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Outbreak Updates Profile picture
@outbreakupdates
Nov 20 • 6 tweets • 2 min read • Read on X
The 1918 flu wiped out 90% of adults in Brevig Mission, Alaska. 🧵

It carried a key mutation: PB2 E627K.

Now, H5N1 is showing signs of similar adaptation.

The strain detected in a Canadian teenager also carries PB2 E627K.

1/
In 1918, this mutation was pivotal in the virus’s jump from birds to humans and its ability to spread rapidly.

Despite lacking other mutations (Q226L / G228S) commonly associated with avian viruses adapting to human-like receptors, the 1918 virus exploited the mutations it had to devastating effect.



2/wwwnc.cdc.gov/eid/article/9/…
The Canadian teen also carries D190E, a mutation linked to altered receptor binding preference.

While H5 viruses typically bind to avian-type receptors, this mutation shifts the virus toward binding human-like receptors.

A critical step in zoonotic transmission.

3/
These mutations in isolation don’t guarantee sustained human-to-human transmission.

But they significantly increase the virus’s ability to infect and replicate in humans.

4/
Combined with evidence of mammalian infections (such as cow infections, mass die-offs in seals and minks) the virus appears to be adapting to mammalian hosts.

This is concerning because mammalian adaptation creates the conditions for further mutations, such as Q226L / G228S, which could enable efficient transmission BETWEEN HUMANS.

Thx @HNimanFC for flagging this.
Interesting reports

wwwnc.cdc.gov/eid/article/9/…

cdcmuseum.org/exhibits/show/…

cbsnews.com/news/killer-fl…

adn.com/alaska-news/sc…

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More from @outbreakupdates

Outbreak Updates Profile picture
Nov 21
H275Y mutation in Canada's H5N1 poultry strains is a red flag.

This mutation, linked to Tamiflu resistance, doesn’t typically show up in North American wild bird influenza strains.

And it's likely driven by human intervention.

1/
H275Y cripples the effectiveness of our main antiviral.

In a pandemic scenario, we lose one of the only tools to slow the virus in humans.

2/
Historically, H275Y has been observed in specific strains of influenza

But its appearance in H5N1 poultry strains in Canada is novel

The low pathogenicity avian influenza strains found in birds in N America rarely carry this mutation

The fact that it’s now appearing in farmed poultry suggests an interaction between human antiviral use & viral evolution.

3/
Read 7 tweets
Outbreak Updates Profile picture
Oct 25
The real threat posed by Mpox 🧵

I believe that diseases that disproportionately affect marginalized groups cannot be left to burn out on their own.

1/
The social and moral costs of neglect far exceed the apparent savings in resources.

Failure to act reinforces a hierarchy of value.

Some lives are considered less worthy of protection.

2/
Think back to the early days of the HIV/AIDS crisis in the 1980s.

When it was first recognized, the response from the government and public was, at best, apathetic and, at worst, outright hostile.

3/
Read 14 tweets
Outbreak Updates Profile picture
Oct 23
Let’s cut through the nonsense.

This isn’t about some noble fight for individual liberty.

The question, “When can I take off my mask?” is pure self-interest masquerading as a legitimate ethical concern.

1/
Let’s call it what it is.

An excuse to dodge responsibility.

You’re not genuinely worried about some profound moral principle.

You’re irritated that you still have to inconvenience yourself for the sake of others.

The real motivation here is to find a convenient moral loophole that lets you prioritize your own comfort over everyone else’s safety.

All while pretending to engage in some deep ethical debate.

2/
If you’re asking when you can take your mask off, it’s really because you don’t want to wear it anymore.

This isn’t an issue of personal judgment.

It’s an issue of responsibility.

If you want to make it about ethics, then understand that real ethics requires a willingness to prioritize the well-being of others, especially the most vulnerable.

3/
Read 14 tweets
Outbreak Updates Profile picture
Oct 22
The pandemic pulled back the curtain on a brutal reality.

Our healthcare system is like a short-term investor that only cares about next quarter’s profits

1/
We’ve been treating health costs like a sprint when it’s really a marathon, and we’re now feeling the burn from all the times we didn’t stretch properly.

If anything, COVID-19 has shown that our focus on immediate, up-front costs is like budgeting for a vacation without considering the credit card bill that hits when you get home.

Spoiler alert: the real expenses pile up once the hangover wears off.

2/
For years, we’ve been content to look at the price tag of an illness as if it were a one-time purchase.

We focus on the direct costs of treating the infection whether it’s a few days in a hospital bed, a round of antibiotics, or a stint on a ventilator while glossing over the fact that the long-term consequences could rack up a tab that makes those initial bills look like pocket change.

3/
Read 12 tweets
Outbreak Updates Profile picture
Oct 21
The normalization of disaster is eroding our willingness to demand meaningful change 🧵

1/
We’ve come to see mass culling, market shutdowns, and disrupted supply chains as a normal part of life in the 21st century.

2/
If disease outbreaks are just the cost of doing business, then we lose the incentive to push for a system where these risks are minimized rather than managed.

3/
Read 19 tweets
Outbreak Updates Profile picture
Oct 15
Just as in the past, it’s not rational decision-making driving change.

It’s a slow, painful reckoning with the cost of ignoring evidence.

Overwhelming evidence rarely leads to change without a drawn-out, brutal fight against stubborn tradition.

1/
In the mid-19th century, Joseph Lister revolutionized surgery with his introduction of antiseptic techniques.

It reduced infection rates dramatically.

2/
royalsocietypublishing.org/doi/10.1098/rs…
Yet, despite the overwhelming evidence and undeniable benefits of antiseptic practices, many doctors and surgeons remained obstinate.

They were clinging to outdated methods that caused unnecessary suffering and death.

Their arrogance and unwillingness to accept new ideas contributed to countless preventable infections.

3/
museumofhealthcare.ca/explore/exhibi….
Read 10 tweets

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