Category: Flu Virus

ON JULY 14TH Americas Centres for Disease Control and Prevention (CDC) reported five new cases of the H5N1 avian flu virus in humans, bringing the total number of cases reported since April to nine. All five were involved in culling infected poultry in Colorado, and appear to have the same strain that has been spreading in dairy cows across the country since December. So far, there is no evidence the virus has adapted to spread between humans, a prerequisite for a flu pandemic. But things can change quicklythe more the virus circulates in animals that come in close contact with humans, the bigger the risk that a pandemic strain will emerge.

Should H5N1 go down this path, would the world be prepared? When SARS-CoV-2 emerged in 2019, humans had no natural immunity, drugs or vaccines. All three exist for H5N1, though how well any of them would work against a possible pandemic virus remains unclear.

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H5N1 avian flu could cause a human pandemic - The Economist

Colorado's state veterinarian yesterday issued a mandatory order for weekly bulk milk-tank testing for highly pathogenic avian influenza, as officials continue to battle the virus in dairy herds, with recent spillover to at least one large layer farm and workers culling the birds.

The order from state veterinarian Maggie Baldwin, DVM, applies to all dairy cow farms licensed by the Colorado Department of Public Health and Environment (CDPHE) and took effect yesterday.

It applies to all farms that aren't currently in quarantine and will apply to all affected farms that are released from quarantine. The samples will be collected by CDPHE-certified collection samplers and submitted to the Colorado State University Veterinary Diagnostic Laboratory.

With 49 outbreaks in dairy cattle reported by the state's agriculture department so far, Colorado by far has reported the most of any of the 13 affected states. The state has 105 licensed dairy facilities. Weld County has been the state's hardest hit area and is where the B3.13 genotype circulating in dairy cattle was recently confirmed at a massive layer farm.

Outbreaks at two large layer farms in Weld County have recently been linked to seven H5N1 infections in cullers, who are working in barns in heat wave conditions, which make it difficult for personal protective equipment (PPE) to provide optimal protection.

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) today added one more confirmation in another herd from Colorado to its list of affected dairy farms, raising the national total to 169 from 13 states.

In its latest updates, APHIS also reported one more outbreak at a poultry farm, a commercial table egg pullet facility in Weld County.

Also, APHIS reported detections in three live bird markets in Florida's Miami-Dade County, which together have nearly 800 birds.

Since H5N1 was first detected in US poultry in early 2022, more than 100 million bird losses have been reported across 48 states, according to APHIS.

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Colorado orders weekly bulk tank avian flu testing for dairy farms - University of Minnesota Twin Cities

Colorado health officials identified two more cases of the highly pathogenic H5N1 avian influenza bird flu in humans over the weekend, bringing the case count in the state to seven people who worked with inflected birds.

A worker at a northeast Colorado commercial egg layer in Weld County, where five other cases occurred, was confirmed sick on Friday. On Saturday, officials identified another presumptive positive case in a worker at a separate poultry farm in Weld County.

Another Colorado resident contracted the virus from infected cattle earlier this month.

The cluster of cases, comprising eight people in Colorado, accounts for most of the bird flu cases reported in humans in the country.

The recently infected workers were dealing directly with infected poultry and experienced mild symptoms such as pink eye and respiratory infection symptoms. Officials with the U.S. Department of Agriculture said last week that heat could have prevented proper use of personal protective equipment, exposing the workers to the virus.

Federal health officials have commissioned Moderna to develop a vaccine to protect people from an avian influenza that has been circulating in dairy cattle in recent months, according to reporting by the Iowa Capital Dispatch.

U.S. Department of Health and Human Services officials said July 3 the agency would devote about $176 million to the effort, with the hope that final clinical trials might commence next year.

This article first appeared in theColorado Newsline,a sistersite of the Nebraska Examiner in the States Newsroom network.

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More northeastern Colorado poultry workers infected with bird flu - Nebraska Examiner

Less than a year ago, the Centers for Disease Control and Prevention funded a disease prediction center at Northeastern University called EPISTORM: The Center for Advanced Epidemic Analytics and Predictive Modeling Technology.

Considered a National Weather Service for epidemic threats, the center was designed to help detect and prepare the United States for the next outbreak of infectious disease, especially in rural areas.

Now, EPISTORM researchers find themselves on the front lines of the bird flu outbreak.

Also known as H5N1, bird flu has been detected in 169 livestock herds on dairy farms in 13 states since March 25, according to the U.S. Department of Agriculture.

The spread to cows is of particular concern to scientists, who say any extension to mammal species creates more opportunities for the respiratory virus to evolve into a strain more dangerous to people.

To help mitigate the outbreak, EPISTORM researchers have produced risk maps highlighting potential hot spots on farms based on the cows travel across state lines, says Alessandro Vespignani, director of Northeasterns Network Science Institute, Sternberg Family Distinguished Professor and head of EPISTORM.

We correctly identified the potential for outbreaks in Colorado, Minnesota, Iowa, Wyoming and Oklahoma, Vespignani says.

The USDA has required testing of dairy cows moved between states since late April, a few weeks after the CDC reported a human infection linked to dairy cattle in Texas which is believed to be the first cow-to-human transmission of H5N1.

The federal health agency says that as of July 3, four people have been infected with bird flu after contact with sick dairy cows, while published reports say seven poultry farm workers in Colorado have contracted H5N1 just this month.

The CDC says from 1997 through late April 2024, 909 people across the globe were reported to have H5N1, 52% of whom died. Since 2022, seven people succumbed after contracting bird flu.

Severity profile: Unknown

The current viruses lack some of the changes observed in prior bird flu viruses, Vespignani says. We have to be very careful crying wolf too much because we dont want to continually say we are on the verge of a new pandemic.

We need to be honest and say we dont know. We dont know what the severity profile of the disease will be, he says.

Vespignani also called for continued testing in farm workers and their families to monitor the potential asymptomatic spread of H5N1.

The more human cases we have, the higher the risk that the virus will pick up the mutation that will make it more adapted to humans and human-to-human transmission, Vespignani says.

The infections reported this month in Colorado are the largest bird flu outbreak to date.

Bird flu, also known as highly pathogenic avian influenza, has affected more than 100 million poultry birds in the U.S. since January 2022. The first human case of H5N1 in the U.S. was reported three months later in a person in Colorado who had been culling infected birds, the CDC says.

Even if this doesnt trigger a human pandemic, it is in the interest of everybody to understand what is going on in farms, where the virus is causing economic harm through the culling of flocks, Vespignani says.

Thats why the epidemic experts community is monitoring (the virus) very carefully, he says.

Human cases of H5N1 in the U.S. have been mild so far, with pink eye or conjunctivitis being a major complaint associated with the respiratory virus. No hospitalizations have been reported.

More testing is needed

We arent doing enough testing, says Sam Scarpino, director of AI + Life Sciences at the Institute for Experiential AI at Northeastern and a member of the EPISTORM innovation center, which is supporting public stakeholders in detecting and preparing the U.S. for the next outbreak of disease.

We just have no idea how many people have been potentially infected by the virus in the past months, Scarpino says.

Public health officials most likely missed some bird flu cases in humans, Scarpino says, adding that he guesses the number could range from 50 to 100.

We know we havent missed thousands because we would see them in the emergency department, he says.

Active surveillance of wastewater by the CDC and private companies such as WW Scan does not indicate spikes in any type of influenza, including bird flu, Scarpino says.

Mammals can be infected with H5N1 if they are exposed to environments contaminated with the virus or if they eat infected birds. Most cows recover with supportive treatment, but avian flu is associated with high mortality in birds, according to the American Veterinary Medical Association.

Follow the evolution of the virus

Scarpino and Vespignani said theyd like to see increased blood testing and group or pool testing of farm workers, their families and co-workers.

We need to know the landscape of transmission, Vespignani says. We need to follow the evolution of the virus. Its in the interest of everybody to understand whats going on, what is the level of spreading on the farms.

We know that so far it has been mostly in dairy cattle. It will be important to understand if there is spillover in meat cattle, he says.

The way we prevent larger outbreaks is by monitoring, carefully isolating people as soon as they get the infection from animals, limiting the number of human cases as much as we can, Vespignani says. He says hes not worried about the food chain as long as people drink pasteurized instead of raw milk.

Farm workers, especially those working around sick animals, can help avoid contracting H5N1 by wearing personal protective equipment, Vespignani says.

Published reports say workers at the egg farm in Colorado where the latest outbreak among humans occurred might not have been wearing heavy and cumbersome PPE due to temperatures in the 100-degree range.

If a farm worker dies, its going to be a preventable death and tragically unnecessary, Scarpino says.

Tests for the public?

The CDC says federal officials are meeting with commercial labs about the possibility of making commercial H5 testing available.

Ten of those licenses are currently in place, and several more are in progress, the CDC says.

Testing is the way we get information in public health, Vespignani says. It is crucial that we have situational awareness.

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How Northeastern researchers are helping predict the outbreak of bird flu on US dairy farms - Northeastern University

Raw milk from cows infected with the H5N1 bird flu has been shown to contain very high levels of the virus, making it quite risky for people to consume.

With FDA data showing some 4.4% of Americans drank raw milk at least once a year, and 1% drank it once a week or more, millions of Americans may be at risk of contracting the virus.

The question is, would an H5N1 infection from raw milk look like a typical influenza infection to most doctors, or would its symptoms be different? And would doctors be testing for influenza?

On that first question, Andrew Pekosz, PhD, professor of molecular microbiology and immunology at Johns Hopkins University Bloomberg School of Public Health in Baltimore, said it's likely an H5N1 infection from raw milk "would be primarily a respiratory infection based on what happens to other animals that either ingest H5N1-containing milk, or what we see with predatory birds and other carnivores who get infected by eating an H5N1-infected bird."

"In those animals, the infection is in the lungs, but also spreads to a lot of other organs, which is what leads to the death of the animal," Pekosz told MedPage Today in an email.

Those animals include cats; in April, data published in the CDC's Emerging Infectious Diseases showed that more than half of 24 domestic cats fed raw milk from sick cows on a dairy farm in north Texas in mid-March became sick and died.

The cats had signs of systemic influenza infection, including lots of nasal discharge, depressed mental state, and stiff body movements, the researchers reported at the time.

If the infection looks like a typical, or possibly more severe, influenza infection, would a doctor or hospital even test for influenza, let alone search for the H5N1 strain?

Pekosz said emergency departments and healthcare professionals have received communications from health authorities, such as CDC Health Alert Network advisories, to be aware of potential H5N1 infections.

"However, it is not something that is high on most healthcare providers' lists of pressing concerns, so it is possible a case could initially be missed, particularly if it's not a severe infection," he added.

James Lawler, MD, MPH, an infectious diseases expert at the University of Nebraska Medical Center's Global Center for Health Security in Omaha, agreed that it would be easy to miss cases of H5N1 infections from raw milk.

"If we do have sporadic cases popping up every now and then, given the state of surveillance in our public health system, we're probably not going to find it," Lawler told MedPage Today. "If a 20-year-old shows up to an emergency department with severe pneumonia in July, many places will not test that person for flu."

"I'm really concerned about people who are consuming raw milk," he added. "I think there's a high likelihood that we're having even more human cases and those are going undetected."

While most human cases in the recent cattle outbreak have been tied to large dairy farms, and a key route of transmission among cows appears to be contaminated equipment, any cattle exposed to wild birds could potentially become infected, experts said. Also, companion animals that drink H5N1-contaminated raw milk -- and interact with humans -- may pose a risk.

Lawler said, ideally, animal caretakers who sell raw milk should recognize that milk from an animal with symptoms "shouldn't be put into the supply chain." However, cows early in infection, or with latent infection, or those that are only mildly symptomatic "still have high amounts of virus in their milk" and thus pose a risk to the supply chain.

While Lawler acknowledged that the chances of H5N1 evolving to efficiently spread between humans remains low, the stakes are high if it does gain that advantage -- and the more chances it has to spread in mammals, and in humans, the more likely that adaptation is to happen, he said.

Cow mammary glands are a particularly problematic substrate because they contain both "flavors" of sialic acid receptors that the virus uses to bind to host cells, he said: alpha 2,3, which is common in birds; and alpha 2,6, which is common in human upper airways.

Humans also have alpha 2,3 receptors, but these are deeper down in the lungs, Lawler said, which is a likely reason H5N1 has been particularly lethal (with greater than 50% mortality) in historic human cases, as it causes severe pneumonia.

Letting the virus persist in cows "means you're potentially allowing the virus to select for strains that can bind to both, and that would be a potentially dangerous virus," he said.

"All these things are concerning, and I'm pretty disappointed in the lack of a sense of urgency we've seen from the federal government and some state agencies as well," Lawler said. "We seem to be relying on hope as our strategy."

"We're continuing the messaging that this is low risk, and I would argue that it's not," he added. "Risk is the product of threat, and then vulnerability and consequence. While the threat is low -- the probability that this virus is going to mutate into something that transmits efficiently between humans is probably still low -- the problem is, if that happens, then our vulnerability and the consequences of that event would be incredibly high."

Kristina Fiore leads MedPages enterprise & investigative reporting team. Shes been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to k.fiore@medpagetoday.com. Follow

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Are Doctors Missing Cases of H5N1 Bird Flu in People Who Drink Raw Milk? - Medpage Today

A new vaccine approach

Sacha told The Lund Report that his interest in improving the vaccine was sparked by his then 4-year-old son being so sickened by H1N1 swine flu in 2014 that he required hospitalization. His family had been vaccinated against the flu, but it didnt protect them against the strain of the virus he picked up while traveling to a conference in Australia, he said.

That got my mind turning, Sacha said. Maybe we should find a different way to vaccinate against influenza. Because these current vaccines that we use, they change every year and theyre clearly kind of a guess based on what (flu) is going to come out.

Currently, annual flu shots are formulated in a manner intended to anticipate how the virus will evolve and trigger antibodies to fight it. Their effectiveness varies year by year and wanes as the virus changes.

Thats because traditional vaccines are keyed toward proteins on the exterior of the virus, which continuously evolve and mutate.

Sofor years, researchers at a variety of institutions have pursued whats called a universal flu vaccine, one that could combat even newer variants of the virus over a persons lifetime with a single inoculation.

The OHSU researchers are working on a version that harnesses the cytomegalovirus, a common herpes virus related to Chickenpox that usually results in mild or no symptoms, but is long-lasting.

The cytomegalovirus provokes an immune response from the bodys T cells, which target the virus internal proteins, rather than the rapidly evolving ones on its exterior.

Thats why researchers were excited by the studys indication of effectiveness for a vaccine based on a 1918 version of the flu, even if the test involved monkeys, not humans.In the universitys statement, Sacha said the vaccine worked because the virus interior protein has been well preserved even after almost 100 years of evolution.

Although just six of the 11 inoculated monkeys survived, Sacha said the trial was successful considering that the monkeys were given a vaccine geared toward a 100-year-old flu strain and then exposed to H5N1, which he called one of the most pathogenic viruses known.

We as humans would never take those odds for a vaccine, but against a virus thats this wicked, its pretty good, he said. Its a start. We have to do better if we are ever going to go forward.

Sacha said future trials will use a version of the vaccine optimized for more current flu strains. The vaccine would then go to clinical trials on humans, which he said could be done fairly quickly because there are testing sites that use healthy volunteers.

Sacha said an earlier experimental HIV vaccine developed by OHSU researchers laid the groundwork for the technology used in the flu vaccine.

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Study holds hope for revolutionary flu vaccine, OHSU researchers say - The Lund Report

DENVER Recognizing that Colorado has not be able to control the spread of highly pathogenic avian influenza among dairy cattle for nearly three months, state agriculture officials on Tuesday announced they would be mandating weekly testing of milk samples for bird flu at all commercial dairy farms in Colorado, effective immediately, in order to curb further spread of H5N1 in the state.

The move by the Colorado Department of Agriculture (CDA) is the first-of-its-kind in the nation since the unprecedented outbreak of highly pathogenic avian influenza (HPAI) was first detected in U.S. dairy cattle on March 25, followed by Colorado, which detected its first outbreak a month later.

Citing difficulties in navigating a challenging, novel outbreak of HPAI in dairy operations, state veterinarian Dr. Maggie Baldwin said Tuesday the order which went into effect Monday is aimed at protecting the dairy and poultry industries as well as public health in Colorado.

Can't view the document below? Click here to read the order from the CDA.

We have seen devastating impacts of this disease not only to our dairy industry, but our poultry industry as well, Baldwin said in a statement, adding the mandate was the best next step in order to protect these vital industries in our state.

Colorado is leading the nation in both the number of bird flu outbreaks among dairy cattle as well as the number of infected workers who have tested positive for H5N1 after coming into contact with infected animals.

As of Tuesday, Colorado had reported 49 bird flu outbreaks among dairy cattle, with more than half of those identified over the past 30 days, according to the U.S. Department of Agriculture (USDA). That means infections have been reported in 47% of Colorados herds since late April.

USDA

The weekly surveillance for H5N1 in bulk-tank milk samples will take place under the joint supervision of the CDA and the Colorado Department of Public Health and Environment (CDPHE), with support from USDA and will be in effect until further notice, a CDA spokesperson said in a news release, adding that dairy producers will receive further guidance directly so they can meet the testing requirements as set by the order.

Dairies currently under quarantine due to bird flu outbreaks or under orders for testing will be subject to those specific orders, the spokesperson said. The order does not include raw milk facilities.

Any dairy producer who does not comply with the order could face criminal charges, according to the document.

The latest effort by the state comes as the CDA simultaneously tries to prevent further spread of the virus in poultry, the species most affected by H5N1.

Spillover events from the strain of H5N1 that has been spreading among dairy cattle have been reported at two commercial poultry facilities in Weld County and the CDA is investigating a potential third spillover event from a dairy operation into a poultry farm.

Those spillover events have forced the state to kill more than 3.2 million domestic chickens during the month of July, the CDA spokesperson said.

The bird flu outbreaks at Colorado dairy farms account for nearly a third of all outbreaks in the U.S., per the USDA's tally, which shows 169 dairy herds have been infected across 13 states as of Tuesday.

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Colorado, epicenter of bird flu in the US, becomes first state to mandate testing for H5N1 at dairy farms - Denver 7 Colorado News

FILE - Chickens walk in a fenced pasture at an organic farm in Iowa on Oct. 21, 2015. Another 1.2 million chickens will have to be slaughtered after bird flu was confirmed on an Iowa egg farm in the second massive case this week just days after nearly 1 million chickens had to be killed on a Minnesota egg farm. (AP Photo/Charlie Neibergall, File)

(NewsNation) Six workers were found to have contracted avian flu, or bird flu, from a single farm in Colorado, the biggest outbreak of the disease in the U.S. so far.

This is the first time multiple cases of bird flu have been connected to one incident. The workers were all involved in culling poultry that had contracted the illness, a standard practice when bird flu is discovered in a flock.

High temperatures are believed to have contributed to the outbreak, as temperatures around 100 degrees made it difficult for workers to wear personal protective equipment (PPE). While PPE is recommended by the Department of Agriculture to help slow the spread of H5N1, there is no requirement that workers use it.

The workers experienced mild respiratory and eye symptoms and the strain of the virus was found to be similar to that found in Michigan.

The good news is that there is no evidence of human-to-human transmission and the similarities to Michigan indicate the virus has not evolved significantly.

However, there are still concerns that a bird flu epidemic could develop in the U.S. as states have taken varying approaches to testing and protecting cattle or workers, making it difficult to tell how widespread bird flu is in cows or people.

While traces of bird flu have been found in milk, authorities say pasteurization is sufficient to kill the virus and there is little to no risk in consuming pasteurized milk or beef cooked to Department of Agriculture recommendations.

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Six cases of bird flu connected to Colorado farm - NewsNation Now

As we continue to see more reports about bird flu, you may be wondering how exactly the virus spreads and whether youre at risk.

Right now, theres a low risk because its mainly seen in birds, but there have been some rare cases, so we need to remain vigilant, said Lysette Cardona, MD, infectious disease specialist with Cleveland Clinic Florida. Theres no documented human-to-human transmission at this point. So it is in the community, but still at a lower risk. Dr. Cardona said that while bird flu is rare, it is contracted when a person has close contact with an infected animal.

Symptoms of the virus typically include fever, fatigue, cough, sore throat, stuffy nose, and nausea.They may also get conjunctivitis, often referred to as pink eye.

Bird flu in humans can be deadly.According to the CDC, in roughly 50% of known cases worldwide, the person died.

However, when detected early, the virus is treatable. People that have immunocompromising conditions or are pregnant, the elderly, may have some type of chronic condition such as with the heart, diabetes, and especially younger infants that have not developed their immunity, may be at risk for more severe illness with any type of influenza, including the bird flu, she said Dr. Cardona.

There is a test available for bird flu, which involves a throat or nose swab.

Since the virus isnt common, its important to tell your doctor right away if you suspect you were exposed to the virus.

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2 Your Health: What to know about bird flu - WCBD News 2

In a new study led by UNC Charlotte researchers from the Center for Computational Intelligence to Predict Health and Environmental Risks (CIPHER) and the North Carolina Research Campus at Kannapolis, University scholars have found evidence that the latest variants of H5N1 influenza commonly known as avian or bird flu are better at evading antibodies, including those of humans, than previous iterations of the virus. The study is currently published as a preprint on the online bioRxiv preprint server for biology research and is awaiting peer-review.

In June 2024, the U.S. Department of Agriculture reported that over 300 mammals had been found to have been infected with the H5N1 virus between 2022 and 2024. The World Health Organization recently reported that approximately five humans have been infected with H5N1 in 2024 alone, but the broader potential impact to human health remains unclear, the UNC Charlotte researchers wrote.

Using advanced AI and physics-based modeling techniques made possible by UNC Charlotte and the North Carolina General Assembly investments in high-performance computing research and artificial intelligence-assisted computational analysis, University researchers have made strides in understanding the specific interactions between H5N1 virus proteins and antibodies, with the goal that these findings will inform the design of stronger, more effective vaccines for the virus.

This project was led by first author Colby T. Ford, a CIPHER visiting scholar in data science and founder of Charlotte-based startup, Tuple, LLC, along with recent College of Computing and Informatics students Shirish Yasa, Khaled Obeid and Sayal Guirales-Medrano, as well as Department of Bioinformatics and Genomics professors Richard Allen White III and Daniel Janies. Tuple, LLC was also a partner in this project.

Historically, our ability to answer biological questions was limited to the throughput of our traditional lab-based processes. Today, however, through the seemingly limitless scale of high-performance and cloud computing, we employ AI and other modeling tools to answer such questions computationally, said Ford. In this study, our aim is to be more forward looking to predict the potential health impacts of H5N1 influenza before a major event catches us off guard.

Building off of CIPHERs previous SARS-CoV-2 research on coronavirus variants and their ability to evade antibodies, this study is based on data pulled from 1,804 computational experiments as well as an in-depth phylogenetic analysis of 18,508 protein sequences of H5N1 collected between 1959 and 2024. CIPHER scholars also visualized the geographic and host shifts found throughout H5N1s history.

According to the study, virus mutations related to host-shifts from birds to mammals had a statistically significant negative impact on the ability of antibodies to bind to and fight off H5N1. Researchers also found that based on the wide variety of host species and geographic locations in which H5N1 was observed to have been transmitted from birds to mammals, there does not appear to be a single central reservoir host species or location associated with H5N1s spread. This indicates that the virus is well on its way to moving from epidemic to pandemic status in the near future.

This study is the latest example of UNC Charlottes groundbreaking efforts to put advanced computational research methods to use toward better understanding and fighting infectious diseases across the globe.

We are entering a whole new era of molecular epidemiology in which we provide a functional insight above and beyond disease surveillance. said Janies, CIPHER co-director and the Carol Grotnes Belk Distinguished Professor in Bioinformatics and Genomics. We demonstrate that large data sets can be analyzed rapidly with high-performance computing and artificial intelligence to assess our preparedness for important problems such as H5N1, which is spreading rapidly to new hosts and regions including American cattle and farmworkers.

H5 related avian influenza A is an emerging pathogen in humans while being an ongoing pandemic in wildlife for over two years, said White, Assistant Professor of Bioinformatics. Our predictive study provides a window to the future of using AI in the arms race against emerging pathogens.

View the paper below:

Colby T. Ford, Shirish Yasa, Khaled Obeid, Sayal Guirales-Medrano, Richard Allen White III, and Daniel Janies. 2024. Large-Scale Computational Modeling of H5 Influenza Variants Against HA1-Neutralizing Antibodies. https://www.biorxiv.org/content/10.1101/2024.07.14.603367 Posted July 17, 2024.

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Using AI, CIPHER bird flu study shows greater anti | Newswise - Newswise