Okay, so. I don’t know how much of a heads up this is when it’s just a notice about these 2 mutations. Do they really raise serious concerns about “increased transmission?”

Sort of. It’s more complex than D701N & E626K, omg pandemic bird flu.

What do these mutations do in H5N1?

https://twitter.com/covid19_disease/status/1894924526150119625

Flu is a segmented, negative sense RNA virus. This means its genome is divided into 8 pieces and they are negative coding sense and serve as a template for transcribing (copying) mRNA from each segment.

D701N and E672K are in a segment called PB2.

I have insomnia a lot lately so may as well share what’s literally keeping me up at night.

It’s a long list but tonight it’s flu. Yes, H5N1, but also seasonal flu. Firing federal scientists brings a flu-filled future.

Have you ever wondered how flu vaccine strains are chosen? Every year the flu vaccine changes to match the strains that are circulating around the world. Right now these are 3 main viruses: H1N1(pdm09) and H3N2 flu A and 1 from the flu B Victoria lineage.

This is going to be another rough week for our colleagues in government & for all of us. Vast cuts of govt scientists hurts everyone’s health.

Let’s talk about what this will do to vaccines.

This is the process. Here’s how they’re going to undermine it:
cdc.gov/vaccines/basic… So as @CDCgov helpfully describes, vaccine development is a long and complex process involving all the HHS agencies.

cdc.gov/vaccines/basic…

Here’s some positive H5N1 news for a change: conditional approval for poultry vaccines made by @Zoetis for chickens.

Why didn’t we do this sooner? The answer is more complex than you might think.

science.org/content/articl… For years, the standard approach in the US, Canada, and Europe has been to cull birds in flocks that get hit with HPAI (highly pathogenic avian influenza). A couple reasons for this:
1. HPAI kills chickens & turkeys (the HP refers to severity in birds)
2. No other alternatives

I wasn’t planning on discussing this publicly (it’s nobody’s business) but after this bullshit MAHA EO, fuck it, it’s personal story time. Let’s talk safe meds.

I lost ~75 pounds taking Ozempic. I don’t give a damn if I have to take it for the rest of my life, it fucking RULES.

https://twitter.com/angie_rasmussen/status/1890201100760072524

I started Ozempic in Feb 2023 after my annual checkup. I told my doctor I am dieting & riding my Peloton maniacally but I can’t lose weight. She said it’s age, my hypothyroid condition, stress, & lack of sleep. It’s not a matter of working harder or more. She prescribed Ozempic.

Giving infectious disease research a break, as promised by the MAHA agenda.

Let's break down what exactly this Executive Order is *really* saying. Fortunately, I speak fluent anti-vax grifterese & can translate.

whitehouse.gov/presidential-a… There's this background section about the terrible epidemic of chronic disease & they are VERY worried about children.

Note the diseases they focus on? Autism spectrum disorders, obesity, & ADD/ADHD = vaccines did it.

"increased prescriptions" = evidence-based medicine is bad

Can’t say whether D1.1 H5N1 (new cow genotype) is more or less virulent than B3.13 (prior cow genotype), as @JenniferNuzzo correctly notes.

Viruses can be more or less virulent than others but the main determinant of pathogenicity is the host. That’s key for assessing H5N1 risk.

https://twitter.com/latimes/status/1888689088078676207

So far most of the cases have been “mild” (an imprecise term I dislike, but good to convey “not severe”). That includes both B3.13 and D1.1 cases. But it’s probably not the virus primarily driving that. It’s more likely determined by how the host responds to infection.

Editing scientific content for political purity is turning MMWR into a compromised propaganda organ.

And why are the propaganda squads at CDC replacing specifically H5N1 bird flu studies?

I’ve got some pretty serious fascism- and flu-related concerns about this.

https://twitter.com/alexander_tin/status/1888005498676433231

Over the last year, the CDC’s H5N1 response has left a lot to be desired. They fucked up testing—again, as with COVID, they failed to make functional PCR primer/probes—and did not take decisive action that IMO could reduce risk, such as offering vaccine to high risk workers.

On Data Purge Eve, many people stayed up late to save the CDC website. @charles_gaba downloaded the whole thing. 👑

A group of us are working to make these preserved data an accessible & publicly available resource. More to come, but get started here 👇🏻

acasignups.net/25/02/02/llink… Page 2. These data were generated with US taxpayer dollars. They belong to the American people. CDC made them available to the world.

Deleting these data is theft. Deletion disobedience is how we take back what is ours.

acasignups.net/25/02/02/links…

Out today in @ForeignPolicy: I wrote about what will happen if there is an H5N1 pandemic with Robert F Kennedy, Jr. in charge of safeguarding the health of Americans.

If RFK Jr is leading HHS & H5N1 begins spreading human to human, the deaths will be counted in millions.🧵👇 RFK Jr already has a sizable body count (in every sense of the term, but here I'm talking about counting corpses and not sexual partners).

If he has control over HHS in a flu pandemic, deaths attributable to him will increase by orders of magnitude.

foreignpolicy.com/2025/01/30/rfk…

@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.