@annamerlan asked me to go over the science around some of the claims about raw milk that Mark McAfee, Raw Farm owner and unpasteurized milk evangelist, has made and this shit is wild.

Buckle up for H5N1 denialism, anti-vax, magical antiviral compounds,

https://twitter.com/annamerlan/status/1884249438027473213

McAfee calls H5N1 "a huge scam...by pharma to create fear & produce a new vaccine."

He doesn't think H5N1 is dangerous & says nobody has gotten sick from drinking raw milk or has anything to fear if they've got a "strong microbiome."

Except for all those dead cats, I guess.

This is bad news. It suggests reassortment of circulating H5N1 viruses with viruses containing N9 NA.

Although this indicates reassortment with avian viruses, it's still bad. Reassortment makes pandemics. The last 3/4 flu pandemics (and maybe 1918 too) were reassortant viruses.

https://twitter.com/BNOFeed/status/1883884687720120501

Reassortment is what happens when 2 flu viruses infect the same host. Because influenza A viruses have segmented genomes divided into 8 pieces of RNA, these can be mixed up in new progeny viruses during replication in a co-infected host.

This leads to unpredictable new viruses.

Would we see a large outbreak in animals if the pandemic started by zoonosis (which it did) as opposed to a lab (which it didn’t)?

Not necessarily. We wouldn’t expect SARS-CoV-2 to impact all hosts equally. What is true for humans may not be true for an intermediate host.

https://twitter.com/rebecca21951651/status/1875311362471256414

The idea that a big outbreak would occur among “intermediate-host(s)-du-jour” is based on multiple assumptions that the host and humans are:

-equally susceptible
-equally permissive
-same tissue tropism
-similar pathogenicity
-similar clinical disease
-same mode of transmission

New year, new fave conspiracy theory: the global shadow government is spraying infectious fog across the entire northern hemisphere with those possibly alien drones everyone was seeing a couple weeks back. The mystery virus has symptoms exactly like seasonal respiratory viruses.

https://twitter.com/inkblue01/status/1874496753267015882

It doesn’t look like fog because it’s full of floating droplets of something that might be normal fog ingredients (aka water) or it might be carcinogens and/or viruses

Has a NIH Director ever appeared in cult-funded propaganda claiming that ivermectin, a drug that doesn't work to treat COVID, was the victim of a conspiracy to obtain FDA authorization for vaccines that do actually work?

There's a first time for everything, I guess. Because in this Covid Collateral "documentary," Jay Bhattacharya implies that ivermectin was suppressed because it would prevent vaccines from getting regulatory approval.

Actually, FDA discouraged ivermectin use because it doesn't work!
importantcontext.news/p/trump-nih-pi…

I spoke with @benjmueller @nytimes about the H5N1 sequences from the severely ill case in Louisiana (link in replies).

The specific mutations don't concern me as much as the increase in human cases around the country coupled with a surge in seasonal flu. Short thread on why 👇 Here's a gift link to the article.

nytimes.com/2024/12/27/hea…

For months now, the CDC has described H5N1 as “mild” compared to prior H5N1 viruses. I disagree—the virus alone doesn’t determine pathogenicity.

I hypothesize that the 2 most critical determinants of H5N1 severity are the host (it’s always the host 🥰) & the route of infection.

https://twitter.com/helenbranswell/status/1869566046774129015

The severely ill Louisiana case was infected by contact with backyard birds. In birds, influenza is gastrointestinal as well as respiratory, so contact with a lot of bird shit can cause a person to become infected.

My replies are perpetually full of anti-vaxxers these days telling me about polio vaccines.

Not shockingly, most of what they are saying is wrong. Luckily, I trained with @profvrr & he taught me a few things about poliovirus.

So let’s discuss the king of the Picornaviridae👇🏻 Let me start off by saying that while poliomyelitis is a terrible disease & I am anti-polio, I fucking LOVE working with poliovirus. It routinely grows to titers of 10e9 in HeLa cells & makes the clearest, most beautiful plaques even in BactoAgar that every other virus hates

Highly recommend going to Bluesky to read this thread about some of the mutations found in the H5N1 virus from the patient in BC.

If you wonder what this means for pandemic risk, the answer is a very complex but unsatisfying “we don’t know”. Host adaptation is complicated.

https://twitter.com/scottehensley/status/1857806576800670013

In terms of basic technical requirements, H5N1 cannot become a pandemic virus without adapting to its host. For humans, that means adapting to different receptors, body temperature, host cell types, tissue organization, etc etc. Big changes from the avian host it’s adapted to.

Thanks to the first Canada acquired H5N1 case, there’s an uptick in “bird flu pandemic imminent” and “omg it’s gone H2H!” posts. Those are not accurate.

However, given the situation in the US, I have some real concerns about this that grow progressively more grave.

https://twitter.com/angie_rasmussen/status/1855414619902529962

First let’s get this out of the way: while a case has never occurred locally in Canada, there have been many human cases of H5N1 during this panzootic (since 2021).

It’s probably direct spillover from a bird or other animal, not human to human transmission.

Finally, we have H5N1 serology data from Missouri. 🙏🏻 @CDCgov.

Both the MO patient and their household contact were positive for antibodies against H5N1 in 1/3 tests. This is not definitive per WHO criteria (2 tests positive) but does suggest infection.

cnn.com/2024/10/24/hea… Testing positive on just 1/3 tests may suggest that these patients had a transient infection. Weak seropositivity can indicate low titers of antibodies, consistent with an immune response to low levels of virus replication.

When you move quickly to assess the origins of an outbreak, you can learn a lot about how it emerged just by analyzing the viral genomes.

In the case of the Marburg virus outbreak in Rwanda, it was a single zoonotic spillover from an unknown host.

Really excellent work here.

https://twitter.com/yvanbutera/status/1847988307994513897

A question I have concerns the animal host. Was it R. aegyptiacus (known Marburg reservoir) or something else?

Because this “limited mutation rate” is interesting. Ebola (also a filovirus) appears to persist without replicating much as seen in outbreaks in survivors.

https://twitter.com/yvanbutera/status/1847988316529901919

Have you ever wondered how Ebola virus manages to induce such a catastrophically lethal host response?

I have. So @mhamdi_zeineb & I joined Satoko Yamaoka & Hideki Ebihara to get some answers about mechanisms of pathogenesis.

SPOILER ALERT: it's VP40
biorxiv.org/content/10.110… Ebola pathogenesis is brutal and super complex. When people hear Ebola hemorrhagic fever (now Ebola virus disease or EVD), they shouldn't think Ebola kills cells and causes bleeding. They should instead think Ebola causes a massive, uncontrolled systemic inflammatory response.

Every time there’s a Marburg or Ebola virus outbreak, my feed instantly fills with filovirus fear porn.

It’s airborne! Deadliest virus ever! OMG IT’S IN EUROPE! Pandemic imminent!

These takes are at best wrong & at worst anti-scientific and racist.

Here are some facts.





You may have heard two travelers, including a medical student who had contact with patients in Rwanda while wearing PPE, got sick on a train in Hamburg.

You may not have heard that they both tested negative for MARV but are staying in quarantine anyway.

ndr.de/nachrichten/ha…

When competent scientists disagree with the conclusions of a peer-reviewed paper in a top-tier journal, they present evidence to show why it’s wrong.

When incompetent scientists have no evidence, they harass journal editors so severely that they abandon the public discussion. Abuse is not acceptable and there should be consequences for academics who relentlessly target journal editors or other professionals for simply doing their jobs. Targeted harassment should never be excused because the harassers are unable to falsify a hypothesis they dislike.

Two years ago, we demonstrated that the SARS-CoV-2 pandemic likely began at the Huanan Market via zoonosis resulting from the wildlife trade.

Many unanswered questions remained about the animals themselves.

Some answers, out today in @CellCellPress.

cell.com/cell/fulltext/… First let's get this out of the way:

We did not find an infected animal. We cannot identify an individual infected animal with environmental samples. To do that, we need a sample taken directly from an infected animal. As far as we know, no such samples were ever collected.

I’m pessimistic about the Pandemic Accord. Here’s a little story about why. In March 2023, I was invited to a Canadian Pandemic Accord stakeholder meeting in Ottawa.

I had just co-authored a report on environmental data that showed genetic proof of wildlife at Huanan Market.

https://twitter.com/nschwalbe/status/1835996332726628525

There were round table exercises in which we were asked to address the components of the Pandemic Accord zero draft that we felt were most important.

The report we had just released raised so many relevant issues to pandemic response:

https://twitter.com/angie_rasmussen/status/1638294984523743233

There are critical outstanding questions about the MO bird flu case that need to be addressed now (and why reporting delays are unacceptable). They concern its pandemic potential.

Where did this virus come from?
How was the infection acquired?
Is human transmission occurring?

https://twitter.com/angie_rasmussen/status/1832304383641497876

Where did the virus come from?

Viruses don’t materialize out of thin air. They only come from infected hosts, so we need to think about how the patient could be exposed to said hosts. No contact with animals reported, but indirect contact or exposure could still occur.

This is being presented like it’s a triumph for flu surveillance, but I don’t think I would brag that the CDC and Missouri DHSS have known it was H5Nx for at least a week, probably longer, and waited to disclose this publicly until a Friday night.

cdc.gov/media/releases… The patient was hospitalized on August 22nd and they only disclosed that it’s H5 with no known animal contact (meaning it could be human transmission) on September 6th? They also haven’t sequenced it or subtyped for neuraminidase yet.

health.mo.gov/news/news-item…

Yesterday I shared this piece by me & 40 colleagues on the harms of the “lab leak” hypothesis inflicts on science & scientists.

I’m not finished talking about it. The origins “debate” has consumed my life for >4 years & I want to talk personally about the damage it has caused.

https://twitter.com/angie_rasmussen/status/1819188374864879711

First I’ll review what the commentary says because I know not everyone will read it. People are busy & @JVirology is not always going to publish thrilling page-turners for non-virologists. But here’s the link if you do want to read—it’s pretty accessible:

journals.asm.org/doi/10.1128/jv…

There's a big problem with the way the US is responding to the H5N1 cattle outbreak.

Samples are not being tested in a timely manner (months later) and then these results are not being disclosed in a timely manner (again, months later) either.

This outbreak is not containable.

https://twitter.com/0bFuSc8/status/1818323870207619332

A central principle of outbreak response and containment is to identify cases so they can be isolated. From there, contact tracing and quarantine measures need to be applied with the goal of eliminating further onward transmission (to cows, as well as spillover to humans).