🚨 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/
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/
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/
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/
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
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1/🔄Appreciate summary on 6 cats w/#H5N1 B3.13 from CO by Colorado Vet Med Assoc (CVMA):
– Only 1 assoc w/known infected dairy farm
– 3 = known indoor/outdoor cats; hunted mice/ small birds & spent time w/owners
– 2 = indoor only cats; Ø direct exposures
2/➡️5 of 6 cases presented w/similar clinical signs & disease progression:
– Initial lethargy & ↓appetite
– Followed by progressive resp signs in some &
– Progressive neurologic signs in most
NOTE: – Presentation indistinguishable from rabies once neurologic signs presented
3/✅NOTE: – Seems it isn't widely known, but @USDA has an #H5N1 cat testing program in place:
– Cats that show neurologic signs & meet certain criteria and then test -ive for rabies are tested for #H5N1
(cc @thijskuiken @RickABright)
1/⚠️Wyoming, we have an #H5N1 PROBLEM⚠️
– 45 WY cattle seqs (initially shared to SRA 6/14) were re-uploaded to GenBank, now w/actual collectn date & locatn
– Collectn date = 4/29 **BUT**
– WY's 1st & only affected herd was confd June 6
2/ – This is either a mistake w/collectn date,
or WY did what OK did – collected samples from an infected herd & then SAT on them for over a month & likely only submitted them once the financial support program rolled out.
3/ – And while @OklahomaAg was less than transparent, they did at least tell us the samples had been collected in April.
– If these collection dates are correct, WY didn't even disclose that delay, & neither did @USDA.
1B/ ***Disclaimers:***
– This assessment describes the chance of #H5N1 B3.13 causing outbreaks in humans (in general), not the risk to specific individuals
– None of this should be taken to mean a B3.13 pandemic in humans is imminent
2/ 1⃣ @UKHSA's assessment notes **onwards transmission to poultry** results in ↑opportunity for human exposures & zoonotic cases
⚠️This exactly why I've been concerned since I noticed @USDA mention B3.13 poultry outbreaks in April
1/⚠️The #H5N1 detection in a cat from Harmon Co, OK is **genotype B3.13**
• There've been NO reported OK dairy herds affected
• But 10 of 12 retail milk samples processed in OK tested PCR +ive
• Only 1 detection in a wild bird in JAN this yr & none in poultry flocks
2/ Harmon Co is in southwest OK, on the border w/TX. – OK is in the central flyway & borders states that've had cattle herd detections (TX, NM, KS, CO – 3 of which had early detections)
– This cat could’ve traveled into TX & been exposed to B3.13 there (dairy herd, poultry farm…
2B/ …or possibly another peridomestic animal like a mouse, or wild bird)
– But given the geography, it’s also possible OK has/had herds and/or poultry farms w/B3.13 that have remained undetected.
1/📢@CDCgov @EIDjournal early release by @utmbhealth team responding to an early #H5N1 dairy cattle outbreak (March):
• Illness in cattle 1st seen MAR 6
•⚠️Several workers had ILI Sx, missed work MAR 4–6⚠️
1B/⚠️Workers w/ILI Sx MAR 4–6:
– Maternity worker treated for ILI Sx (Rx not specified)
– 2 milkers w/ILI Sx stayed home
– Notes "rumors of […] conjunctivitis among TX dairy farm workers"
– Ø conjunctivitis/ severe illness/ hospitalizations reported in workers from this farm
1C/ *** It's not clear if public health was ever notified.***
👆Is a missed opportunity to test workers, collect serum/ other samples.
– Maybe there's a chance this could still be followed up?
I rly hope the One Health Approach cited means more is in the works in terms of surveillance (in cows as well as humans), but IDK how much authority @CDCgov has at dairy farms.
@USDA @USDA_APHIS aren't recommending testing for asymptomatic cows and >>
#H5N1 #HPAI #AvianFlu
2/
And communication & genetic sequence submissions from @USDA have already been lacking.
Since this response has to be coordinated b/n multiple federal & state agencies, maybe it's time to create a coordinating task force?
#H5N1 #HPAI #AvianFlu
3/