1. Some thoughts on #H5N1 #birdflu in cows. A 🧵
A bunch of new herds were announced by a couple of states today — Colorado and Iowa. The former reported +5 & looks like it may have another pending; It now has 18 in total, maybe 19. Iowa reported 2 more, taking it to 10.

https://twitter.com/HelenBranswell/status/1804267476852564220

2. To the best of my ability to keep up — and that's being challenged — I think there have been 125 herds reported in 12 states since the end of March. This graph combines @USDA's numbers from yesterday with the newly reported herds from Colorado & Iowa.

1. @USDA posted an FAQ today about the federal order restricting movement of dairy cattle infected with
#H5N1 #birdflu. Interesting information therein.
A 🧵
New to me: USDA says 8 poultry operations in 5 states have had poultry outbreaks with the virus detected in cows. 2. Minnesota hasn't reported #H5N1 #birdflu in cattle, but it has had at least 1 poultry outbreak with the cattle virus, @USDA reveals. More evidence, probably, that the virus is far more widely spread than has been realized. The FAQ is here: aphis.usda.gov/sites/default/…

1. Listening to an @ASTHO - @IDSAInfo - @CSTEnews webinar on #H5N1 #birdflu in cows.
Of interest so far:
— @USDA is monitoring feral swine; no detections of H5 so far.
— in the "small number" of samples tested to date, doesn't look like cows are shedding virus thru feces. 2. @USDA Rosemary Sifford said the infections are "mostly" being seen in lactating herds.
1 herd was found to be positive despite the fact there were no clinical signs among the cows.
Sifford said USDA doesn't yet know how long infected cows shed virus.
#H5N1 #birdflu

1. A 🧵 on #flu, #Covid & #RSV (mostly flu). The
#influenza-like illness season is pretty much over. The percentage of people seeking care for ILIs is below 2.9%, that dotted line. You can catch flu at any time of the year, but chances of catching it now thru the summer are low. 2. It's not just #flu. #Covid activity now is at low levels nationally and #RSV activity has declined to the point where @CDCgov says the season is ending. Hallelujah.
cdc.gov/respiratory-vi…

1. A 🧵on #flu & #Covid activity trends based on reports today from @CDCgov. Most of the data is for the week ending Feb. 3. The #influenza-like illness (ILI) season seems to have peaked at the end of Dec, with declines in flu, Covid & #RSV since then. But the season isn't over. 2. There was a bit of an uptick in #flu activity in the central & south central US. It corresponds with an increase in flu B detections there. Pre-Covid, flu B often arrived in a late season wave. We may see that again this year.
Map on left is the week ending 1/27; right is 2/3.

1. Traditionally I've done #flu updates on Fridays, but given our new reality — #Covid is here to stay — & the expansion of data on @CDCgov's website, I'm going to broaden the scope going forward. Top line news: Lotta illness out there right now.
cdc.gov/respiratory-vi… 2. Most parts of the country are ensconced in #influenza-like illness season right now. (Minn, what are you doing to stay so healthy?) This graphic doesn't just represent #flu activity; #Covid, #RSV & other ILIs are also captured here. @CDCgov's FluView: cdc.gov/flu/weekly/

1. It's fall, pharmacies are pushing you to get a #flu shot. What's going on with #influenza, you wonder? Let's break down @CDCgov's most recent FluView report, posted today. It's for the week ending Oct. 7, the first week of the 2023-24 flu season. 🧵 cdc.gov/flu/weekly/ 2. Know this: #influenza "seasons" run over a period from the beginning of Oct to the end of the following Sept. To say last week was the first week of the 2023-24 season signals only that we're in a new monitoring period. It doesn't mean #flu activity has actually picked up.

1. Wondering where things are standing with flu? Here's a thread based on the most recent FluView from CDC, posted Friday, for the week ending Sept. 16. Tl;dr version: Flu still hasn't started to take off yet. If you are trying to time your shot to closer to the season, hang on. 2. The percentage of positive tests for flu at clinical labs across the country is virtually unchanged from the previous week & the week before that. Of 39,000 people who were tested for flu — presumably because they had flu-like symptoms — 315 or 0.8% actually had flu.

1. Trying to figure out how to time your #flu shot for this fall? Here's the latest from @CDCgov on flu in the US, for the week ending Sept 9. Tl;dr version: Not much flu going around yet. If you can hold off getting a shot, you might want to. Flu shots wane over the season. A 🧵 2. Only 0.7% of specimens taken from people suspected of maybe having #flu were positive for flu in the week ending Sept. 9. That's virtually unchanged from the week before, when it was 0.8%. As you can see from this epi curve, flu hasn't yet started to take off.

1. Every time you approach a pharmacy these days, someone is asking if you want your #flu shot. This could give you the impression flu season is upon us. So I thought it might be time for a flu 🧵, based on today's FluView from @cdcgov.
cdc.gov/flu/weekly/ind… 2. The short answer is: #Flu season is not yet upon us. Out of nearly 31,000 specimens submitted to clinical labs across the US in the week ending Sept 2 — specimens taken from people who presumably were suspected of maybe having flu — only 233 or 0.8% were positive for flu.

1. #ACIP is meeting today to discuss the changes to the #Covid vaccination schedule announced yesterday by @US_FDA. statnews.com/2023/04/18/fda…
I will live-tweet, though don't expect a flurry of tweets.
No votes today. @CDCDirector is expected to approve the changes later today. 2. @CDCgov's Georgina Peacock just told #ACIP that when the national public health emergency ends in May, there will be some loss of capacity to get #Covid data from the states. CDC is trying to sign extensions to data-sharing agreements with states, but expects some won't sign.

1. @WHO has issued an update on the #Marburg outbreak in Equatorial Guinea. It is not reassuring. A 🧵
Before getting into it, a note on the Marburg outbreak in Tanzania. WHO says the case count remains at 8, with 5 deaths. If accurate, this outbreak doesn't seem to be growing. 2. Equatorial Guinea: The case count is up to 38 confirmed & probable #Marburg cases; at least 89% are dead. Authorities don't know the identify/whereabouts/disease outcome of 1 case. (shudder)
The most recent case tested positive on April 7. Not yet clear how s/he got infected.

1. #Flu activity remains low in the US. A short thread on the data for the week ending March 11, which @CDCgov issued today.
The percentage of people seeking care for #influenza-like illness remains below the epidemic threshold. Early start, early end to this season. 2. I'm still watching to see if there is going to be a #flu B spring surge; so far no real sign of it. About one-fifth of the viruses tested last week were flu B, which is higher than earlier in the season. But one-fifth of a low number is a low number, as you can see here.

1. #Flu activity has dropped off dramatically since its peak around Thanksgiving, but this odd early season still can't seem to bring itself to an end. For the 6th week in a row it is hovering just above the epidemic threshold.
A 🧵 2. That said, rhinoviruses & human coronaviruses are causing more #influenza-like illness right now than #flu is, according to the Biofire syndromic trends. syndromictrends.com

1. @WHO has finally issued an update on the #Marburg situation in Equatorial Guinea. The "finally" is not criticism of WHO. They issue these with info provided by an affected country & sometimes countries are not eager to share information.
The situation is complex.
A 🧵 2. There has only been 1 confirmed case of #Marburg so far, but that is mainly because 8 other people suspected of having had the disease died without testing. This is Equatorial Guinea's first #Marburg outbreak & @WHO is concerned about the country's capacity to cope.

1. @WHO has issued an update on the #H5N1 situation in Cambodia. It confirms what has come out over the past few days. 2 confirmed cases, an 11 yo girl who died & her father who remains asymptomatic. 11 other contacts tested negative. A couple of noteworthy points.... 2. The #H5N1 virus was from a strain of H5 viruses that has been circulating in southeast Asia since 2014. This is a different strain from the one that has swept across the Americas in the past couple of years. Different strain could equal slightly different behavior.

1. @CDCgov has been told of 4 more children who died from #flu this season, bringing the 2022-23 total to 115 so far. There have been years with a higher pediatric death toll, but it's tragic to see so many kids die from flu. No word on their vaccination status. (Graph = mine)
🧵 2. @CDCgov's latest FluView report, out today, reports that #flu activity is low in most parts of the country. In the few places where it isn't low, it has declined from the previous week. It remains to be seen if flu season is effectively over or if there's more to come.

1. #Flu activity is at low levels now in most of the country, but the percentage of visits to health providers that are for flu-like illnesses is still limping along just above the epidemic threshold level for the 4th week in a row.
A 🧵 2. #H3N2 viruses, which have been dominant all season, have really declined. In the week ending Feb. 11, #H1N1 viruses made up the bulk of the illness-causing viruses. There's an uptick in #fluB viruses, but they make up a very small proportion of viruses so far this season.

1. #Flu activity in most parts of the country is now low, @CDCgov reports in its latest FluView update, for the week ending Feb. 4. For the 3rd week in a row the rate of outpatient visits that are for flu-like illnesses has hovered just above the epidemic threshold. 2. That said, most of the country is reporting minimal or low activity. NYC, NM and Puerto Rico are outliers on that. You can find the FluView report here: cdc.gov/flu/weekly/ind…

1. #Flu activity continues to decline across the US, though the percentage of outpatient visits for #influenza-like activity is hovering just over the epidemic threshold. There's always a chance of more flu, especially flu B, but for now the big wave is pretty much done.
A 🧵 2. #Flu outbreaks reported from long-term care facilities has dropped down considerably, a sign there's less flu circulating. Those are the folks who are most vulnerable, so this is a good thing.

1. A #flu 🧵:
Activity continued its sharp decline in the week ending Jan 21. It's barely over the epidemic threshold at this point nationally; in 6 regions it's below it. But for the fact that we've seen little #fluB activity, it would be tempting to guess flu season is over. 2. But virtually all — 99.5% — of the #flu activity so far this season has been caused by flu A. There hasn't been much flu B since the first half of the 2019-20 season. In the Before Times, it was common to see flu B in late winter, early spring. This year? Ask me in June.