Thread by @DrEricDing

⚠️WAIT HOLD UP—Pasteurization of milk actually may **not** neutralize all viruses sufficiently to stop infectivity—“many viruses cannot”. It seems that fat globules in whole milk and 2% fat milk can protect viruses from high temperature pasteurization (dairy research shows for foot and mouth disease virus)—and show residual infectivity of the virus after pasteurization. ➡️My trusted colleague points out that the USDA & CDC has presented **zero evidence** avian flu cannot survive pasteurization in whole/2% fat milk🥛. He warns that until such evidence is shown, we need to be careful of USDA/CDC’s claims that virus in milk can “reliably” be neutralized via current pasteurization temperatures.

2) Contrast that above study with this USDA statement that “pasteurization would kill the virus” — but without any caveats or proven evidence.

➡️folks need to keep in mind that the U.S. Dept of Agriculture is actually the **COMMERCE AGENCY FOR AGRICULTURE**—it’s mission is to protect and help agriculture industry. Public health is a side priority.

3) If we look at the study 📖 above, it seems that the pasteurization neutralized the virus in majority of the samples. But in 7 of the experiments… injection of the pasteurized milk sample into a naive uninfected steer ==> showed the cattle getting still infected from the pasteurized milk injection❗️
journalofdairyscience.org/article/S0022-…

4) In the U.S., pasteurization standard is 161 degrees F (or 71.7 Celsius) for a holding time of at least 15 seconds. ➡️Yet if we look at the temperatures and holding times in the study, we see the 7 samples that showed infectivity of pasteurized milk all above 72 C and 18 seconds… ➡️ even pasteurized milk infectivity at 82.5 C and 36 seconds! ❗️

5) There is another type of pasteurization called ULTRA-PASTEURIZATION, which requires heating to 280 degrees F (137.8 C) for 2 seconds. This is likely safest. ➡️Try to find **ultra-pasteurized milk if possible**.

6) Caveats:

the study in infectivity of pasteurized milk is for foot and mouth disease virus, not avian flu.

The infectivity is for injection of the milk into a naive uninfected steer, not ingestion of the milk orally.

We need true data on avian flu virus titer in pasteurized milk from USDA and CDC to know for sure.

7) I agree that this milk virus titer level info is actually a high priority area for USDA / CDC to provide data on.

https://twitter.com/rickabright/status/1775904447664718332

8) Side datapoint on cats— cats 🐈‍⬛ have died of avian flu already. It seems that cats maybe getting the flu virus from somewhere like in their water (or eating dead birds) are "ingesting" and thus maybe how they got infected. A lot of variables that are very easily tested experimentally. Best thing to do is experiment and discuss, vs just blanket assume safety.

9) speaking of ingesting the virus, public health officials have already warned about avian flu from raw and undercooked eggs. So ingesting the virus is a thing.

And by *cooked* eggs 🥚— we mean no “runny” eggs with undercooked egg yolk! Fully cooked eggs 🍳 only folks.

10) Eye infection of avian flu is a thing as well. Scientists have directly warned about conjunctivitis in humans from avian flu because our eyes have the same type of sugar-complexes as birds that allows the avian flu to infect. See thread 🧵

https://twitter.com/drericding/status/1775878622705865096

11) Folks—FDA says about pasteurization:

“It is not practical to target viral pathogens in cooking or pasteurization processes because of their extreme heat resistance. Viral pathogens should be controlled through a rigorous sanitation regime”

Page 1:
fda.gov/files/food/pub…

12) “There is massive (unprecedented) exposure of wild carnivores (feasting on sick/dead birds) and potentially also other mammals (through contaminated water and surface areas, including grasslands),” Ron Fouchier, an influenza virologist at Erasmus Medical Center in Rotterdam. “The infected mammals get infected upon feeding/drinking, which is an alternative route of infection of mammals.”

➡️we seriously need USDA & CDC to do a study of virus titer level needed for ingestion infection

statnews.com/2024/04/03/h5n…

13) CDC says: inhalation 🫁, mouth 👄 , eyes 👁️, and nose 👃. #AvianFlu

https://twitter.com/drericding/status/1775968434947276840

14) to be clear, pasteurized milk is most likely okay. Yet the FDA says standard pasteurization isn’t perfect (ultra pasteurized is best). But the reason we are talking about milk so much is because dairy cows have the highest levels of the virus concentrated in milk. 👇

https://twitter.com/drericding/status/1775613778274431238