0bFuSc8 Profile picture
Apr 23 8 tweets 3 min read Read on X
More info (some concerning) on our ongoing, multi-state #H5N1 outbreak in dairy cattle from the always thorough & informative @sciencecohen:


#HPAI
1/science.org/content/articl…
🚨 Concerning 🚨 – Vets relay anecdotes of dairy workers w/flu-like Sx who don’t not want to be tested or seen by docs.

I’m guessing there’s been a lack of clear communication w/these workers (often migrants, non-English speaking or undocumented)

@RickABright #H5N1 #HPAI
2/ Image
Wastewater analysis (ongoing & retrospective) can help add info 👆, would be cost effective & should be relatively straightforward for @CDCgov to implement, as @RickABright has been saying.

#H5N1 #HPAI
3/
🚨 Also concerning 🚨 – Birds tested +ive for the 3.13 strain of #H5N1 & were culled at a MN turkey farm right next to a dairy farm that **refused to test** its cattle.

@RickABright #H5N1 #HPAI
4/ Image
Apparently since USDA hasn't designated #H5N1 in cattle a “program disease” (even though it has in poultry), the fed government can’t cattle movement or require testing & reporting of infected herds or of the humans who work with them.

@RickABright #H5N1 #HPAI
5/
Necropsies on (some) infected dairy cows haven’t found #H5N1 virus in their respiratory tracts.

This, along w/large amount of #H5N1 virus being found in milk, supports direct spread via milk/ milking equipment.

#HPAI
6/ Image
I appreciate USDA scientists are working hard, but the agency’s communications have been lacking —they haven’t been timely or transparent— and will impact credibility.

Mid/disinformation will flourish in an information vacuum.
#H5N1 #HPAI
7/ Image
Good to *finally* get confirmation from FDA that they’re studying the impact of pasteurization (& other processes) on #H5N1 in milk, but this shouldn’t have taken nearly 1 mo into this multi-state outbreak.

Communication must get better, all around.

#HPAI
8/8 Image

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More from @0bFuSc8

Nov 20
1/🔁🧬The #H5N1 found in the O'ahu HI outbreak is clade 2.3.4.4b genotype A3:

➡️Genotype A3 has been been circulating in wild birds & it's detectn is consistent w/spread via migrating wild birds

➡️A3 is distinct from B3.13/cattle subclade
**Not linked to US dairy cattle outbrk Image
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2/➡️A3 is related to D1 (D1.1 & D1.2 seen in other #H5N1 outbrks along Pacific Flyway)
– D1.1 & D1.2 are both reassortants of A3 & North Am LPAI

➡️This doesn't mean the O'ahu outbrk is directly linked to D1 outbrks – Only that there are multiple subclades in wild birds currently Image
Image
3/➡️In North America, #H5N1 genotype D1 (mostly D1.1) has been predominant recently in wild birds & poultry outbrks along the Pacific Flyway
– A3 has been seen less frequently (1 wild bird detectn) &hadn't been found in poultry recently AFAIK, but has now made an appearance in HI
Read 5 tweets
Sep 20
1/📈+7 new #H5N1 affected CA herds as @HelenBranswell suspected – @CDFAnews reports +7 for a total of 17 on their page:

– All 7 herds "in a group targeted for testing due to elevated risks from their recent connections with the initial affected premises"

cdfa.ca.gov/AHFSS/Animal_H…

Image
2/🚩Locations for CA #H5N1 affected herds continue to only be disclosed as "Central Valley"

▶️NOTE: @CDFAnews is testing all herds w/in 6mi of a known #H5N1 +ive premises as well as herds w/epi links
– Good to see active case finding measures instead of waiting for Sx or…⤵️⤵️
3/ …instead of waiting for Sx or for farmers to initiate testing, but still concerning seeing these #'s grow.

***Also NOTE: – Thre's a new poultry #H5N1 outbreak in CA's Central Valley being reported today.
More on this to follow.
Read 7 tweets
Sep 7
1/⚠️@HealthyLivingMo reports 1st case of #H5 #AvianFlu in MO:
▶️Adult w/underlying conditions
▶️Hospitalized Aug 22, tested +ive for FluA
▶️Since recovered, d/c'ed home
⛔️No known animal exposure
✅#H5 detected through normal flu surveillance by MO pub health & conf'd by @CDCFlu Image
2/▶️1st case of #H5 detected via flu surveillance nationally, & not through outbreak testing

▶️Addl testing ongoing at @CDCgov – should confirm subtype (likely #H5N1 as there's no other #H5 #AvianFlu in the US)

🧬Sequencing vital to ID clade; whether this is B3.13 or not
3/▶️Ø dets on Rx
▶️Ø dets provided about contacts monitored, status, etc

❓Qs remain: – w/o known exposure, important to investigate #H5N1 source:
– Recent travel, incl w/in US
– Exposure to raw dairy prodcts
– Contacts who work w/animals
– New/ sick pets in own home or contacts
Read 8 tweets
Sep 6
1/🔁🧬– #H5N1 Update: – The 10 seqs uploaded to GISAID 8/31 are now also on SRA & @nextstrain – all are from cattle (locations are inferred):
▶️6 from CO
▶️3 from WY
 – 1 seq has PB2 D740N
 – 1 seq has PB2 A676V ("bulk tank")
 ***More on these⤵️***
▶️1 from ID

cc @RajlabN

Image
Image
1B/▶️The 6 #H5N1 seqs from CO group near each other

▶️The 3 #H5N1 seqs from WY also group near each other
Image
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1C/ ***Keep in mind there's some uncertainty w/these locations as they have to be inferred due to lack of location metadata provided
– WY has 1 detected herd, but there are 92 samples from WY. 45 of these have actual locatn metadata, but the others could be from a different state
Read 10 tweets
Sep 5
1/🆕🧬Update: – Sequencing of #H5N1 from CA herds:
– Virus is 2.3.4.4b genotype B3.13
– “nearly identical” to seqs of CO herds
– This means this was NOT a new spillover
– Consistent w/spread from cattle

** But **⤵️

cc @HelenBranswell @RickABright
latimes.com/environment/st…


Image
Image
2/▶️** While it’s good news there hasn’t been a new, 2nd spillover of #H5N1 from wild birds to cattle, it’s a CLEAR indicator @USDA’s #H5N1 testing reqs are INADEQUATE (or being skirted).

⚠️If this spread was indeed due to interstate cattle mvmnt, why wasn’t it picked up >>
3/⚠️ >>… why wasn’t it picked up (& interrupted) by @USDA’s mandatory pre-movement #H5N1 testing?
– Was testing 30 cows (from a larger group) inadequate to detect #H5N1 in some healthy appearing cows?
– Or did someone, somehow knowingly skirt @USDA’s testing reqs?
Read 8 tweets
Sep 3
1/🇰🇭🆕@WHO DON on case of #H5N1 in 15yo girl in #Cambodia (died Aug 20):
– Recall, this was Cambodia's 10th human case & 2nd death

***🧬Interesting detail *** – virus confirmed to be #H5N1 clade 2.3.2.1c BUT internal genes are from H5 clade 2.3.4.4b viruses, a novel reassortant Image
2/▶️The DON states, "This novel reassortant influenza A(#H5N1) virus has been detected in human cases reported in Cambodia since late 2023."

🔗 who.int/emergencies/di…
Image
3A/✳️IIRC the last time we heard about a reassortant 2.3.2.1c/ 2.3.4.4b #H5N1 was in @FAOVietNam's statement Apr 5:
– Has been detected across the Greater Mekong Subregion
– Detected in chickens & muscovy ducks in Vietnam through active surveillance


Image
Read 8 tweets

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