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
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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
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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
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More from @0bFuSc8

Aug 11
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

(H/t also @thijskuiken)
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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)

🔗 vdl.vetmed.illinois.edu/assets/files/N…
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Read 15 tweets
Jul 30
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

@HelenBranswell @Alexander_Tin @RickABright


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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.

@RajlabN @cbarbermd
@HelenBranswell @RickABright
#H5N1
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.

🔗This was WY's press release:
wlsb.state.wy.us/editable-page/…
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Read 5 tweets
Jul 27
1/⚠️@UKHSA upgraded it's situational assessment for #H5N1 B3.13 from level 3 to 4 (of 6):
✅This clear, accurate risk assessment is appreciated

—Points I'd like to touch on:—
1⃣Onwards transmission to poultry
2⃣↑Risk of reassortment
3⃣No apparent ↓xmsn w/↑biosecurity measures
Image
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

assets.publishing.service.gov.uk/media/66a0ff6d…
Read 13 tweets
Jun 24
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



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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…
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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.

@RickABright @HelenBranswell @KrutikaKuppalli @thijskuiken @Alexander_Tin
Read 5 tweets
Jun 9
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⚠️

wwwnc.cdc.gov/eid/article/30…
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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?
Read 7 tweets
Apr 20
Good to see @CDCgov's #H5N1 update, but this isn't at all clear about (IMO much needed) surveillance in dairy farm/ other farm workers.

Epi field study/ site visit are good steps but likely not nimble enough to address the current situation.
#HPAI #AvianFlu
1/

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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/
Read 4 tweets

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