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Discussion thread: H5N1 avian flu in US dairy cows including human cases (poultry, dairy workers) - March 24, 2024 +

Can we interpret 8 states with positive cows, and the same 8 states with wastewater positives as limited human transmission?

Or are we still thinking this could be farm runoff?

According to this study:
...
The presence of H5 in municipal wastewater indicates that contributions into the wastewater system include excretions or byproducts containing influenza viral RNA with an H5 subtype, but do not indicate the species that may be shedding an H5 influenza.
...
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Idaho's avian flu outbreak in dairies is largely self-monitored; experts warn of potential health risks

July 15, 2024
Excerpts:

Idaho dairy producers are navigating one of the worst outbreaks of an avian flu strain in the U.S., and from an animal health and public health standpoint, the situation is largely self-monitored.
...

“I don’t know if this will turn out to be a pandemic, but we’re watching all the ingredients, and we’re watching that sequence,” said Dr. David Pate, retired president and CEO of St. Luke’s Health System. “Certainly, if you were planning out how we think a pandemic would occur, this is what you would be planning out.

In response to the COVID-19 pandemic, Pate and another Idaho doctor, Dr. Ted Epperly, wrote the book “Preparing for the Next Global Outbreak” and Pate has been watching the avian flu outbreak closely. He argues that more should be done to prepare in case the situation becomes more dangerous for human health
​...

As of July 12, there are 18 facilities in nine Idaho counties under quarantine, including two in Canyon County. The last reported detection in Idaho was on June 20, and producers feel that the state may have reached its peak and is showing signs of decline in the spread of the virus, said Idaho Dairymen’s Association CEO Rick Naerebout.

However, this may change when migratory birds start returning to the state for the winter, he said.
...
This is a big hit to Idaho, which has more than 400 dairy operations and ranks third in U.S. for milk production, according to the Idaho Dairymen’s Association.​

https://www.ktvb.com/article/news/l...isks/277-a824f7e7-4976-4ab3-b24d-44b58cfed452
 
Bird flu snapshot: As the number of infected dairy herds mount, so too does pessimism about driving H5N1 out of cows
​There are more human cases of H5N1 bird flu infection, and another state has joined the list of those with infected dairy cow herds.

Colorado announced Sunday night that five workers involved in the culling of chickens at an H5N1-infected poultry operation had tested positive for the virus. Four of the cases have been confirmed by the Centers for Disease Control and Prevention; the fifth is currently deemed “presumptive” positive because the individual’s test sample hasn’t yet reached the CDC. All five had mild symptoms — conjunctivitis and minor respiratory complaints. None required hospitalization.

Additional testing by the CDC is needed to fully characterize the viruses responsible for these infections. But assuming they are the same as the one circulating in cows (which has occasionally spilled over into poultry operations), these cases will bring to nine the number of human infections recorded since this outbreak was first detected in late March. The CDC, at the request of the state, is helping investigate the new human cases in Colorado.

And on Friday came news that another state had discovered a bird flu-infected herd. Oklahoma announced that a sample collected in April that was only recently tested was found to be positive. No explanation was given for the remarkably slow turnaround in the testing of the sample. Oklahoma called itself the 13th state to find H5N1 in dairy cattle, but in reality its place on the list should be lower, as several states only discovered positive herds in May and June.
​…..

These new human and animal developments support a blunt risk assessment from the Norwegian Institute of Public Health, which gave voice to a rising sense of pessimism about the prospects for containing the H5N1 outbreak in cows in a recent report.

“There are no clear signs that the outbreak is or is about to come under control,” the 26-page document on the public health risks associated with the ongoing spread states plainly.
​………
:tiphat:
https://www.statnews.com/2024/07/15/bird-flu-snapshot-h5n1-infected-herds/
 
Despite bird flu anxiety in the dairy barn, a yearly tradition carries on at an Iowa county fair


By Eric Boodman

July 16, 2024
​Decorah, Iowa — It was livestock check-in day at the Winneshiek County Fair, and the dairy barn was consumed with a kind of pre-prom anxiety.​
...

Just as authorities fretted about Christmas Covid spikes, so vets are trying to prevent trailers from clanking back home with microscopic stowaways replicating in udder cells.

They’re also hoping to avert inter-species spread. Cow-to-chicken could wipe out a whole poultry flock. Cow-to-pig could put the virus into an efficient mutation machine, potentially allowing a pathogen that prefers udders and bird intestines to become one that likes living in our lungs. Though the handful of human infections documented so far in farmworkers have been mild, cow-to-human is a real risk, too. The longer H5N1 circulates in cattle, the more it poses a pandemic risk for us.
​---
States like Iowa, Wisconsin, and Minnesota have so far allowed lactating dairy cows at shows, but only if they’re flu-tested in the seven days before they arrive. In Colorado, meanwhile, such precautions are recommended but not required.​
...
To the outside eye, the occupants of the Winneshiek County dairy barn seemed relaxed. When they weren’t coiffing or cleaning up after their cattle, they lounged in beach chairs, popping fried cheese curds, enjoying the breeze of industrial fans. But there was an undercurrent of concern: They didn’t want anyone overstating the flu threat or giving their industry a bad rap. “Our milk is totally 100% safe to drink because everything’s pasteurized,” said Mark Knutson, who milks around 400 cows in Ossian. “But, you know, the media gets hold of it, blows it out of proportion, scares everybody.”​ Then again, he thought some precautions made sense. Knutson is on the fair board, which had canceled this year’s open-class dairy show — partially because of low enrollment, partially because of bird flu risk — bringing the number of lactating cows down to a tenth of what it might’ve been.​
---

To D.M., the co-owner of a herd of 500, who wanted to be identified only by initials, testing was the reason he was sitting this year’s cow shows out.

They’ll test the cows’ milk, that way they’ll find out if there’s any more of it out there, which is none of their business, as far as I’m concerned,” he said. If bird flu had arrived on his farm, he didn’t want to know. He’d of course isolate any sick animals in the sick pen, and discard their milk, the way he always does. The cows are his livelihood. He takes care to keep them healthy, and to keep his product pristine. But he’s too afraid of the stigma that might accompany a positive test — so afraid that he wouldn’t even apply to the federal program that would reimburse him for liquid pounds he couldn’t sell, leaving money on the table. Vets were hearing such views from other clients, too, and nationally, only around 30 producers have applied for government compensation.

“If it shows up, you don’t know if your creamery is going to keep taking your milk,” he said, even though the protocol is for sales to start back up again after a 30-day hiatus.

For now, that was probably hypothetical. While Iowa had recorded 13 infected herds, there hadn’t yet been any reported cases on dairies in the state’s northeast corner; the closest ones were a few hours to the west, or north in Minnesota. But in his and some of his neighbors’ views, it was only a matter of time. They talked as if spread were inevitable, bovine H5N1 on its way to being endemic, an annoying fact of life that dairies just have to deal with.

Complete article: https://www.statnews.com/2024/07/16/bird-flu-dairy-cattle-biosecurity-county-fairs/

 
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https://data.wastewaterscan.org/tra...0xOIoBBmY3NjlhYbgBGw==&selectedChartId=f769aa
 

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Influenza A Virus Wastewater Data

Updated July 19, 2024

Main Findings from Wastewater Surveillance

During the two most recent weeks, (June 30, 2024–July 13, 2024), a total of 301 of 743 sites reported data meeting criteria for analysis for influenza A virus for both weeks or for either week, and 1 (<1%) site from 1 state was at a high level (>80th percentile compared to levels recorded at that site between October 1, 2023 and March 2, 2024).
...
Data Table
...
Id:137 7 California Plumas Above Average 67.86 Two-Week Maximum <10,000 2023-01-03
Id:164 7 California San Luis Obispo Above Average 66.67 Two-Week Maximum 30,000 2022-02-28
Id:494 7 Illinois Vermilion Above Average 66.67 Two-Week Maximum 30,000 2022-10-06
Id:1719 7 Oregon Clackamas Above Average 65.38 Two-Week Maximum 30,000 2023-09-27
Id:1729 9 Oregon Jackson High 85.0 Two-Week Maximum 20,000 2021-09-27

...

https://www.cdc.gov/nwss/wastewater-surveillance/Flu-A-data.html
 
How to Pinpoint the H5N1 Mortality Rate in Humans''

Avian flu is reported to kill more than half the people it infects. The reality is much more complicated.

BY TERESA CARR
07.22.2024
...
Like many experts, Peter Palese, a microbiologist at the Icahn School of Medicine at Mount Sinai in New York, thinks that the CFR of 52 percent for H5N1 calculated by the WHO likely overestimates the disease’s severity. To meet the WHO’s definition of an H5N1 case, the person must have had a fever and tested positive for the virus in a lab with the technical capacity to follow WHO protocols. Because many of the outbreaks have been in rural areas without sufficient testing capabilities, the case count is drawn almost exclusively from patients who were sick enough to be hospitalized. Meanwhile, said Palese, many milder infections likely went undetected, although the exact number of those silent infections is unknown.

“It is not completely clear whether these high fatality rates are real,” said Palese.

“These numbers are something we have to use because we don’t have something better, but people in the business are aware that they are potentially deceptive.”


Outbreaks are like an iceberg where serious infections are immediately visible, but the larger numbers of mild infections are out of sight below the water line, said Malik Peiris, a virologist at the University of Hong Kong with extensive experience with H5N1. One of the best ways to get a more accurate case count, he said, is to test community members’ blood for antibodies against H5N1, which would indicate a previous infection: “That gives you a much more accurate picture of the bottom of the iceberg.”

Researchers have conducted dozens of such studies. But results from that research, said Peiris, “are a bit mixed and somewhat confusing.” While antibody studies of some H5N1 outbreaks find evidence of widespread mild infections, studies of other H5N1 outbreaks do not, even among people who worked closely with infected birds. Peiris described the disparity as “rather puzzling.”

It’s possible, said Peiris, that antibody tests miss some cases. Type A influenza viruses such as H5N1 are characterized by the combination of two proteins on their surface: hemagglutinin, which can be one of 18 types numbered H1 to H18, and neuraminidase, numbered N1 to N11. Compared to the H1 and H3 proteins in the influenza A viruses responsible for seasonal flu, H5 proteins trigger a weaker response from the immune system, said Peiris: “People may be getting mildly infected, but it’s not enough to elicit an antibody response.”

...
https://undark.org/2024/07/22/avian-flu-actual-mortality-rate/
 
"Enormous concern": New bird flu transmission paths confirmed


By Bronwyn Thompson
July 25, 2024​

Excerpts: (the whole article is very informative)

...“This is one of the first times that we are seeing evidence of efficient and sustained mammalian-to-mammalian transmission of highly pathogenic avian influenza H5N1,” said corresponding author of the study Diego Diel, director of the Virology Laboratory at the Animal Health Diagnostic Center (AHDC) at Cornell University.​

Cornell scientists have uncovered more about the 'spillover' of the highly pathogenic avian influenza (HPIA) H5N1 clade 2.3.4.4b virus, which is characterized as a "significant increase in the intensity, frequency and geographic range" of the zoonotic disease and has killed hundreds of millions of wild and farmed birds since it took hold in 2021. It's now reported in every state in the US, and every continent, except Australia and the rest of Oceania, has had outbreaks.​
-snip-
"Our epidemiological investigation combined with genome sequence and geographical dispersal analysis provides evidence of efficient intra- and inter-species transmission of HPAI H5N1 genotype B3.13," the researchers noted. "Soon after apparently healthy lactating cattle were moved from Farm 1 to Farm 3, resident animals in Farm 3 developed clinical signs compatible with HPAI H5N1 providing evidence to suggest that non-clinical animals can spread the virus."
-snip-
“It is a highly pathogenic strain,” explained Erin M. Sorrell, associate professor at Johns Hopkins Bloomberg School of Public Health in Maryland. “It has the ability to replicate outside the traditional locations where low-pathogenic influenza does: the intestinal tract for poultry; the upper and lower respiratory tracts in humans. The virus becomes systemic in its infection.”​
-snip-
An unedited version of Cornell University research has been published in Nature, while the UNC study has been published on the bioRxiv preprint server.​

...https://newatlas.com/biology/mammal-avian-influenza/
 
Influenza A Virus Wastewater Data

Updated July 25, 2024

Main Findings from Wastewater Surveillance

During the two most recent weeks, (July 7, 2024–July 20, 2024), a total of 303 of 777 sites reported data meeting criteria for analysis for influenza A virus for both weeks or for either week, and 1 (<1%) site from 1 state was at a high level (>80th percentile compared to levels recorded at that site between October 1, 2023 and March 2, 2024).
...
Data Table
...
Id:137 7 California Plumas Above Average 67.86 Two-Week Maximum <10,000 2023-01-03
Id:164 7 California San Luis Obispo Above Average 66.67 Two-Week Maximum 30,000 2022-02-28
Id:313-C 8 Florida Orange Above Average 72.73 Two-Week Maximum 280,000 2023-09-30
Id:314-C 7 Florida Orange Above Average 67.65 Two-Week Maximum 60,000 2023-09-30
Id:454 8 Illinois Lake Above Average 76.74 Two-Week Maximum 60,000 2022-10-05
Id:548 7 Kansas Johnson Above Average 65.79 Two-Week Maximum 110,000 2023-09-17
Id:1719 7 Oregon Clackamas Above Average 65.38 Two-Week Maximum 30,000 2023-09-27
Id:1729 9 Oregon Jackson High 85.0 Two-Week Maximum 20,000 2021-09-27

...
https://www.cdc.gov/nwss/wastewater-surveillance/Flu-A-data.html
 
I just did a very brief search, and below describes One-Mile Farm, in Ashland, which resides along the Bear Creek and it's watershed...According to the United States Census Bureau, the county has a total area of 2,802 square miles (7,260 km2), of which 2,784 square miles (7,210 km2) is land and 18 square miles (47 km2) (0.6%) is water.[10] A portion of the Umpqua National Forest is in Jackson County.

Located entirely within Jackson County is Bear Creek and its watershed, a tributary of the Rogue River.[11] The population centers of Medford, Ashland, Phoenix, Talent, and Central Point are located along the stream. It connects with the Rogue River near the Upper and Lower Table Rock lava formations. ~Wikipedia

...One-Mile Farm, Standing Stone’s 260-acre farm rented from the City of Ashland, where beef, lamb, eggs, and chicken are raised for the restaurant’s menu.... In a few months, these broilers will make the one-mile journey back to the restaurant in crates, where they are slaughtered and processed in the newly opened poultry processing room.
The on-site poultry slaughter and processing room is licensed by Oregon Department of Agriculture and operates under the producer-grower 20,000 bird per year exemption from federal inspection. It’s only one of two existing in Jackson County and the first in the state built in an existing restaurant....https://smallfarms.oregonstate.edu/poulet-gullet-poultry-processing-standing-stone-brewery
 
Clackamas has over 4,000 Dairy/Beef and Poultry Farms ` Wikipedia. ....and this: "The Clackamas River is a popular destination for fishing, swimming, kayaking, and camping, and it also supports agricultural uses such as irrigation and livestock grazing."...https://snoflo.org/river-levels/clackamas-river.

Clackamas County, OR
@clackamascounty
Right now, COVID-19 is surging in Oregon. Summer travel may increase the risk of it spreading. If you have respiratory illness symptoms, there’s a good chance you have COVID-19. Learn more at https://bit.ly/3GTzGCE
 
A few observations. This current H5N1 virus appears to have evolved to have transmission primarily through milk and/or non-sterilised milking equipment in cows, and specifically mammary glands. There is nothing I have seen thus far that suggests it is transmitting from cows as a respiratory disease (please correct me if I am wrong here).

It is however transmitting (somehow) back into birds, which are most likely acting as an intermediate vector to go on to infect other herds and mammalian groups i.e cats and racoons (and maybe other animal groups and/ or cattle herds) - I am not sure the transmission mechanisms to birds and other mammals have been determined as yet, which makes containment within dairy herds very unlikely.

The marked presence in wastewater is also very concerning. Think about increased potential for jumps to rats and mice. (Added thought: The elephant in the room is whether bovine faeces and urine are also infected, and therefore a major transmission risk - it seems most likely to me if we are to account for wild bird re - infections which are known to grub around in manure, and urine to account for high levels in wastewater)

However, as things stand it appears that the species jump has been accomplished through adaptation to a more bird-like transmission route - i.e non -respiratory and specifically milk & mammary glands and faeces. It appears that despite this being an HPAI it is not so severe in its effects in terms of mortality in this form.

So my questions are firstly, how high is the risk of effective reassortment with other flu types that are efficient at respiratory spread? An H5N1 virus that re-adapts to become a respiratory virus could substantially affect mortality rates in any host mammalian species. If it remains as it currently is, it may continue to be relatively inconsequential in terms if illness and deaths caused at least initially if a successful species jump occurs, whether that is in humans, cattle or any other mammalian species.

The bigger risk here is that populations / governments consider this 'another Covid' and 'a storm in a teacup' in its initial phases and do not take this seriously because in this format it is not 'too bad', and we find later in extensive circulation it can successfully re-assort with established seasonal flu's, then further down the line it can cause serious problems. This applies whether it is in farmed animals (food supply) or in humans.

I hope that the worlds expert virology labs are studying this question of production of viable H5 re-assortments in great depth so we - and governments - can understand what the risks posed by this virus are, both in the short and longer term. There seems to be a lot of complacent attitudes out there.
 
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...

Vaccination


Getting a seasonal flu vaccine will not protect against H5N1 bird flu

While getting a seasonal flu vaccine only prevents seasonal flu and will not protect against H5N1 bird flu, it is important that people who may have frequent exposure to infected or potentially infected birds or other animals get a seasonal flu vaccine, ideally 2 weeks before their potential exposure. This is because it can reduce the very rare and theoretical risk of getting sick with human and avian influenza A viruses at the same time.
​...

https://www.cdc.gov/bird-flu/prevention/index.html
 
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