NIAID-funded researchers had early data to suggest that pasteurization does appear to be effective.
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.
Those four samples came from an initial collection of 22 commercial milk products purchased in the Columbus, Ohio, area. “It was basically just me hitting up the five grocery stores between campus and my house,” said Bowman.
(Rach3: One more reason to stick to wine. )
EXCLUSIVE
Early tests of H5N1 prevalence in milk suggest U.S. bird flu outbreak in cows is widespread
By Megan Molteni April 25, 2024
Andrew Bowman, a veterinary epidemiologist at Ohio State University, had a hunch. He had been struck by the huge amounts of H5N1 virus he’d seen in milk from cows infected with the bird flu and thought that at least some virus was getting off of farms and going downstream — onto store shelves.
He knew the Food and Drug Administration was working on its own national survey of the milk supply. But he was impatient. So he and a graduate student went on a road trip: 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.
The researchers expect additional lab studies currently underway to show that those samples don’t contain live virus with the capability to cause human infections, meaning that the risk of pasteurized milk to consumer health is still very low. But the prevalence of viral genetic material in the products they sampled suggest that the H5N1 outbreak is likely far more widespread in dairy cows than official counts indicate. So far, the U.S. Department of Agriculture has reported 33 herds in eight states have tested positive for H5N1.
“The fact that you can go into a supermarket and 30% to 40% of those samples test positive, that suggests there’s more of the virus around than is currently being recognized,” said Richard Webby, an influenza virologist who has been analyzing the samples at St. Jude’s Children’s Research Hospital in Memphis, Tenn., where he heads the WHO Collaborating Center for Studies on the Ecology of Influenza in Animals.
Earlier this week, the FDA announced that its effort had found evidence of the H5N1 virus in samples of milk purchased from store shelves, but it provided no detailed results. On Thursday, during an online symposium hosted by the Association of State and Territorial Health Officials, the FDA disclosed a high-level readout from the agency’s investigation. Results returned Thursday morning showed PCR-positive milk in 20% of samples, “maybe with some preponderance for areas with known herds,” said Donald Prater, acting director of the FDA’s Center for Food Safety and Applied Nutrition. He did not say how many samples the FDA had analyzed or from what geographic area.
The testing by PCR — polymerase chain reaction — turned up only genetic traces of the virus, not evidence that it’s alive or infectious.
The FDA has been adamant that H5N1, which is heat-sensitive, is very likely killed through the process of pasteurization.
The agency is still assessing those samples for viral viability by attempting to grow virus from milk found to contain RNA from H5N1. The FDA plans to release results of those studies in the coming days. On Wednesday, Jeanne Marrazzo, the new director of the National Institute of Allergy and Infectious Diseases, told reporters that a team of NIAID-funded researchers had early data to suggest that pasteurization does appear to be effective.
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.
Those four samples came from an initial collection of 22 commercial milk products purchased in the Columbus, Ohio, area. “It was basically just me hitting up the five grocery stores between campus and my house,” said Bowman.
(Rach3: One more reason to stick to wine. )
Re: Bird-flu ? What me worry ?
I wonder why your "Pravda" media keeps you in a permanent state of panic? (I wonder if I wonder?)
I can't and won't waste the remaining years of my life worrying about any pandemic, as I'm just grateful for the standard of living I've got and the happiness index of it. All of it could vanish in a moment, but I'm not risk-averse and fully understand that - along with my family.
Be philosophical and drink more wine.
I can't and won't waste the remaining years of my life worrying about any pandemic, as I'm just grateful for the standard of living I've got and the happiness index of it. All of it could vanish in a moment, but I'm not risk-averse and fully understand that - along with my family.
Be philosophical and drink more wine.
Re: Bird-flu ? What me worry ?
From WAPO May 3 in part:
"...Of course, just because milk remains safe to drink doesn’t mean avian flu isn’t a potential threat to human health. I was honored to learn historian John M. Barry, author of the seminal book on the 1918 influenza pandemic, is a Checkup reader. He emailed me to express his worries, and I took him up on the offer to speak by phone.
“The question is, are we in the early stages of watching the evolution of this virus toward something that will become respiratory and spread through the aerosols between mammals and humans?” he said. “It’s too early to say that that’s happening, but there are some things that are disconcerting.”
Indeed, while the spread of H5N1 from birds to mammals has long been documented, we have not previously observed this scale of outbreak among mammals. Health officials do not know how cows are spreading the virus to one another and whether there could be asymptomatic transmission. And there are concerns that some farms might not cooperate with federal guidance to test and isolate affected cows.
Barry reminds us that “virtually nothing” is known about how the 1918 influenza jumped species or how long these evolutionary changes took to occur. And even if we did know these details, it would be unwise to expect avian flu to follow the same playbook.
All that said, we should keep in mind that there are not yet any instances of human-to-human transmission during this avian flu outbreak. And I remain reassured that federal health officials have a plan for manufacturing and distributing treatment and vaccines, should bird flu become the next pandemic."
Reassured ?
"...Of course, just because milk remains safe to drink doesn’t mean avian flu isn’t a potential threat to human health. I was honored to learn historian John M. Barry, author of the seminal book on the 1918 influenza pandemic, is a Checkup reader. He emailed me to express his worries, and I took him up on the offer to speak by phone.
“The question is, are we in the early stages of watching the evolution of this virus toward something that will become respiratory and spread through the aerosols between mammals and humans?” he said. “It’s too early to say that that’s happening, but there are some things that are disconcerting.”
Indeed, while the spread of H5N1 from birds to mammals has long been documented, we have not previously observed this scale of outbreak among mammals. Health officials do not know how cows are spreading the virus to one another and whether there could be asymptomatic transmission. And there are concerns that some farms might not cooperate with federal guidance to test and isolate affected cows.
Barry reminds us that “virtually nothing” is known about how the 1918 influenza jumped species or how long these evolutionary changes took to occur. And even if we did know these details, it would be unwise to expect avian flu to follow the same playbook.
All that said, we should keep in mind that there are not yet any instances of human-to-human transmission during this avian flu outbreak. And I remain reassured that federal health officials have a plan for manufacturing and distributing treatment and vaccines, should bird flu become the next pandemic."
Reassured ?
Re: Bird-flu ? What me worry ?
From STAT News May 3:
Vivien Dugan isn’t getting much sleep these days.
The director of the influenza division at the Centers for Disease Control and Prevention, Dugan is leading the team of CDC scientists that is working with partners — in the U.S. Department of Agriculture, the Food and Drug Administration, and state and local health departments — to respond to the H5N1 bird flu outbreak in dairy cattle.
The response has been pedal to the metal since the USDA announced on March 25 that a strange illness that had been affecting milk production in some herds since early this year was caused by bird flu. Since then, 36 herds in nine states have tested positive for the virus.
Assessing the risk from the situation and messaging it to the public is a balancing act, she admitted. While workers on affected dairy farms are being exposed to the virus — one has tested positive so far — for the individual American elsewhere, the risk is low, for the moment. Demetre Daskalakis, director of CDC’s National Center for Immunization and Respiratory Diseases — in which the flu division is housed — said Wednesday that 25 people have been tested for H5N1 in the context of this outbreak, and over 100 people have been monitored for symptoms because they were believed to have been exposed.
Related: Republicans, concerned about dairy industry, urge calm about H5N1 bird flu (Rach3: Deja vu Trump's " over by April 1" re: COVID.)
The responding agencies have long experience working with poultry farmers, who’ve been plagued by this virus for the past couple of years. But its move into cattle has been like crossing into a new country for the agencies. Dairy farmers have no experience with bird flu. Many farmers and farm workers haven’t been eager to cooperate with authorities.
In an ideal world, blood samples from people who had contact with the infected farm worker would have been studied to look for H5N1 antibodies to see if he transmitted the virus to anyone, a technique called a serology study. But Dugan said she believes that the people involved wouldn’t grant permission.
STAT asked Dugan about the work the CDC is doing, the complaints from scientists globally about the amount of information the United States has been sharing, and where the needle on her H5N1 risk meter sits right now. As we spoke, a colorful statue of a rooster was visible on a credenza behind her — apt decor for a flu researcher.
The interview has been edited for length and clarity.
Q.The numbers of people tested and/or monitored seems to be implausibly low, given the numbers of workers who would have been exposed to the infected animals. How hard is the U.S. looking for cases?
We had a team pretty much ready to go six weeks ago, when this first really started to show up on our radar. But this is not the average poultry-worker response situation. These are dairy farms. The poultry space and poultry industry, they’ve been responding to H5 for the past 2 ½ years, really. There’ve been more than 8,000 people that have been monitored for symptoms in the H5 poultry space. It’s a different environment altogether when we’re talking about dairy cattle and dairy farms.
That said, we are really thinking about how we would go about doing the investigation we would normally do for a novel flu case — where they’re all nationally notifiable infections in people — in a way that makes scientific and epidemiological sense.
The states are really focusing on that, really trying to get as much information as they can. So it’s really more in that local space. We’re supporting them in that effort. Some states have been able to contact workers directly and actively monitor. Others, of course, have not been as successful.
So it’s a work in progress. We have a couple of potential locations that we’re trying to do more with in getting the logistics sorted out. But no studies have been completed yet.
Q.No studies have been completed yet. Have any studies started?
That’s probably a good question for some of the impacted states. We don’t want to get ahead of them for any work they may be doing that we don’t have all the details on.
Q.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 are a lot of sensitivities. There are a lot of things that we as public health officials may not be aware of in thinking about dairy farms. We’re used to working with poultry farms and poultry workers where they’re culling all the birds. These cows are not being culled. So it’s a very different space.
We’re working very closely with the state public health partners, where potentially they might be a lead of a study. And we would be in the background supporting. Sometimes we don’t need to deploy a team, we can equip our state public health partners to do the information gathering and work collaboratively with them to do that.
Q.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.)
The scientific world has been watching H5 for a long time. CDC has been very involved in that. And whenever there have been unusual outbreaks, this country has always pushed for rapid case finding and data sharing.
Q.I’m hearing from people outside the United States that when the shoe is on the other foot, when the outbreak is here, they’re not seeing the information sharing that they would hope for, or even evidence that the work that is crucial to finding out whether or not this could get seeded into the human population is happening. Do you have any response to that?
It’s a complicated situation as far as [there are] new partners and new individuals and a different group of farm workers. We’re doing everything we can and thinking about messaging, multilingual messages, communications, PPE [personal protective equipment], biosecurity on farms, and collaboration with USDA to really protect workers. That is definitely one of our highest priorities, and it always is.
But also we’re really thinking about this in the medium and longer term of what allowing a virus to circulate within a new mammalian host could mean. I don’t think anybody really can predict what might happen, but we certainly know flu viruses change. And we do not want to give the virus that opportunity, if we can avoid it.
By the way, I think you need to add to your statue collection. The chicken needs a cow.
Yeah.
On data sharing, we are trying to be as forthcoming and as transparent as we can with the data that we have. I think we’re doing that in the “Spotlights” that we’re putting out every Friday. We got the Texas human virus sequence out as quickly as we could.
So I think we’re trying to do that as much as we can. We can always do more. But a lot of this, again, is our partnerships with the states. We defer to them. We have to be behind the scenes and let them talk about what’s going on in their state.
Q.Can I ask about your personal read on the risk here? If this virus gets seeded into the cow population and it evolves in cows, what do you think this does to the human risk from H5N1?
[Dugan grimaced.] I think it would definitely impact the risk, for sure. Our current assessment of the risk to the general public health is low. That could change. And so I think we’re remaining very vigilant — if anything, more vigilant in this space.
These viruses change. If this were to become seeded in cows and become a cow-endemic virus, it certainly would increase that risk to people.
And certainly our pandemic planning [operation] has been really thinking about this and trying to be as vigilant as we can now, to try and understand not just current risk, but the future risk so that we’re as prepared as we can be.
But the risk could be quite big.
Q.You said you still think the risk is low. But 15 years ago this spring, CDC was notified about two kids from California who had tested positive for swine flu who hadn’t had exposure to pigs or each other. Before April 17, 2009, the risk of a swine flu pandemic would have seemed pretty low. And then CDC got those two samples, and everything changed really fast. Do you think about that?
Well, yeah. It’s probably why I’m not sleeping very much right now.
I think that the threat of a pandemic is always looming in the flu space. The way that Dan Jernigan [Dugan’s predecessor] always described public health to me is that it is an art form. There’s a balance that you have to strike. There’s a difference in the pandemic risk versus the immediate risk right now. And so I think that’s what we’re trying to message to the average person who is walking about and living their lives. The risk to them is low.But you’re right. It could absolutely change.
Helen Branswell covers issues broadly related to infectious diseases, including outbreaks, preparedness, research, and vaccine development. Follow her on Mastodon and Bluesky.
@HelenBranswell
linkedin.com/in/helen-branswell-22ab936/
Vivien Dugan isn’t getting much sleep these days.
The director of the influenza division at the Centers for Disease Control and Prevention, Dugan is leading the team of CDC scientists that is working with partners — in the U.S. Department of Agriculture, the Food and Drug Administration, and state and local health departments — to respond to the H5N1 bird flu outbreak in dairy cattle.
The response has been pedal to the metal since the USDA announced on March 25 that a strange illness that had been affecting milk production in some herds since early this year was caused by bird flu. Since then, 36 herds in nine states have tested positive for the virus.
Assessing the risk from the situation and messaging it to the public is a balancing act, she admitted. While workers on affected dairy farms are being exposed to the virus — one has tested positive so far — for the individual American elsewhere, the risk is low, for the moment. Demetre Daskalakis, director of CDC’s National Center for Immunization and Respiratory Diseases — in which the flu division is housed — said Wednesday that 25 people have been tested for H5N1 in the context of this outbreak, and over 100 people have been monitored for symptoms because they were believed to have been exposed.
Related: Republicans, concerned about dairy industry, urge calm about H5N1 bird flu (Rach3: Deja vu Trump's " over by April 1" re: COVID.)
The responding agencies have long experience working with poultry farmers, who’ve been plagued by this virus for the past couple of years. But its move into cattle has been like crossing into a new country for the agencies. Dairy farmers have no experience with bird flu. Many farmers and farm workers haven’t been eager to cooperate with authorities.
In an ideal world, blood samples from people who had contact with the infected farm worker would have been studied to look for H5N1 antibodies to see if he transmitted the virus to anyone, a technique called a serology study. But Dugan said she believes that the people involved wouldn’t grant permission.
STAT asked Dugan about the work the CDC is doing, the complaints from scientists globally about the amount of information the United States has been sharing, and where the needle on her H5N1 risk meter sits right now. As we spoke, a colorful statue of a rooster was visible on a credenza behind her — apt decor for a flu researcher.
The interview has been edited for length and clarity.
Q.The numbers of people tested and/or monitored seems to be implausibly low, given the numbers of workers who would have been exposed to the infected animals. How hard is the U.S. looking for cases?
We had a team pretty much ready to go six weeks ago, when this first really started to show up on our radar. But this is not the average poultry-worker response situation. These are dairy farms. The poultry space and poultry industry, they’ve been responding to H5 for the past 2 ½ years, really. There’ve been more than 8,000 people that have been monitored for symptoms in the H5 poultry space. It’s a different environment altogether when we’re talking about dairy cattle and dairy farms.
That said, we are really thinking about how we would go about doing the investigation we would normally do for a novel flu case — where they’re all nationally notifiable infections in people — in a way that makes scientific and epidemiological sense.
The states are really focusing on that, really trying to get as much information as they can. So it’s really more in that local space. We’re supporting them in that effort. Some states have been able to contact workers directly and actively monitor. Others, of course, have not been as successful.
So it’s a work in progress. We have a couple of potential locations that we’re trying to do more with in getting the logistics sorted out. But no studies have been completed yet.
Q.No studies have been completed yet. Have any studies started?
That’s probably a good question for some of the impacted states. We don’t want to get ahead of them for any work they may be doing that we don’t have all the details on.
Q.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 are a lot of sensitivities. There are a lot of things that we as public health officials may not be aware of in thinking about dairy farms. We’re used to working with poultry farms and poultry workers where they’re culling all the birds. These cows are not being culled. So it’s a very different space.
We’re working very closely with the state public health partners, where potentially they might be a lead of a study. And we would be in the background supporting. Sometimes we don’t need to deploy a team, we can equip our state public health partners to do the information gathering and work collaboratively with them to do that.
Q.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.)
The scientific world has been watching H5 for a long time. CDC has been very involved in that. And whenever there have been unusual outbreaks, this country has always pushed for rapid case finding and data sharing.
Q.I’m hearing from people outside the United States that when the shoe is on the other foot, when the outbreak is here, they’re not seeing the information sharing that they would hope for, or even evidence that the work that is crucial to finding out whether or not this could get seeded into the human population is happening. Do you have any response to that?
It’s a complicated situation as far as [there are] new partners and new individuals and a different group of farm workers. We’re doing everything we can and thinking about messaging, multilingual messages, communications, PPE [personal protective equipment], biosecurity on farms, and collaboration with USDA to really protect workers. That is definitely one of our highest priorities, and it always is.
But also we’re really thinking about this in the medium and longer term of what allowing a virus to circulate within a new mammalian host could mean. I don’t think anybody really can predict what might happen, but we certainly know flu viruses change. And we do not want to give the virus that opportunity, if we can avoid it.
By the way, I think you need to add to your statue collection. The chicken needs a cow.
Yeah.
On data sharing, we are trying to be as forthcoming and as transparent as we can with the data that we have. I think we’re doing that in the “Spotlights” that we’re putting out every Friday. We got the Texas human virus sequence out as quickly as we could.
So I think we’re trying to do that as much as we can. We can always do more. But a lot of this, again, is our partnerships with the states. We defer to them. We have to be behind the scenes and let them talk about what’s going on in their state.
Q.Can I ask about your personal read on the risk here? If this virus gets seeded into the cow population and it evolves in cows, what do you think this does to the human risk from H5N1?
[Dugan grimaced.] I think it would definitely impact the risk, for sure. Our current assessment of the risk to the general public health is low. That could change. And so I think we’re remaining very vigilant — if anything, more vigilant in this space.
These viruses change. If this were to become seeded in cows and become a cow-endemic virus, it certainly would increase that risk to people.
And certainly our pandemic planning [operation] has been really thinking about this and trying to be as vigilant as we can now, to try and understand not just current risk, but the future risk so that we’re as prepared as we can be.
But the risk could be quite big.
Q.You said you still think the risk is low. But 15 years ago this spring, CDC was notified about two kids from California who had tested positive for swine flu who hadn’t had exposure to pigs or each other. Before April 17, 2009, the risk of a swine flu pandemic would have seemed pretty low. And then CDC got those two samples, and everything changed really fast. Do you think about that?
Well, yeah. It’s probably why I’m not sleeping very much right now.
I think that the threat of a pandemic is always looming in the flu space. The way that Dan Jernigan [Dugan’s predecessor] always described public health to me is that it is an art form. There’s a balance that you have to strike. There’s a difference in the pandemic risk versus the immediate risk right now. And so I think that’s what we’re trying to message to the average person who is walking about and living their lives. The risk to them is low.But you’re right. It could absolutely change.
Helen Branswell covers issues broadly related to infectious diseases, including outbreaks, preparedness, research, and vaccine development. Follow her on Mastodon and Bluesky.
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Re: Bird-flu ? What me worry ?
Yes, as opposed to Covid, there is already some natural resistance (herd immunity?) to H5N1 in humans and this alone means that the threat is certainly far less than a brand new disease.Rach3 wrote: ↑Fri May 03, 2024 6:30 amFrom WAPO May 3 in part:
"...Of course, just because milk remains safe to drink doesn’t mean avian flu isn’t a potential threat to human health. I was honored to learn historian John M. Barry, author of the seminal book on the 1918 influenza pandemic, is a Checkup reader. He emailed me to express his worries, and I took him up on the offer to speak by phone.
“The question is, are we in the early stages of watching the evolution of this virus toward something that will become respiratory and spread through the aerosols between mammals and humans?” he said. “It’s too early to say that that’s happening, but there are some things that are disconcerting.”
Indeed, while the spread of H5N1 from birds to mammals has long been documented, we have not previously observed this scale of outbreak among mammals. Health officials do not know how cows are spreading the virus to one another and whether there could be asymptomatic transmission. And there are concerns that some farms might not cooperate with federal guidance to test and isolate affected cows.
Barry reminds us that “virtually nothing” is known about how the 1918 influenza jumped species or how long these evolutionary changes took to occur. And even if we did know these details, it would be unwise to expect avian flu to follow the same playbook.
All that said, we should keep in mind that there are not yet any instances of human-to-human transmission during this avian flu outbreak. And I remain reassured that federal health officials have a plan for manufacturing and distributing treatment and vaccines, should bird flu become the next pandemic."
REASSURED?
What has to be taken into account for the 1918 Spanish Flu outbreak are its origins as a virus that was virtually brand new as a result of a major antigenic shift. (From what hasn't been determined). In other words a huge mutation as opposed to the minor one that usually happens each year with the current crop of flu viruses. H5N1 apparently did not exist before 1918 and must have come from somewhere else. In the current case we know that we are still dealing with a known virus and appear to have the tools to deal with it in its current state.
As for Covid, despite claims from scientists and virologists that this occured when it was transferred from bats to humans at the market place in Wuhan, I just don't believe it. The fact that the virology clinic was just down the road from that market place is too much of a coincidence for me and I'll stick with the theory that it was man made and escaped the lab.
To add to that, I remember being a part of a conversation (at a social gathering) in early December 2019). One of the gathering was a scientist who had recently returned from China as part of a joint research project and I remember him saying that there was some serious shite going to go down quite soon unless something was done. When questioned all he would say was that it was in China and he hoped that they would clean it up. He never mentioned viruses and he refused to elaborate any further, acting as if he'd already said too much. I promptly forgot it and it wasn't until much later when the pandemic was getting into full swing that this moment came back to me. What is significant was that he had been back from China for at least a month, well before the first 'reported' cases. I am sure, as are the others I know from that gathering, that he was referring to Covid 19.
Re: Bird-flu ? What me worry ?
The Spanish flu outbreak after WW1 was made worse by the depredations and shortages of WW1. Many people hadn't enough good food during this period, particularly in France, and the demobbed military was in pretty bad shape. This made people all the more susceptible to diseases of every kind.
Whatever the 'origins' of Covid-19, we have had pandemics forever and it's certain we will have more. Our inherent tendency towards 'safetyism' means that we've developed a bad habit of trying to explain things which are threats in order to control or regulate these. Good luck with this!!
Whatever the 'origins' of Covid-19, we have had pandemics forever and it's certain we will have more. Our inherent tendency towards 'safetyism' means that we've developed a bad habit of trying to explain things which are threats in order to control or regulate these. Good luck with this!!
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