1/ Yesterday, the @WHO declared mpox a public health emergency of international concern (PHEIC).

This is the 2nd time in 2 years that the WHO has declared a PHEIC for mpox.

with @vladduthiersCBS on @CBSMornings 2/ There have already been more than 17K cases in Africa so far this year – more than the total for all of last year.

1/ COVID study shows mask and vaccine mandates saved lives

with @CBSNews' @LanaZak cbsnews.com/video/covid-st…
2/ A new study published in the JAMA Health Forum yesterday found that:
🔹mask requirements & vaccine mandates were associated with ⬇️ deaths
🔹prohibitions on vaccine or mask mandates were associated with ⬆️death rates

jamanetwork.com/journals/jama-…

1/ New Hope Against Dementia: study says singles vaccine also appears to delay onset of dementia
with @CBSMornings' @tonydokoupil @AdrianaDiaz @nateburleson 2/ A study published yesterday in Nature Medicine found that the new Shingrix vaccine was more protective than the old Zostavax vaccine in delaying dementia.

The Zostavax shingles vaccine was discontinued after the Shingrix vaccine was approved.

nature.com/articles/s4159…

1/ Why are People Promoting Raw Milk?
by @elizabethics for @RollingStone


If you drink unpasteurized milk, you don't just risk getting #H5N1 bird flu.rollingstone.com/culture/cultur… 2/

1/ Tick-borne infections are on the rise around the country

with @CBSMornings @GayleKing @tonydokoupil @nateburleson 2/ A unique collaboration among hunters,
the Texas Parks & Wildlife Department @TPWDnews,
& researchers at @Baylor University
is helping to map what tick-borne diseases can be found where.

1/ #H5N1 bird flu update on @CBSMornings with @GayleKing @vladduthiersCBS @nateburleson

Who's at risk for bird flu right now?
🔹You're at risk if you're a dairy farmworker &/or if you drink raw milk. 2/
🔹If the virus mutates (which is what viruses do!) & becomes transmissible between humans, we could have a pandemic virus on our hands.

1/ #H5N1 bird influenza is deadly to birds.

Most of our flu vaccines are manufactured using eggs.

Birds lay eggs, but they can't do that if they're dead.

Houston, we have a problem.

cbsnews.com/video/scientis… 2/ Influenza virus is grown in eggs.

Then the virus is inactivated (i.e. killed) & formulated into flu vaccine.

1/ What is H5N1 bird flu costing dairy cattle farmers?

Let's say you have a 5,000 cow dairy.

Those cows produce an average of 85 lbs of milk per day
= 425K lbs of milk/day x 7 days/week
= 2.975M lbs of milk/week 2/ Milk producers are paid by "hundredweight" (cwt).

The current class III price is $18.66/cwt of milk.

1/ #H5N1 news today 📢📢📢

@USDA has announced an indemnification program for dairy farms to be based on the amount of milk🥛 lost from cows🐄 sick with H5N1. 2/ @USDA will also offer farmers support for biosecurity measures on the farm:
🔹to protect against potential spread between animals 🐄 & humans🧑‍🌾: PPE &/or outerwear laundering services
🔹to make biosecurity plans
🔹to pasteurize milk🥛 before disposal

1/ The @US_FDA is taking precautions in case the H5N1 bird flu starts spreading from person-to-person, possibly igniting an epidemic/pandemic.

with @CBSNews @AMGreenCBS

cbsnews.com/video/fda-prep… 2/ Long before the COVID pandemic, infectious disease experts like me have worried about the possibility of an influenza pandemic.

The 1918 flu pandemic, which is estimated to have killed 50 to 100 million people worldwide, is one of the deadliest in human history.

1/ H5N1 bird flu candidate vaccine viruses have been identified:
(jump to 1:33)
🔹2 are "well-matched" to H5N1 infecting dairy cattle
🔹but how "well-matched" are they really? this conclusion is based on ferret dataastho.org/education/hpai… 2/
🔹Candidate vaccine viruses are used to make antigen (i.e. the target you want the immune system to see) for vaccines.
🔹Adjuvant has also been stockpiled.
🔹Adjuvants help strengthen the immune response to antigen in vaccines.

1/ There are still lots of unanswered questions re: H5N1 bird flu

🔹How quickly is the virus mutating and evolving?

A PB2 E627K mutation was found in the human case in Texas, but not seen in birds or cows.
(1:04:50)astho.org/education/hpai… 2/ The PB2 E627K mutation has been seen in other human cases of H5N1.

It is one step towards mammalian (but NOT human) adaptation in experimental studies. (h/t @RickABright)

1/ Stemming the spread of H5N1 bird flu
🔹The federal government is ramping up testing of dairy cows
🔹Cows will now have to be tested before being transferred to another state
🔹H5N1 viral fragments detected in grocery store milk
🔹The risk to humans remains low at this time 2/ Remember PCR tests from COVID?

They can be positive even after you’ve recovered because they’re picking up dead virus.

Some PCR tests on pasteurized milk from grocery stores have come back positive for bird flu... but that could just be dead virus.

1/ H5N1 bird flu has been detected in the milk supply




We currently believe the milk supply to be safe.

Some other key points:washingtonpost.com/health/2024/04…
nytimes.com/2024/04/23/hea…
fda.gov/food/alerts-ad… 2/ The levels of virus fragments being found in milk by PCR are high.

Milk from different cows is combined into big vats.

You wouldn't see such high levels of virus if only a couple cows were infected... it would be diluted down.

This implies many cows have been infected.

1/ The 2nd human case of H5N1 bird flu was reported in the US yesterday.

This case was in Texas & likely involved transmission from an infected cow🐄 to this individual.

The 1st case was reported in Colorado in 2022.

with @tonydokoupil @GayleKing @nateburleson 2/ The person in Texas became ill with H5N1 bird flu after direct contact with infected dairy cattle🐄.

The patient's primary symptom was conjunctivitis (i.e. pink eye).

The patient is isolating & is being treated with an antiviral for flu... as are their close contacts.

1/ Health workers fear it's profits before protection as CDC revisits airborne transmission by @KFFHealthNews' @amymaxmen

So incredibly brave of Dr. @sonyastoked to speak out:
nbcnews.com/health/health-…
2/

1/ U.S. Healthcare System Reels from Cyberattack

with @CBSNews' @errolbarnettcbsnews.com/news/change-he… 2/ The February 21st cyberattack on a medical payment processing company Change Healthcare, a unit of insurance giant UnitedHealth Group's Optum division, is the worst cyberattack on the U.S. healthcare system in history.

1/ Ohio is reporting an outbreak of pediatric pneumonia cases.

This is similar to the "white lung syndrome" (aka ARDS) that is being seen in Europe & China.

THIS IS NOT DUE TO A NOVEL PATHOGEN CAUSING A NEW PANDEMIC.

on @CBSEveningNews @CBSNews with @noraodonnell & @megoliver
2/ Lung "white out" = acute respiratory distress syndrome (ARDS)

This can be caused by viral & bacterial infections as well as other conditions.

Before people had much immunity to COVID in 2020, this was how people with COVID most often presented to the hospital.

1/ New @KFF polling data on flu/COVID/RSV vaccines


with @CBSNews' @AMGreenCBS
kff.org/coronavirus-co…
cbsnews.com/video/long-cov… 2/ We're entering respiratory virus season:
flu + COVID + RSV

For the first time ever, we have safe & effective vaccines against ALL THREE!

But will people get them?

% of adults planning to get the annual FLU vaccine:
🔹more than 50% of all adults
🔹almost 75% of adults 65+

1/ I went out exploring in the medina in Marrakech this morning:

https://twitter.com/celinegounder/status/1700385454992867466?s=20

2/ I couldn't get past this without interfering with relief efforts. It seems like the worst of the destruction was behind this, in the oldest parts of the medina.

The oldest parts of the medina in Marrakech date back to the 12th century.

1/ The @CDCgov is now forecasting an acceleration in new COVID hospitalizations over the coming month.

with @CBSMornings @CBSNews' @GayleKing @tonydokoupil @nateburleson 2/ Note that people 70+ are driving the bulk of that increase in hospitalizations (see the top purple🟪line on the right).

covid.cdc.gov/covid-data-tra…