Here's why the flu virus increases heart attack risk by 6x Becker's Hospital Review
See original here:
Here's why the flu virus increases heart attack risk by 6x - Becker's Hospital Review
A sample of avian influenza isolated from a Chilean man who fell ill last month contains two genetic mutations that are signs of adaptation to mammals, officials from the Centers for Disease Control and Prevention said on Friday. In experimental animal studies, the mutations, both of which are in what is known as the PB2 gene, have previously been shown to help the virus replicate better in mammalian cells.
The risk to the public remains low, health officials said, and no additional human cases have been linked to the Chilean man, who remains hospitalized.
Moreover, the sample was missing other critical genetic changes that scientists believe would be necessary for the virus, known as H5N1, to spread efficiently among humans, including mutations that would stabilize the virus and help it bind more tightly to human cells.
There are three major categories of changes we think H5 has to undergo to switch from being a bird virus to being a human virus, said Richard J. Webby, a bird flu expert at St. Jude Childrens Research Hospital. The sequences from the person in Chile have one of those classes of changes. But we also know that of those three sets of changes, this is the easiest one for the virus to make.
PB2 mutations have been found in other mammals infected with this version of the virus, as well as in some people infected with other versions of H5N1. The mutations most likely emerged in the Chilean patient over the course of his infection, experts said.
The spread of H5N1. A new variant of this strain of the avian fluhas spread widely through bird populations in recent years. It has taken an unusually heavy tollon wild birds and repeatedly spilled over into mammals, including minks, foxesand bears.Heres what to know about the virus:
What is avian influenza? Better known as the bird flu, avian influenza is a group of flu virusesthat is well adapted to birds. Some strains, like the version of H5N1 that is currently spreading, are frequently fatal to chickens and turkeys. It spreads via nasal secretions, saliva and fecal droppings, which experts say makes it difficult to contain.
Should humans be worried about being infected? Although the danger to the public is currently low, people who are in close contact with sick birds can and have been infected. The virus is primarily a threat to birds, but infections in mammalsincrease the odds that the virus could mutate in ways that make it more of a risk to humans, experts say.
How can we stop the spread? The U.S. Departmentof Agriculture has urged poultry growers to tighten their farms biosecurity measures, which includes preventing contact between wild birds and domestic animals. But the virus is so contagious that there is little choice but to cull infected flocks, experts say.
Is it safe to eat poultry and eggs? The Agriculture Department has said that properly prepared and cooked poultry and eggs should not pose a risk to consumers. The chance of infected poultry entering the food chain is extremely low, according to the agency.
Can I expect to pay more for poultry products? Egg prices soared when an outbreak ravaged the United States in 2014 and 2015. The current outbreak of the virus paired with inflation and other factors is contributing to an egg supply shortageand record-high pricesin some parts of the country.
We understand them to be a step on the path to adaptation to humans and increased risk to humans, said Anice C. Lowen, an influenza virologist at Emory University. So certainly its concerning to see them.
But these mutations alone are probably not sufficient to produce a virus that spreads easily among humans, she added.
Those genetic changes have been seen previously with past H5N1 infections, and have not resulted in spread between people, Vivien Dugan, acting director of the influenza division at the C.D.C.s National Center for Immunization and Respiratory Diseases, said in a statement.
Nevertheless, its important to continue to look carefully at every instance of human infection, as well as other mammalian spillover events, and to track viral evolution in birds, Dr. Dugan said. We need to remain vigilant for changes that would make these viruses more dangerous to people.
The sample was sequenced by the National Influenza Center in Chile and uploaded to GISAID, an international database of viral genomes, overnight, C.D.C. officials said.
Chiles Ministry of Health reported the case to the World Health Organization on March 29. The patient, a 53-year-old man, developed respiratory symptoms, including a cough and a sore throat, and was hospitalized when his condition deteriorated, according to the W.H.O.
Investigation into the case is continuing, and how the man became infected remains unclear. But the virus had recently been detected in birds and sea lions in the region where the man lives.
According to the preliminary findings of the local epidemiological investigation, the most plausible hypothesis about transmission is that it occurred through environmental exposure to areas where either sick or dead birds or sea mammals were found close to the residence of the case, the W.H.O. reported last week.
It is the 11th reported human case of H5N1 since January 2022, according to the C.D.C., none of which have been associated with human-to-human transmission. Since H5N1 was first detected in birds in 1996, there have been hundreds of human infections globally, mostly in people who were in close contact with birds.
Still, experts have long been worried about the possibility that avian influenza, which is well adapted to birds, might evolve to spread more easily among humans, potentially setting off another pandemic. An H5N1 outbreak on a Spanish mink farm last fall suggests that the virus is capable of adapting to spread more efficiently among at least some mammals. And every human infection gives the virus more opportunities to adapt.
The mutations documented in the Chilean patient are a step in the wrong direction, Dr. Lowen said.
This version of the virus has spread rapidly through wild birds in the Americas, sparking regular outbreaks in farmed poultry. The virus has become so widespread in birds that it has repeatedly spilled over into mammals, and continued sporadic human infections are anticipated, the C.D.C. wrote in a recent technical report.
See the original post here:
Bird Flu Sample from Chilean Man Showed Some Signs of Adaptation to ...
Read this article:
SciCheck Digest
Public health organizations have explained that the reason there were far fewer cases of the flu in 2020 and 2021 was likely due to measures adopted to slow the spread of the virus that causes COVID-19, such as handwashing and social distancing. But a post on social media has spread the false claim that the dip in flu cases suggests that COVID-19 was a hoax.
How is COVID-19 transmitted?
SARS-CoV-2, the virus that causes COVID-19, isspreadfrom person to person through respiratory droplets or particles when infected people cough, sneeze, talk or breathe.
Most often, transmission occurs when such droplets or particles are breathed in or land in or on a persons eyes, nose or mouth. As a result, risk is thought to be highest when people are in close contact with one another, typically within 6 feet or so of an infected person, accordingto the Centers for Disease Control and Prevention.
Especially in places with poor ventilation, however, SARS-CoV-2 can be spread through small respiratory particles that linger in the air and can reach those who are further than 6 feet away. Such airborne transmissions have occurred in enclosed spaces without adequate ventilation and have often involved exercising, shouting or singing by an infected person. Prolonged exposure to these conditions, typically more than 15 minutes, the CDC says, raises the risk of such spread.
While it is possible for someone to be infected by touching a contaminated surface, the agencysaysthe risk is generally considered to be low.
People who are infected with the coronavirus but dont have symptoms canstill spreadthe virus. Although vaccinationreducesthe risk of viral transmission, it doesnt eliminate it which may beespecially truewith the highly transmissible omicron variant.
TheCDC, for example, expects that anyone with Omicron infection, regardless of vaccination status or whether or not they have symptoms, can spread the virus to others.
Link to this
Measures adopted to slow the spread of COVID-19 such as wearing masks, keeping six feet apart, washing hands frequently and staying home also slowed the spread of viruses that cause the flu.
Thats likely the reason that recorded cases of influenza dropped dramatically in 2020 and 2021, as explained by the U.S. Centers for Disease Control and Prevention, the World Health Organization, and many other researchers and scientists.
The flu is caused by influenza viruses that spread mostly through respiratory droplets, similar to the way the virus that causes COVID-19 spreads. Since the 2011-2012 flu season, the number of flu cases in the U.S. has been around 30 million each year with about 40,000 deaths, according to the CDC, which did not give estimates for the 2020-2021 season because of the low rates of infection.
But a post has gone viral on social media showing a graph from the WHO that demonstrates the dip in cases of the flu. The post includes text that references a well-worn but false claim that COVID-19 was a hoax, saying, One of the greatest mysteries of COVID-19: Where did the flu go in 2020 and 2021?
Social media users responded with comments such as, Pretty much they repackaged that years flu strain as the rona & took away your civil liberties & destroyed the lives and businesses of thousands, if not millions of people.
The post originated on Twitter, where it has amassed more than 7 million views, according to the site, and elicited a comment good question from Twitter CEO Elon Musk. It then spread as a screenshot meme to other platforms, including Facebook and Instagram, where it generated such inaccurate comments as COVID is basically the influenza Flu.
Weve already addressed similar claims that have spun the falsehood that cases of the flu were wrongly counted as or confused with COVID-19.
A WHO spokesperson told us in an email on April 12 that the current claim is also not accurate, adding, the surveillance systems/testing for the two are entirely different.
Thats because the flu and COVID-19 are different illnesses caused by different viruses. As we said, the flu is caused by various types of influenza viruses. COVID-19, however, is caused by a specific type of coronavirus that was first identified at the end of 2019 SARS-CoV-2. That virus spreads more easily than viruses that cause the flu, and COVID-19 has killed 1.1 million people in the U.S. since it emerged just over three years ago, which dwarfs the annual 40,000 killed by the flu.
COVID-19 killed more than 260,000 people in the U.S. in 2022, according to the CDC. In 2021 it killed more than 470,000 and in 2020 it killed more than 354,000, making it the third-leading cause of death in both years behind heart disease and cancer according to the National Institutes of Health. Its likely to be the third leading cause of death again in 2022, according to the Kaiser Family Foundation, although official figures havent yet been released.
The WHO spokesperson also reiterated the point thats been made widely by public health organizations and scientists for years: One of the postulated reasons for the low levels of influenza activity was the effect of lockdowns and travel restrictions during that period.
In fact, the level of recorded influenza cases for one strain of flu virus was so low in that period that researchers thought it may have disappeared entirely.
So, its wrong to suggest that the dip in recorded cases of the flu during the pandemic is a mystery or that COVID-19 is a hoax. The reduction in flu cases isnt a mystery, and its been explained as the result of widely adopted measures that affect the spread of viruses.
Editors note: SciChecks articles correcting health misinformation are made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.orgs editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation.
Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) How to Protect Yourself & Others. Archived 22 Oct 2020.
Centers for Disease Control and Prevention. 2020-2021 Flu Season Summary. 25 Oct 2021.
Karlsson, Erik, et al. Review of global influenza circulation, late 2019 to 2020, and the impact of the COVID-19 pandemic on influenza circulation. Weekly Epidemiological Records. World Health Organization. 25 Jun 2021.
Rubin, Rita. Influenzas Unprecedented Low Profile During COVID-19 Pandemic Leaves Experts Wondering What This Flu Season Has in Store. Journal of the American Medical Association. 25 Aug 2021.
World Health Organization. Influenza Laboratory Surveillance Information Virus detections by subtype reported to FluNet. Accessed 11 Apr 2023.
Fichera, Angelo. Instagram Post Distorts Facts on COVID-19 Death Reporting. FactCheck.org. 16 Dec 2020.
Gambardello, Joseph A. Doctors in Video Falsely Equate COVID-19 With a Normal Flu Virus. FactCheck.org. 21 Oct 2020.
Spokesperson, World Health Organization. Email to FactCheck.org. 12 Apr 2023.
Mole, Beth. COVID may have pushed a leading seasonal flu strain to extinction. Ars Technica. 30 Sep 2022.
More:
Fewer Cases of Flu Due to Pandemic Precautions, Contrary to Viral Claim
NEW YORK -- A man in Chile is infected with a bird flu that has concerning mutations, but the threat to people from the virus remains low, U.S. health officials said Friday.
Past animal studies suggest these mutations could cause the virus to be more harmful or spread more easily, health officials said. But they also said there is no evidence that the mutations would make it easier for it to take root in a persons upper lungs a development that would raise concerns about spread among people.
The mutations do not change public health officials assessment of the overall risk to people from the H5N1 virus, which "continues to be low, said Vivien Dugan of the Centers for Disease Control and Prevention.
The mutations, which have appeared only in the one hospitalized patient, may have occurred after the man got sick, CDC officials said. Theres no evidence that the mutated virus spread to other people, mixed with other flu viruses, or developed the ability to fight off current medicines or evade vaccines, agency officials said.
Such genetic changes have been seen in past bird flu infections.
Nevertheless, its important to continue to look carefully at every instance of human infection," Dugan said. "We need to remain vigilant for changes that would make these viruses more dangerous to people.
This type of flu, called Type A H5N1, was first identified as a threat to people during a 1997 outbreak in Hong Kong, when visitors to live poultry markets caught it.
Sporadic outbreaks have followed, and more than 450 people have died in the past two decades from bird flu infections, according to the World Health Organization. The vast majority of infected people got it directly from birds.
As bird flu hits other species, however, scientists fear the virus could evolve to spread more easily among people. And it has been spreading widely, to birds and animals in scores of countries.
In the U.S., it has recently been detected in wild birds in every state, as well as in commercial poultry operations and backyard flocks across the country. Since the beginning of last year, tens of millions of chickens have died of the virus or been killed to stop outbreaks from spreading, one of the reasons cited for soaring U.S. egg prices.
The new lab analysis looked at the virus found in the lungs of a 53-year-old man living in Chiles Antofagasta region. It may be that he became infected through contact with sick or dead birds or infected sea lions, according to a WHO summary of the case.
The man was healthy and had not traveled recently. On March 13, he started getting a cough, sore throat and hoarseness, the WHO said.
His symptoms worsened and he eventually was sent to an intensive care unit and treated with antiviral medicines and antibiotics. He is still hospitalized and being monitored, CDC officials said.
Genetic sequencing this week revealed the two concerning mutations. Chilean and American health officials have been working together on the investigation.
Andrew Pekosz, a flu researcher at Johns Hopkins University, said he hasn't seen the preliminary analysis of the Chilean patient's infection.
When these viruses get into humans, there's a likelihood that they start to adapt to grow better in us, and this is a sign that is happening, he said.
There are three or four kinds of mutations that would need to be seen in a H5N1 virus before that would really raise the alarm signal that something is happening of concern, he added.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institutes Science and Educational Media Group. The AP is solely responsible for all content.
Here is the original post:
Bird flu: Scientists find mutations, say threat is still low
In the year 2000, Dutch scientists went on a mission of exploration not to discover lands or riches, but to identify unknown causes of acute respiratory infections.
These illnesses, from the common cold to pneumonia, have been a plague on mankind throughout history. Most are caused by viruses, so if youve ever been told you probably have a virus by a clinician, they were likely correct. However, respiratory illnesses can be much more severe than simple colds.
Respiratory infections are the leading cause of death in children under 5 globally and a major reason for hospitalization of children in developed countries. They are also a major cause of disease and death among people at high risk for severe disease, such as premature infants, older adults and those with underlying conditions.
However, meticulous research studies by many groups over decades had failed to identify a virus or bacteria in every person with an acute respiratory illness. Did this failure to detect a microbe result from tests that werent good enough, or viruses that doctors and scientists didnt know about? The answer was partly the first; modern molecular tests are much better, so doctors find more known viruses.
But the Dutch group discovered a new virus, human metapneumovirus, abbreviated HMPV or MPV, which turns out to be a leading cause of respiratory infections. HMPV often presents like other common respiratory viruses, with congestion, cough and fever.
As a pediatric infectious disease specialist and virologist, I have led my team in HMPV research for over 20 years, and Ive personally cared for many children with this infection. Ive received emails from colleagues, clinicians and parents all over the country and the world with questions about severe and tragically fatal cases.
The U.S. saw a spike in HMPV detections during the first few months of 2023. This trend is similar to the higher-than-normal case rates of respiratory syncytial virus, or RSV, and influenza in the fall of 2022 and winter of 2023, likely related to decreased population immunity after two years of wearing face masks and social distancing.
Still, I find that many people even in health care are unfamiliar with this virus.
The human metapneumovirus was isolated from people with acute respiratory infection and sequenced in 2001 using a combination of specialized culture and molecular techniques.
It is related to RSV, which is the leading cause of serious respiratory infection in children and a major problem in adults. Both viruses are in the same large group with measles, mumps and parainfluenza viruses, all of which are leading causes of childhood disease.
However, abundant data shows that HMPV is distinct from its cousin RSV in many ways. First, the order of genes in its genome is quite different. In addition, HMPV is missing two genes that RSV uses to overcome the immune response that would normally target it; yet HMPV has its own ways to block immunity.
Third, genetic analysis by several different groups shows that the closest recent ancestor of HMPV is a bird virus, avian metapneumovirus. This is an agricultural pathogen of chickens and turkeys. Evolutionary and genetic analysis suggests that the human virus diverged from the bird virus several hundred years ago. This is an example of a zoonosis: an animal virus that jumps to humans. In this case, HMPV became established as a permanent pathogen of humans.
Understanding how HMPV successfully made the leap might help predict which other animal viruses could be capable of transforming into primary human pathogens. The recent H5N1 bird flu outbreak which has been transmitted to humans only to a limited extent illustrates this risk.
Despite its being recognized only two decades ago, many studies have confirmed that HMPV is a major cause of respiratory infection in humans. Initial research groups focused on children and quickly discovered that HMPV caused respiratory infections in children worldwide, including Canada, Australia, Japan, Hong Kong, South Africa and Argentina.
Indeed, HMPV is a common cause of acute respiratory disease in children in every country examined, and most children get the infection for the first time by age 5. One study using samples collected over 25 years in the U.S. found that HMPV was the second most common cause of lung infection in children after RSV. Other studies of multiple childrens hospitals in U.S. cities found that HMPV was the second most common cause of respiratory infections, leading to hospitalization and pneumonia.
Children with underlying risk factors, such as those born prematurely and those with conditions like asthma,or those who have compromised immune systems, such as organ transplant recipients or children being treated for cancer, are at higher risk for severe HMPV. Most children who become hospitalized with HMPV are otherwise healthy before they acquire it, yet many require intensive care from the illness.
HMPV is also a common cause of serious lung infections among adults. This is especially true in adults over 65 years old, or those with underlying conditions. A New York study over four winters found that HMPV was as common in hospitalized older adults as RSV or influenza, with similar rates of ICU care and death.
Studies over three winters in Nashville of adults over age 50 detected rates of HMPV hospitalization and emergency department visits that were similar to RSV and influenza. HMPV and RSV were more common than the flu in people 65 and older, presumably because many were vaccinated against the flu.
Another national study of adults hospitalized for pneumonia showed that HMPV was as common as RSV, and nearly as common as influenza. As in children, HMPV is a particular problem for adults with chronic conditions such as asthma, cancer or chronic obstructive pulmonary disease, also called COPD.
Similar to the dire effects of flu and COVID-19 in nursing homes, HMPV has also caused numerous outbreaks among vulnerable older adults in long-term care facilities.
Despite being a common cause of serious respiratory disease, HMPV remains underdiagnosed by clinicians and little recognized by the general population. Most people with an acute respiratory illness dont get any testing, and if they do, only complex molecular testing can detect HMPV. But this testing is usually done only for hospitalized patients under select circumstances.
People tend to believe what they see, and therefore even health care professionals are most aware of diseases they test for frequently. But HMPV circulates predictably every year, and in North America the peak is typically February through May. So if youve had a cold recently this winter or spring, HMPV was a likely culprit. Childrens hospitals around the country are seeing an increased number of cases, including many in the ICU. Based on past research, this is almost certainly happening in adults too its just that usually only those patients with severe illness are tested for HMPV.
Right now, there are no specific antiviral drugs to treat HMPV as there are for flu and COVID-19. As with the many other respiratory viruses that cause colds, most infected people will do just fine with rest and fluids.
But some may develop trouble breathing and need to seek medical attention. Children or adults with serious underlying conditions should be especially careful, and just as with COVID-19, using hand sanitizer and washing hands can reduce transmission.
Preventive vaccines and antibodies for HMPV are in development but are still a way off. So, for the moment, wear a mask if youre sick and avoid others who are sick. You may dodge a repeat engagement with this virus that youve had but hadnt heard of.
More:
Human metapneumovirus, or HMPV, is filling ICUs this spring a ...
The story of how theH5N1viruses came to be created and the response to a 2019 safety breach raises uncomfortable questions about the tremendous trust the world is placing in research labs.
Alison Young| Opinion contributor
A look at security in America's biolabs
A guided tour of safeguards in biosafety labs.
USA TODAY
This exclusive article is adapted from former USA TODAY investigative reporter Alison Youngs forthcoming book "Pandoras Gamble: Lab Leaks, Pandemics, and a World at Risk," which will be released April 25. In this excerpt, Young reveals for the first time details of a December 2019 lab safety breach involving one of the worlds most infamous lab-created gain of function viruses and the efforts that were made to downplay the event, avoid notifying health authorities and oversight bodies, and keep the public and policymakers in the dark.
Inside the high-security Influenza Research Institute at the University of Wisconsin-Madison, two experienced scientists were pulling ferrets out of their HEPA-filtered cages on a Monday in December 2019. Another researcher, still in training, was also in the room to watch and learn.
One by one, the animals were put into a biosafety cabinet, where a solution was washed into their nostrils. Its a procedure used to collect evidence of infection, and this particular experiment involved exposing the animals to a highly controversial lab-engineered strain of H5N1 avian influenza virus.
The virus they were working with that day was far from ordinary, and there should have been no room for the safety breach that was about to happen and the oversight failures that followed.
The experiment underway involved one of two infamous lab-made bird flu viruses that had alarmed scientists around the world when their creation became widely known nearly a decade earlier. In each case, scientists had taken an avian influenza virus that was mostly dangerous to birds and manipulated it in ways that potentially increased its threat to humans.
In nature, the H5N1 virus has rarely infected humans. But when people have been sickened, usually through close contact with infected birds, more than half died. So it is fortunate that the H5N1 virus isnt capable of spreading easily from person to person. If the virus were ever to evolve in ways that gave it that ability, it could cause a devastating pandemic.
Opinions in your inbox: Get exclusive access to our columnists and the best of our columns
And yet in late 2011 the world learned that two scientific teams one in Wisconsin, led by virologist Yoshihiro Kawaoka, and another in the Netherlands, led by virologist Ron Fouchier had potentially pushed the virus in that direction. Each of these labs had created H5N1 viruses that had gained the ability to spread through the air between ferrets, the animal model used to study how flu viruses might behave in humans.
The ultimate goal of this work was to help protect the world from future pandemics, and the research was supported with words and funding by twoof the most prominent scientists in the United States: Dr. Francis S. Collins, director of the National Institutes of Health, and Dr. Anthony Fauci, director of the NIHs National Institute of Allergy and Infectious Diseases.
Kawaoka contended it would be irresponsible not to study how the virus might evolve in nature. Some people have argued that the risks of such studies misuse and accidental release, for example outweigh the benefits. I counter that H5N1 viruses circulating in nature already pose a threat, he said at the time.
Yet these groundbreaking scientific feats set off a heated international debate over the ethics and safety of gain of function research. The controversy continues to this day.
Concerns about the safety of biological researchhave taken on heightened urgency in the wake of the COVID-19 pandemic and growing acceptance of the possibility that it was caused by a lab accident in China. In February, it was revealed that analysts at the U.S. Department of Energy had joined the FBI in leaning toward a lab accident as the most likely source of the pandemic, though other U.S. intelligence agencies lean toward a natural origin or are undecided.
Where's the apology?: COVID may have leaked out of a Chinese labafter all. So much for 'misinformation.'
Former U.S. surgeon general: We'll never know the full truth about COVID-19 origins. Political infighting won't help.
The story of how theH5N1viruses came to be created and how the University of Wisconsin and the Kawaoka lab would later respond to the 2019 safety breach during the ferret experiment raises uncomfortable questions about the tremendous trust the world placesin these kinds of labs.
We are trusting that every hour of every day their layers of laboratory containment equipment are working properly, that all of their employees are sufficiently trained, qualifiedand attentive, and that their written safety and incident response protocols are followed in real-life practice.
When something goes wrong, we are trusting that thelabs will immediately notify local public health officials who are responsible for preventing outbreaks and the federal authorities who oversee the safety of experiments with genetically engineered organisms.
Given that so much about this work is shrouded in secrecy, what happened in Wisconsin raises the question: Should the public givethis trust blindly?
In 2013, six years before the 2019 safety incident with the ferret experiment at Kawaokas lab in Wisconsin, another member of his research team accidentally pierced their finger with a needle that had an engineered H5N1 virus on it.
It was a moment of poor judgment, human error around 6:30 p.m. Nov.16, 2013, that set off a series of emergency calls that would eventually raise concerns in the nations capital.
An expert at the Centers for Disease Control and Preventiontold officials at Wisconsins state health department that while the likelihood the scientist would develop symptoms of H5N1 was low, the needlestick should be considered a serious exposure and treated aggressively. The chief medical officer at the Wisconsin Department of Health Services told the university that the researcher would need to quarantine for seven days and take a treatment-level dose of Tamiflu twice a day for 10days.
Six months earlier, while seeking funding and approval for the controversial experiments, Kawaoka had assured officials at the National Institutes of Health that the university had a designated quarantine apartment.
But it turned out that wasnt the case.
So lab officials told the researchers family to pack up their belongings and go to a hotel. And the injured researcher was sent to quarantine at home.
Officials in the NIH office responsible for overseeing research with engineered organisms were alarmed to learn that the university didnt have a dedicated quarantine facility for such emergencies.
This policy is not what was communicated to us in Dr. Kawaokas application to perform research with mammalian transmissible strains of H5N1, wrote Dr. Jacqueline Corrigan-Curay, acting director of the NIH Office of Biotechnology Activities, in a letter to the university.
A researchers home, the NIH told the university, was not an appropriate quarantine site for Kawaokas high-risk studies because influenza viruses can be transmissible through the air, and many residences are in high-occupancy buildings, like apartments, that share air exchange and other infrastructure.
Trying to provide an explanation, university officials told NIH there had been a miscommunication between Kawaoka and the universitys administration. Wisconsin officials noted that the needlestick was not expected to put the researcher at high risk of infection,and that this engineered virus was determined not to be a mammalian-transmissible strain.
The scientist with the needlestick completed quarantine without showing symptoms or becoming ill.
But even if a high-risk incident occurred with a more dangerous strain, UW officials told the NIH, the lab worker would still be quarantined at home.
Could an accident have caused COVID-19?: Why the Wuhan lab-leak theory shouldn't be dismissed
'I remember it very well': Dr. Fauci describes a secret 2020 meeting to talk about COVID origins
It was a stunning change by the university to a critical safeguard that federal officials thought was in place for the Kawaoka labs research. The NIH demanded the university find a dedicated quarantine facility outside of workers residences, such as a hospital isolation room, or face the suspension or termination of its grant funding, correspondence shows.
The university didnt want to use the UW Hospital as a quarantine site.
Their concerns included that researchers might be unwilling to come forward about potential exposures if they faced being confined in hospital isolation rooms. The university and its medical team also worried about the increased potential for the public to learn about its lab accidents, noting in correspondence that it would be much harder to control the spread of information and as a result there would be a higher probability of incorrect information being told to (the)general public and potentially members of the media.
The university eventually agreed to NIHs demands. And on Dec.24, 2013, the NIH gave its approval for Kawaokas lab to resume its research manipulating H5N1 virus strains that were transmissible to mammals.
By 2014, there was a growing discomfort at the highest levels of the U.S. government about the risk of an accident with an engineered virus.
Wisconsins needlestick incident, which drew questions within NIH but wasnt publicly known, was soon followed by a series of high-profile accidents at federal labs in 2014 from safety breaches with anthrax and avian influenza at the CDC to the discovery of forgotten vials of smallpox that had been kept for decades in a storage room on the NIH campus.
In October 2014, citing these federal lab incidents, the White House Office of Science and Technology Policy announced a moratorium on new federal funding for certain gain-of-function research while the risks and benefits of the controversial experiments were studied.
The funding pause remained in place for three years until it was finally lifted in December 2017. But it was only in 2019 that some of the halted experiments were quietly allowed to begin again under a revised federal oversight process, which was criticized for keeping secret the details of the new experiments and the basis for the government approvals.
The Kawaoka lab was one of the first to receive approval and NIH funding.
Not long after the Kawaoka lab was greenlighted in 2019 to resume work with its infamous lab-created H5N1 influenza virus the one that had helped spark the worldwide debate over gain-of-function research there was an accident.
And in the days and weeks that followed, efforts were made to downplay the significance of the event, avoid notifying public health officials and oversight bodies, and keep the public and policymakers in the dark.
A lot was at stake.
Not only would the incident draw attention to safety issues at the UWlab, but it also would raise larger questions about the rigor and effectiveness of how the U.S. government was overseeing the riskiest experiments in which scientists are creating enhanced pathogens with pandemic potential.
More clues could be found: Deleted COVID-19 genetic fingerprints show it's still possible to dig for lab leak evidence
When the accident happened on Dec.9, 2019, Kawaokas three scientists were working in an enhanced biosafety level 3 agriculture lab suite at the University of Wisconsins Influenza Research Institute.
This facility had been built specifically for Kawaokas research and featured labs with negative air pressure, watertight and airtight seals, double HEPA-filtered exhaust airand redundant air handling systems.
The experiment they were performing involved a virus whose name describes the components of its engineering: VN1203HA(N158D/N224K/ Q226L/T318I)/CA04. It was the virus described in Kawaokas controversial H5N1 gain-of-function experiments that had been published nearly eight years earlier, the NIH would later confirm in written responses to my questions.
It was the virus that had gained the concerning ability to spread between ferrets and had raised fears it could do this among humans.
On that December day, two experienced researchers from Kawaokas team were helping train a colleague as they collected samples from ferrets. The animals were part of a transmission experiment and had been in contact with other ferrets infected with this engineered H5N1 virus or another wild-type flu strain.
The three scientists wore several layers of personal protection equipment. One of their most important pieces of personal protective equipmentwas the air-purifying respirator that each wore to ensure they didnt breathe any air from inside the laboratory. Even though they were using a biosafety cabinet, there was always the potential for virus to be present in the rooms air.
These kinds of high-tech respirators encase workers heads in a protective hood with a clear face-plate. A blower attached to a belt delivers purified air through what looks like a vacuum cleaner hose that runs up the scientists back and attaches to the hood behind their head.
Labs are responsible for training workers how to properly assemble and use this kind of equipment.
As one of the senior researchers preparedto start collecting samples from the next round of ferrets, the trainee realized there was a problem with their respirator.
The powered air-purifyingrespirator (PAPR) hose had somehow disconnected from the unit that supplied safe, filtered air. Instead, the detached hose dangled loose in the labs potentially contaminated air.
The hose was immediately reconnected, Wisconsin officials later said, and one of the experienced researchers radioed out to the labs operations manager as the trainee began the process of exiting the lab, incident records show.
The trainee was initially told to follow the labs quarantine procedure to keep them fromspreading the virus if they were infected. The university would later say this was done out of an abundance of caution. But at some point, a lab compliance official released the worker from quarantine.
It is unclear whether this quarantine release happened within minutes, hoursor days of the incident. Nor is it clear whether university officials first consulted with any public health and oversight agencies.
Kawaoka and university officials wouldnt agree to be interviewed and provided little information in response to my questions.
If there were ever a virus requiring that everyone follow safety and incident reporting rules, this was it. The system of oversight in place that day had been created in response to the international furor over this very virus.
Yet, after the trainees respirator hose disconnected in December 2019, the university didnt notify local or state public health officials about the incident or consult with them before discontinuing the trainees quarantine, despite representations going back years indicating this would occur following any potential exposure.
The university says it didnt need to notify them. Thats because UW officials, in consultation with the universitys health experts, made their own determination that no potential exposure had occurred.
Officials at Public Health Madison & Dane County, the local health department, told me they defer to the universitys judgment and expertise when it comes to lab safety issues. The department said it does not need to be notified of something that was determined to not be a significant exposure. It is also not incumbent on us to further evaluate whether there was a significant exposure, if UW reports that there was not.
The university also didnt immediately alert other key oversight entities that the public relies upon to ensure the safety of this kind of particularly risky research.
UW officials waited two months until Feb. 10, 2020 to file a report that should have been made immediately to the NIH Office of Science Policy, which oversees U.S. research with genetically manipulated organisms like the engineered H5N1 influenza virus involved in the experiment.
Records show the universitys internal biosafety committee, which had approved the Kawaoka labs research, wasnt apprised of the Dec. 9, 2019, incident until Feb.5, 2020.
The university was less slow in reporting the incident to the federal funding officials at NIHs National Institute of Allergy and Infectious Diseases, which provided the grant for the controversial experiments. But UW still waited 10days until Dec.19, 2019 to report the incident to NIAID program staff, according to information provided to me in writing by NIH officials.
The grants terms required immediate notification in the event of an illness or exposure. It was UWs contention, however, that neither of the two criteria were met because there was no reasonable risk of virus exposure, NIH officials told me. When the university eventually notified grant officials, it said it was doing so in the spirit of transparency and responsible conduct of research, the NIH said.
UW officials, who for months wouldnt answer many of my questions about the incident, eventually said that Kawaoka informed his program officer at NIH in early December, before following up with an incident summary on Dec. 19.
Opinion alerts: Get columns from your favorite columnists + expert analysis on top issues, delivered straight to your device through the USA TODAY app. Don't have the app? Download it for free from your app store.
As I pressed NIH to reconcile the agencys statement with UWs account, a few more details emerged. NIH said that the first time UW contacted anyone at the agency was on Dec.12, 2019 three days after the incident. Thats when UW first requested a phone call from an NIAID program officer. A first discussion about the incident happened on Dec.13, and on Dec.16, during a follow-up discussion, NIAID staff asked UW to send in a written description of the incident.
Both NIAID Director Anthony Fauci and NIAID Principal Deputy Director Hugh Auchincloss were briefed about the incident, the NIH said in a written response to my questions. But NIH would not tell me when Fauci and Auchincloss were briefed or whether they provided guidance on how the UW incident should be handled.
UW officials said Kawaokas lab immediately reported the incident to the CDCs select agent lab regulators. But the university didnt answer my questions about why the incident was immediately reported to the CDC and not NIH given UWs stated position that there wasnt any potential exposure.
It is unclear whether Kawaokas team consulted the CDC in advance of the universitys decision to release the researcher from quarantine. CDC officials including Dr. Samuel Edwin, who heads the select agent program didnt answer my questions about this.
When the university finally notified the NIH Office of Science Policy about the ferret incident two months after it happened UW officials unsuccessfully tried to justify their significant delay by saying the incident was not reportable because even though the trainees PAPR tube had detached, in their view there was no potential exposure.
The universitys justifications, records show, included that the ferrets had been handled inside a biosafety cabinet and that the contact ferrets had been exposed to infected ferrets for only about 24hours and were not shedding virus yet.
The university also told NIH officials that the air the observer would have breathed during the few seconds the hose was disconnected would have come from inside the PAPR hood, which would have been HEPA- filtered before the hose disconnected.
The labs report to the NIH doesnt say how they determined this.
The reason UW finally told the NIH oversight office about the incident was because lab regulators at the Federal Select Agent Program as well as the NIH office that funded the research recommended it be reported.
The report UW finally submitted to the NIH Office of Science Policy includes the following notation: *Confidential do not release this information without written authorization of the University of Wisconsin-Madison.
What were the consequences of UWs delayed reporting of the incident? The NIH Office of Science Policy told me it reminded the institution about its reporting responsibilities, and noted that it should have been immediately reported to OSP.
If NIH delivered that message, UW officials say they never heard it. This is certainly the kind of information we would have remembered or recorded in notes taken at the time, a UW spokesperson said by email.
UW repeatedly pointed to a short email from an NIH analyst thanking the university for its Feb. 10, 2020, report and adding that the actions taken in response to this incident appear appropriate. NIH says this email referred onlyto UWs biosafety actions, not to the universitys failure to file an immediate report.
In the end, the trainee apparently didnt become infected. But how the university and the lab oversight system handled the incident should be cause for concern.
It is all too easy to sensationalize this research, to misconstrue events, and misrepresent the nature of incidents rightfully reported by institutions to regulatory agencies, said Kelly Tyrrell, UWs director of media relations, in a email that spoke in broad brushstrokes about the importance of research, the humanity of researchers, and how sometimes there can be differences in interpretations of incident reporting requirements and about regulations.
Tyrrell said that UW takes safety seriously, and that the Kawaoka lab has never had an incident where public health or safety have been put at risk.
There are few people in the world trained to understand the nature of the pathogens involved, the biosafety and biosecurity measures in place and the protocols developed and followed, Tyrrell continued. Most people are also not equipped to appropriately evaluate the risk. It is unfortunate that some seek to capitalize on this knowledge gap.
Alison Young is an investigative reporter in Washington, D.C., and serves as the Curtis B. Hurley Chair in Public Affairs Reporting for the University of Missouri School of Journalism. From2009 to 2019, she was a reporter and member of USA TODAYs national investigative team. She has reported on laboratory accidents for 15 years. Her first book, "Pandoras Gamble: Lab Leaks, Pandemics, and a World at Risk," is scheduled for release on April 25.
Read the original:
Lab-created bird flu virus accident shows lax oversight of risky 'gain ...
BEIJING, April 12 (Reuters) - A Chinese woman has become the first person to die from a type of bird flu that is rare in humans, the World Health Organisation (WHO) said, but the strain does not appear to spread between people.
The 56-year-old woman from the southern province of Guangdong was the third person known to have been infected with the H3N8 subtype of avian influenza, the WHO said in a statement late on Tuesday.
All of the cases have been in China, with the first two cases reported last year.
The Guangdong Provincial Centre for Disease Control and Prevention reported the third infection late last month but did not provide details of the woman's death.
The patient had multiple underlying conditions, said the WHO, and a history of exposure to live poultry.
Sporadic infections in people with bird flu are common in China where avian flu viruses constantly circulate in huge poultry and wild bird populations.
Samples collected from a wet market visited by the woman before she became ill were positive for influenza A(H3), said the WHO, suggesting this may have been the source of infection.
Though rare in people, H3N8 is common in birds in which it causes little to no sign of disease. It has also infected other mammals.
There were no other cases found among close contacts of the infected woman, the WHO said.
"Based on available information, it appears that this virus does not have the ability to spread easily from person to person, and therefore the risk of it spreading among humans at the national, regional, and international levels is considered to be low," the WHO said in the statement.
Monitoring of all avian influenza viruses is considered important given their ability to evolve and cause a pandemic.
Reporting by Dominique Patton; Editing by Christopher Cushing
Our Standards: The Thomson Reuters Trust Principles.
Follow this link:
China records world's first human death from H3N8 bird flu, WHO says
Whatever path the virus hits upon, H5N1 needs an altered PB2 to become a human pathogen. Think of evolving into a pandemic virus as a ladder that H5N1 has to climb, Beer says. Then this is the first step. It seems an easy step. H5N1 has managed it several times already in the current avian flu virus outbreak.
See original here:
From bad to worse: How avian flu must change to trigger a human ...
