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L.A. County Confirms H5 In Two Cats - Investigating 3 More Suspected Feline Cases - Dec 20th Animal Health Alert

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  • L.A. County Confirms H5 In Two Cats - Investigating 3 More Suspected Feline Cases - Dec 20th Animal Health Alert

    L.A. County Confirms H5 In Two Cats - Investigating 3 More Suspected Feline Cases




    Cats As Potential Vectors/Mixing Vessels for Novel Flu

    #18,496

    Eight days ago, in California: LA County Health Dept - Suspected H5 Bird Flu Detected in Los Angeles County Cats That Consumed Recalled Raw Milk, we saw suspicions raised over the deaths of two cats after they consumed raw milk in Southern California.

    Late yesterday, those suspicions were confirmed, after lab results came back positive for H5 influenza. At the same time, LA county announced they were investigating 3 more suspected feline infections in another household (potentially linked to raw meat consumption).


    Since June we've seen nearly 60 domestic cats confirmed by the USDA to have died after contracting H5N1, although the actual number is likely much higher. Cats are particularly susceptible to H5 influenza, often with severe - or fatal- results (see A Brief History Of Avian Influenza In Cats).

    While rare, cats have also been shown capable of transmitting avian flu (H7N2) to humans (see Preprint: Avian Influenza Virus Infections in Felines: A Systematic Review of Two Decades of Literature) raising concerns over their potential role in spreading the virus, or affecting its evolution.


    We've a lengthy update from LA County, which describes their findings, their current investigation, and their advice to the public. I'll have a postscript after the break.

    For Immediate Release:
    December 18, 2024

    The Los Angeles County Department of Public Health has confirmed two cases of H5 bird flu in cats that consumed recalled raw milk from Raw Farm, LLC. In addition, Public Health is investigating three other possible cases of H5 bird flu in three cats from a different household.

    The confirmed two infected indoor cats from one household consumed raw milk linked to a recall of raw milk and cream products prior to onset of symptoms, which included . lack of appetite, fever and neurologic signs. The infected cats died after severe worsening of their illness, and subsequently tested positive for Influenza A, a rare result in cats. Public

    Health received the results of confirmatory testing, which confirmed the infection of H5 bird flu. Additional pets in the home are under quarantine.

    Public Health is now investigating additional possible cases of H5 bird flu in three cats from a different household. One cat has tested positive for Influenza A, a rare result in cats. Two other cats, which have died after worsening respiratory illness, are presumed to have also been positive for Influenza A. Public Health is awaiting confirmatory testing. These cats were not known to be exposed to raw milk, however public health is investigating other possible sources of infection, including raw meat.

    The nationwide H5 bird flu outbreak has seen other cats infected with the virus after consuming infected raw milk.

    People who had direct contact with the cats are monitoring for symptoms and have been offered antiviral prophylaxis. There have been no human cases of bird flu associated with exposure to these cats yet identified. The investigation is ongoing.

    Although human cases of bird flu are rare and the risk to residents remains low, this detection of H5 bird flu in cats who consumed raw milk underscores the importance of being proactive about preventing ongoing transmission of the virus.

    “The risk of H5 bird flu remains low in Los Angeles County, but these confirmed cases of the virus in pet cats are a reminder that consuming raw dairy and meat products can lead to severe illness in cats," said Dr. Barbara Ferrer, Ph.D., M.P.H., M.Ed., Director of the Los Angeles County Department of Public Health. “To avoid the spread of disease, including H5 bird flu, we strongly encourage residents and their pets to avoid raw dairy and undercooked meat products, limit contact with sick or dead animals, report sick or dead birds and keep pets or poultry away from wild animals and birds.”

    Cats may be exposed to H5 bird flu by consuming infected birds or other animals, being in environments contaminated with the virus, and consuming unpasteurized milk from infected cows. Cats infected with H5 bird flu may develop severe illness that can include fever and neurologic signs, and that can rapidly progress to death. Transmission of the H5 bird flu virus from mammal to mammal can occur. Cats have transmitted another influenza strain to humans, but there have been no known cases to date of H5 bird flu transmitted from cats to humans as part of this nationwide H5 bird flu outbreak.

    Raw milk, which is milk that has not been pasteurized, can carry harmful germs including influenza. These germs can present serious health risks to you, your family, and your pets. Anyone can become sick from drinking raw milk or consuming raw milk products. The people at the highest risk for severe illness include people who are pregnant, adults 65 years and older, children younger than 5 years, and people with weakened immune systems.

    Public Health continues to strongly encourage residents to avoid consuming raw milk and to not feed it to their pets; this includes frozen raw milk products since freezing does not eliminate harmful germs that can cause illness. Pasteurized milk remains safe to drink.

    Symptoms of H5 bird flu infection in humans include eye redness or discharge, cough, sore throat, runny or stuffy nose, diarrhea, vomiting, muscle or body aches, headaches, fatigue, trouble breathing and fever.

    Anyone who has consumed these specific recalled raw milk products and is experiencing symptoms should immediately contact their health care provider or local health department.
    Samples from birds, cats, and wild mammals in LA County continue to be tested for H5 bird flu at our Public Health Laboratory. In addition, the Public Health Laboratory routinely tests clinical specimens from humans for H5 bird flu as part of ongoing surveillance.

    Best Practices to Reduce Risk for You and Your Pets

    While the current risk of transmission of H5 bird flu to LA County residents and pets remains low, Public Health encourages these best practices:

    · Avoid Raw Dairy and Undercooked Meat Products: Do not drink raw milk or eat raw cheeses and undercooked meat products. Do not feed these to your pets. Raw milk, even from healthy cows, may be contaminated with harmful germs that can make you and your pets very sick. Freezing raw milk does not eliminate the harmful germs that may be in the product.

    · Limit Contact with Animals: Avoid unprotected contact with sick or dead animals or birds or any materials contaminated with bird feces. Avoid handling wild birds and observe them only from a distance. If you have to handle wild birds, even if they appear healthy, wear a well-fitting mask and gloves, and practice good hand hygiene, as some birds may carry the virus without showing symptoms.

    · Report sick or dead birds: Contact your local animal control agency if you see sick or dead birds. Symptoms can vary; infected birds or animals may be unable to fly, have seizures, have difficulty walking or be found dead.

    · Protect pets or poultry: Keep pets or poultry away from wild animals and birds. Ensure that wild birds cannot defecate into areas holding or housing pet birds or poultry.

    · Remove Bird Feeders and Baths: Take down bird feeders and communal bird baths to reduce the risk of the virus spreading from bird-to-bird.

    · Get a Seasonal Flu Vaccine: People should receive a seasonal flu vaccine. While this vaccine does not prevent avian influenza infection, it can reduce the risk of getting sick with human and bird flu viruses at the same time.


    For questions or to find a nearby clinic or doctor, residents can call the Public Health InfoLine at 833-540-0473. Open every day from 8 a.m. to 8 p.m.
    For more information, visit our websites:
    Avian flu in animals:
    publichealth.lacounty.gov/vet/HPAI.htm
    Avian flu in humans: ph.lacounty.gov/acd/diseases/h5n1.htm


    Ten days ago, in Emerg. Microbes & Inf.: Marked Neurotropism and Potential Adaptation of H5N1 Clade 2.3.4.4.b Virus in Naturally Infected Domestic Cats, we looked at a report on the HPAI H5 infection of a house full of domestic cats in South Dakota last April.

    Ten cats died, many with severe neurological symptoms, but only two were ever tested. As a result, 80% of the cats in that incident were not added to the USDA's list. It is likely that the majority of feline H5 infections across the country are never reported or confirmed.


    Isolates from the two cats that were tested showed signs of viral adaptation to a mammalian host. The authors wrote:

    Cat H5N1 genomes had unique mutations, including T143A in haemagglutinin, known to affect infectivity and immune evasion, and two novel mutations in PA protein (F314L, L342Q) that may affect polymerase activity and virulence, suggesting potential virus adaptation. Dead cats showed systemic infection with lesions and viral antigens in multiple organs. Higher viral RNA and antigen in the brain indicated pronounced neurotropism.


    While the virus still lacks the ability to transmit efficiently from human-to-human, every mammalian infection is another opportunity for the virus to crack that code.

    Although the CDC continues to rank the risk to general public from avian flu as low, they do provide very specific guidance to pet owners on how to limit their risk of infection from the virus (see What Causes Bird Flu in Pets and Other Animals).


    And given the escalating amount of HPAI virus being reported in wild birds, poultry, and livestock across the country, it is advice well worth heeding.

    https://afludiary.blogspot.com/2024/12/la-county-confirms-h5-in-two-cats.html​
    Last edited by Michael Coston; December 21, 2024, 09:53 AM.
    All medical discussions are for educational purposes. I am not a doctor, just a retired paramedic. Nothing I post should be construed as specific medical advice. If you have a medical problem, see your physician.

  • #2
    LA County Issues Another Raw Milk Warning



    #18,497

    Despite ample evidence of its dangers, the `raw milk' movement in the United States continues to grow. A 2022 study published in the Journal of Food Protection found that:

    Results show that 4.4% of U.S. adults reported consuming raw milk at least once in the past year, with 1.6% reporting frequent consumption of raw milk (once per month or more often) and 1.0% reporting consumption once per week or more often

    Over the past month we've seen several recalls of raw milk in California after evidence of H5N1 contamination surfaced (see here, here, and here), and this week it was confirmed that at least 2 cats died in Los Angeles from the H5 virus after consuming raw milk.

    Two days ago California's governor declared a State of Emergency over the bird flu threat (see statement) and this week we've seen several new states report human infections (Delaware, Louisiana, Wisconsin), including one which is in intensive care.

    While it may not deter raw milk aficionados, the LA County Dept. of Public Health issued another warning late yesterday on the dangers of consuming unpasteurized dairy products. I'll have a bit more after the break.

    For Immediate Release:

    December 19, 2024

    Public Health Warns Against Consuming Raw Milk Following Additional Detections of H5 Bird Flu Virus

    The Los Angeles County Department of Public Health is urging residents to avoid consuming or feeding to their pets raw milk due to the ongoing spread of H5 bird flu in dairy cows. A recent statewide recall by the California Department of Food and Agriculture (CDFA) reported additional detections of bird flu virus in samples taken from a raw milk bulk tank at the Valley Milk Simply Bottled dairy farm of Stanislaus County.

    Residents should avoid consumption of all raw milk and not feed it to their pets -- whether obtained from a licensed retailer, local farm, neighbor, or friend. Raw milk, which is milk that has not been pasteurized, can harbor harmful bacteria and viruses, including bird flu, which can pose serious risks to public health. While consuming raw milk is never advised from a public health standpoint, the risk is especially concerning at this time, given the ongoing spread of bird flu virus among dairy cattle and following recent
    multiple detections of the virus in raw milk products.

    Obtaining raw milk through unlicensed distributors carries an elevated risk as these products are not permitted or regulated by The California Department of Food and Agriculture’s (CDFA) rigorous requirements for milk producers. In order to be sold commercially in California, raw milk must be produced on a dairy farm that holds a market milk permit issued by CDFA. CDFA inspects farms and bottling facilities, collecting milk samples for laboratory analysis, and communicating with the dairy farmers on any issues indicated by laboratory test results. While permitted raw milk is tested and regulated, there is no guarantee that it is completely safe and may still pose significant health risks for both humans and pets.

    Anyone can become sick from drinking raw milk or consuming raw milk products. The people at the highest risk for severe illness include people who are pregnant, adults 65 years and older, children younger than 5 years, and people with weakened immune systems.

    The products impacted by this new recall may be marketed as Valley Milk Simply Bottled Raw Cow Milk and DESI Milk Raw Cow Milk and are distributed in quart (32 oz), half gallon (64 oz), and one gallon (128 oz) plastic jugs. The recalled jugs have an expiration date of DEC 23 2024 through DEC 30 2024 marked on the container.

    CDFA is notifying retailers to remove the affected raw milk from their shelves. People may have already purchased the raw milk that may be contaminated with H5 bird flu virus from retailers prior to the recall and should immediately discard any remaining product or return it to the retail point of purchase. This includes frozen raw milk products since freezing does not eliminate harmful germs that can cause illness.

    No human illnesses associated with this raw milk recall have been reported in LA County. Public Health recently
    confirmed H5 bird flu in four cats that consumed recalled raw milk and became sick and died, which is part of an ongoing investigation. Cats infected with H5 bird flu can develop severe illness that may including neurologic signs, respiratory signs or liver disease that can rapidly progress to death.

    Anyone who has consumed these specific recalled raw milk products and is experiencing symptoms should immediately contact their health care provider or local health department.

    About Raw Milk

    Raw milk is milk that has not been pasteurized to kill harmful bacteria. Raw milk—and products made from it such as queso fresco—can carry harmful germs, such as Listeria, Salmonella, Campylobacter, E. coli, viruses and parasites. These germs can present serious health risks to you and your family.

    Pasteurization is the process of heating milk to a high enough temperature for enough time to kill harmful germs, which can cause serious illness. This process does not eliminate milk’s nutritional value.

    Raw milk, even from healthy cows, may be contaminated with harmful germs that can make you very sick. In fact, raw milk is one of the riskiest foods to consume. People who get sick from raw milk might have many days of diarrhea, stomach cramping, and vomiting. Some people might develop severe or even life-threatening diseases, including pregnancy loss; blood infection; hemolytic uremic syndrome, which can result in kidney failure, stroke, and even death; Guillain-Barré syndrome, which can cause paralysis and even death.

    Anyone can become sick from drinking raw milk or consuming raw milk products. The people at the highest risk for severe illness include people who are pregnant, adults 65 years and older, children younger than 5 years, and people with weakened immune systems. People in these groups should not consume raw milk or products made with it.

    Drinking or accidentally inhaling raw milk containing bird flu virus may lead to illness. In addition, touching your eyes, nose, or mouth with unwashed hands after touching raw milk with bird flu virus may also lead to infection. Symptoms of bird flu infection in humans include eye redness or discharge, cough, sore throat, runny or stuffy nose, diarrhea, vomiting, muscle or body aches, headaches, fatigue, trouble breathing and fever.

    For questions or to find a nearby clinic or doctor, residents can call the Public Health InfoLine at 833-540-0473. Open every day from 8 a.m. to 8 p.m.

    For more information, visit our websites:

    Avian flu in animals:
    publichealth.lacounty.gov/vet/HPAI.htm

    Avian flu in humans: ph.lacounty.gov/acd/diseases/h5n1.htm




    While H5N1 hasn't demonstrated the ability to spread efficiently from human-to-human, the virus is constantly reinventing itself, and we really don't know how much further it must evolve before it could spark a pandemic.

    Reports of HPAI being `one mutation away' are likely over-stated, but the virus can sometimes make giant leaps literally overnight via Antigenic `Shift' or Reassortment.






    And that can happen anytime the H5 virus co-infects a host (avian, human, mammalian) with another, potentially more transmissible, influenza virus. The concern being that even a mild H5 infection - in someone who is also infected with seasonal flu - could produce a more transmissible `H5Nx' virus.

    It is also possible that a reassortment could produce a more severe H1 or H3 influenza virus; one with the internal genes from H5.

    Although this may sound far-fetched, at least twice in my lifetime (1957 & 1968) a reassortment between seasonal flu and an avian flu virus - likely in a human host - produced a pandemic virus.
    • The first (1957) was H2N2, whichAccording to the CDC`. . . was comprised of three different genes from an H2N2 virus that originated from an avian influenza A virus, including the H2 hemagglutinin and the N2 neuraminidase genes.'
    • In 1968 a novel H3N2 virus emerged (a reassortment of 2 genes from a low path avian influenza H3 virus, and 6 genes from H2N2) which supplanted H2N2 - killed more than a million people during its first year - and continues to spark yearly epidemics more than 50 years later.

    Note: The 2009 H1N1 pandemic - although it was a triple-reassortment containing some avian-origin genetic contributions - emerged from swine.
    The consumption of raw milk - particularly during flu season - increases the chances of having someone co-infected with avian and seasonal flu, which opens the door to seeing a reassortment event.

    And while the generation of a pandemic virus may be a statistical long-shot, influenza viruses have a long history of beating the odds.


    #18,497 Despite ample evidence of its dangers , the `raw milk' movement in the United States continues to grow. A 2022 study published in t...


    All medical discussions are for educational purposes. I am not a doctor, just a retired paramedic. Nothing I post should be construed as specific medical advice. If you have a medical problem, see your physician.

    Comment


    • #3
      LA County Animal Health Alert : H5 bird flu confirmed in Domestic Cats




      Credit - LA County H5 Bird Flu in Animals



      #18,503

      On Thursday, in L.A. County Confirms H5 In Two Cats - Investigating 3 More Suspected Feline Cases, we learned of a second household where HPAI H5 was suspected in the infection, and deaths, of cats in Los Angeles.

      Unlike the first event - which was linked to raw milk consumption - the second outbreak appears linked to commercial raw meat pet food.
      Yesterday the LA County Health Department (animal health division) published the following AHAN - for veterinarians - on the second incident. This is a lengthy document, and I've only reproduced some excerpts, starting with the summary below.

      Veterinarians in particularly will want to follow the link to read it in its entirety.
      • Five indoor-only, domestic cats in one household in Los Angeles (LA) County died after consuming recalled raw milk. Four of these cats were tested and confirmed to be infected with H5 Bird Flu. This group includes the two cats described in an earlier alert issued 12/12/2024.
      • There are additional recalls on raw dairy products. The current recalls include:
        • All sizes of raw milk and cream produced by Raw Farm, LLC in California betweenNovember 9-27, 2024 (lot numbers 20241109 through 20241127).
        • All “Valley Milk Simply Bottle Raw Cow Milk” and “DESI Milk Raw Cow Milk” distributed in quart (32oz), half-gallon (64 oz), and one-gallon (128 oz) plastic judges with a code date marked on the container of “DEC 23 2024 through DEC 30 2024”, produced by Valley Milk Simply Bottled of Stanislaus County.
      • From a separate household in LA County, a symptomatic cat has tested presumptive positive for H5 bird flu after consuming two different brands of raw pet food composed of raw poultry and raw beef. The investigation for this case is currently ongoing.
      • Animal health staff should specifically ask pet owners about exposure to raw milk and raw diets, share information about the risk of raw milk and raw diets, and caution pet owners NOT to consume raw dairy products, nor offer them to pets.
      • Animal health staff should wear appropriate personal protective equipment (PPE) when in contact with animals suspected or confirmed of being infected with H5 bird flu; acutely sick animals that have history of exposure to raw milk or raw milk products, wild birds or raw or undercooked animal products.
      • Animal health staff are strongly recommended to receive their seasonal flu vaccine. Although this vaccine is not proven to prevent infection with H5 Bird Flu, it can help protect staff from seasonal human flu which is circulating right now.
      • REPORT suspected cases of H5 bird flu in cats and other animals. Testing for the virus may be available. A complete dietary history for the animal (including raw dairy, raw poultry and/or meat, and bird exposure) is needed.

      We get more details on the investigation (which includes 13 affected cats, with at least 7 deaths).

      On 11/22/24, eight cats in one household were offered raw milk produced by Raw Farm, LLC. The raw milk was from a lot that was not included in the recalls issued on 11/24/24 and
      11/27/24 but was included in the third recall issued on 12/3/24. Between November 20 and December 7, 2024, seven of the cats became ill. Between December 2-10, five died or were euthanized. The other two cats are under quarantine and improving.

      This group includes the two cats described in an earlier alert issued on 12/12/2024. Clinical signs were variable but progressive. They included fever, lethargy, dehydration, anorexia, icterus, respiratory distress, and neurologic signs (primarily seizures, although one had nystagmus). One cat had evidence of lung lobe consolidation.

      Of the five deceased cats that drank the recalled raw milk, four were tested for influenza A by PCR testing of samples from multiple body sites (oropharyngeal, rectal, and/or brain). All samples collected were confirmed positive for Influenza A, and further subtyped as H5N1 also known as H5 Bird Flu, by the National Veterinary Services Laboratory (NVSL).

      These are the first confirmed cases of H5 bird flu infections in cats in Los Angeles County. They were sequenced by NVSL with sequences identical to the raw milk they ingested which was recalled from Raw Farms. H5 bird flu has been detected in domestic cats in other states since the beginning of this national and international outbreak that began in wild birds in late 2021.

      From a separate household in LA County, Veterinary Public Health is investigating five indoor only domestic cats that became ill presumably after consuming two different brands of raw pet food diets composed of raw poultry and raw beef.

      Approximately 2 weeks after consuming the raw diets, two cats presented with acute respiratory distress to veterinary clinics and were humanely euthanized. One of these cats had known pre-existing cardiac disease. Two other cats presented with symptoms including lethargy, reduced appetite, upper respiratory, neurologic, and ocular signs of disease. One cat was treated for corneal edema and uveitis in one eye. The other cat displayed ataxia, uveitis and bilateral retinal detachment in both eyes and was tested with a respiratory panel from a commercial veterinary diagnostic laboratory, which resulted as presumptive positive for Influenza A and Feline Calicivirus.

      This sample was further detected as positive for H5 bird flu at the California Animal Health and Food Safety (CAHFS) Laboratory and the sample will be sent to NVSL for confirmation, subtyping, and sequencing. The investigation is ongoing and includes testing of the raw pet food diets by the Food and Drug Administration (FDA).


      They report no evidence of cat-to-cat transmission or cat-to-human transmission, although we've seen some evidence of both with other avian flu viruses (see EID Journal: Avian H7N2 Virus in Human Exposed to Sick Cats).

      They caution, however:

      . . . people who come into close contact with animals, especially wild birds and their feces, infected cats, infected poultry, or with infected dairy cattle or their milk, have a higher level of risk of exposure. It is important to take proper precautions.

      For more on HPAI H5 in domestic cats, you may wish to revisit:
      .
      https://afludiary.blogspot.com/2024/...t-h5-bird.html

      All medical discussions are for educational purposes. I am not a doctor, just a retired paramedic. Nothing I post should be construed as specific medical advice. If you have a medical problem, see your physician.

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