A person has tested positive for the H5N1 strain of bird flu just days after livestock across four states were reported to be infected. Edwin Remsberg via Getty Images
Last week, officials announced that a number of dairy cows across 11 total herds in Texas, Kansas, Michigan and New Mexico have tested positive for the H5N1 strain of avian influenza, also known as bird flu. Now, the first human case of bird flu has been confirmed in Texas.
Whereas the livestock are likely to have contracted the virus through contact with birds carrying the strain, the infected person became ill after exposure to sick cowsmarking just the second human case of H5N1 in United States history and the first in the Lone Star state.
The patient is reportedly doing well and being treated with an antiviral drug, according to a statement from the Texas Department of State Health Services (DSHS). Eye inflammationor pink eyeis their only current symptom, and they have been instructed to isolate to prevent further spread. The Centers for Disease Control and Prevention (CDC), which conducted testing to confirm the single case, is not currently pursuing any further tests of humans who may have also been exposed, reportsSTAT News Helen Branswell.
We are not aware of reports that any of this individuals close contacts have developed any symptoms, Nirav Shah, principal deputy director of the CDC, tells the publication. The fact that there are not other samples cooking right now is reassuring, insofar as that were not aware of other individuals who are symptomatic following an exposure to livestock.
The CDC remains vigilant in looking for others who report H5N1-like symptoms, though the virus presents no known risk to the public at large. Meanwhile, officials continue to stress that the milk supply is safe.
The cattle infections do not present a concern for the commercial milk supply, per the statement. Dairies are required to destroy or divert milk from any sick cows, plus pasteurization kills avian flu viruses.
Since avian flu spilled over into mammals, its potential to evolve and infect humans has remained a concerning unknown for scientists. Foxes, raccoons,sea lions, bears, minks and other mammals across the globe have contracted H5N1 and died. But up until last month, many scientists thought that livestock, such as dairy cows and goats, would not be susceptible to the strain. Now, it appears that mammal-to-mammal spreadfrom cow to cow, and potentially from cow to humanmay be more probable than previously assumed.
How else could it move so rapidly? Gregory Gray, an infectious disease epidemiologist at the University of Texas Medical Branch, tells the New York Times Emily Anthes and Apoorva Mandavilli. However, it remains possible that each cow independently contracted the virus from a bird, perhaps through contaminated food or water.
Officials say the virus has shown no signs of evolving in a way that would make it spread easily among humans, per the New York Times.
In the past 20 years, approximately 900 human cases of avian flu have been reported across 23 countries. Older strains were more aggressive in humans, but recent iterations have generally yielded milder symptoms and less frequent infections. In 2022, the first U.S. human case of the H5N1 strain was confirmed in a Colorado man working on a poultry farm. He reported feeling fatigued and later recovered.
With the new case, health officials maintain that it is extremely rare for the virus to transmit between people, though they continue to approach the situation with caution.
On the positive side, it seems like this was a very mild case, and its the only case thats been identified so far, Lauren Ancel Meyers, director of the Center for Pandemic Decision Science at the University of Texas at Austin, tells the Texas Tribunes Neelam Bohra. But at the same time, it seems like theres quite a bit of this virus that has been detected in cattle populations. Anytime a virus jumps into a new species, especially a rapidly evolving virus like influenzawe need to be approaching it with the utmost caution and vigilance to make sure we really understand the situation.
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What happened
A dairy worker in the Texas Panhandle developed a mild case of H5N1 avian influenza after working with infected cows, Texas health officials said Monday. The patient is only the second person known to have contracted this strain of bird flu in the U.S. and the first anywhere infected through mammals, The Associated Press said.
"Initial testing has not found changes to the virus that would make it more transmissible to humans," the CDC, FDA and USDA said jointly. "This indicates that the current risk to the public remains low."
The Texas patient exhibited only eye inflammation, but the case "has alarmed disease trackers monitoring for the worst-case scenario: human-to-human transmission," The Washington Post said. Bird flu has been spreading through wild animals and, since March 25, dairy herds in Texas, Kansas, Michigan and New Mexico, so the jump to humans "really wasn't a question of if but when," UTHealth Houston's Dr. Luis Ostrosky said to the Houston Chronicle.
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The dairy worker is expected to fully recover. And there is no current plan to cull the infected herds, the USDA said. Pasteurized milk is believed to be safe.
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Texas has confirmed that one person has been infected with bird flu, a virus that until now had only been reported in livestock within the state. The case is a case of highly pathogenic avian influenza virus type A, also known as H5N1 avian influenza, according to the Centers for Disease Control and Prevention (CDC).
According to a press release, the patient has been treated with antiviral influenza medicine and has been asked to isolate to avoid further infections. The CDC states that this case does not change its assessment of the human health risk of H5N1 avian influenza to people in the United States, which it considers to be low. However, it points out, there are people who are at higher risk of becoming infected.
This is the second human case of this type of virus in the United States. In 2022, a case was reported in Colorado. Since late 2021, CDC has detected outbreaks of this virus in wild birds and poultry. The Department of Agriculture confirmed cases of the virus in cattle in New Mexico in addition to others in Texas, where the case of the infected person also occurred.
Avian influenza, or bird flu, is an infectious type of influenza that is transmitted between birds. Most strains of the virus cannot infect humans, but some, such as H5N1 which was identified in 1997 can infect humans.
According to the CDC, H5 avian influenza is common in wild birds in the United States and globally.
According to the CDC, human infections with this type of virus are rare but have occurred sporadically around the world.
There are some people at higher risk of infection such as farmers, hunters, and other individuals who come into direct contact with possibly infected animals.
Cases of H5N1 avian flu in the United States have had mild symptoms such as eye infection or upper respiratory symptoms, and severe symptoms such as pneumonia, which has resulted in some deaths in other countries.
Other symptoms may include fever, muscle pain, headache, cough, shortness of breath, diarrhea, stomach pain, chest pain, nose or gum bleeding, and conjunctivitis. These may appear three to five days after infection.
According to the National Health Service in England, patients with avian flu are treated with antiviral drugs, which can reduce the severity of symptoms, which in turn prevents complications and increases the likelihood of survival. These drugs can also be given to those who have been exposed to the virus.
If symptoms are more severe and have caused other complications, treatment may be extended.
The CDC has a help center on its website where they point out preventive actions such as avoiding direct contact with wild birds and observing them only from a far distance. It is also advised to avoid exposure to other dead or sick animals such as domesticated animals, including livestock, as well as organic residues or possibly contaminated materials. If a dead or injured bird is found, report it and do not touch it.
If they come in contact with an infected bird or other animal and develop symptoms, they should be isolated at home away from other household members and should not go to work or school until they are found to be free of infection. The local or state public health department should be notified so they can assist in offering help.
Likewise, it is advisable to eat poultry that has been properly handled and cooked.
Yes, there is a seasonal flu vaccine, which is recommended for anyone over six months of age, and should be given two weeks before exposure to possible infected birds. The CDC notes that this vaccine does not prevent infection but can reduce the risk of getting sick from both human and avian viruses at the same time.
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(Bloomberg) -- A person in Texas contracted bird flu, most likely after being exposed to infected dairy cows, public health officials said, as an emerging outbreak among the animals spreads in the country.
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The risk to the general population remains low, the US Centers for Disease Control and Prevention said. It is the second human case of bird flu, formally known as highly pathogenic H5N1 avian influenza, in the US since 2022 when infections started gaining speed in wild and domesticated birds and other mammals.
The patient, who had no symptoms apart from red eyes suggestive of conjunctivitis, is receiving antiviral drugs and recovering, according to the Texas Department of State Health Services.
The outbreak among dairy herds is relatively recent, with early reports of infected cows from Kansas, Michigan, New Mexico and Idaho. Unlike with chickens and other poultry flocks that are generally culled to prevent the spread of the virus, the US Department of Agriculture isnt recommending the destruction of infected cows at this stage.
The situation is rapidly evolving, the USDA said. The CDC is working with state health departments to monitor people and groups that may be at risk.
Read more: Bird Flu Found in Michigan, Idaho Cows as Virus Spreads in US
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Avian - or bird - flu is highly infectious but cases are generally uncommon in humans.
A person has tested positive for bird flu in the US, health officials reported this week, the countrys second human case.
H5N1 was confirmed in a person who had been exposed to dairy cows thought to be infected with the virus in Texas.
H5N1 is a type of highly pathogenic avian influenza or bird flu. While uncommon in humans, when a person is infected, the mortality rate is about 60 per cent, according to the World Health Organization (WHO).
The Texas patients only symptom was eye inflammation or redness, according to the US Centers for Disease Control and Prevention (CDC), which confirmed the case.
The patient has been treated with the antiviral drug oseltamivir which is marketed under the brand name Tamiflu.
This was the second human case in the US, with a person in Colorado who had direct exposure to poultry and was involved in culling infected birds testing positive in 2022.
The CDC said the risk of H5N1 remains low in the US, adding that people with prolonged, unprotected exposure to infected birds and other animals such as livestock were at a greater risk of being infected.
US officials had reported the virus was found in dairy cows in Texas and Kansas last week, with unpasteurised milk samples from sick cattle testing positive. They said it appeared to come from wild birds.
The officials emphasised that there was no concern about commercial milk supply with dairies required to send milk from healthy cows. They also use pasteurisation which is proven to inactivate bacteria and viruses.
Seasonal flu vaccines do not protect against H5N1, according to the CDC. The agency also warned that people should avoid unprotected exposure to sick or dead animals.
According to a European Centre for Disease Prevention and Control (ECDC) report from last week, there have been some 888 cases of H5N1 reported in 23 countries since 2004.
The ECDC said that there have been six other cases worldwide this year in Cambodia and Vietnam with one death in each country.
The last European country to report cases of H5N1 in humans was the United Kingdom which reported four human cases last year. These were picked up through asymptomatic surveillance of individuals who were exposed to infected birds.
Between December 2, 2023, and March 15, 2024, there were 227 outbreaks in domestic birds and 414 outbreaks in wild birds across 26 countries in Europe, the ECDC said in its latest report.
Wastewater testing has become a hallmark of viral surveillance during the COVID-19 pandemic, and a new study looking at samples collected near homeless encampments reveals novel viral mutations and transmission patterns and 26% of water samples containing SARS-CoV-2 genetic material. The study was published today in Environmental Science & Technology Letters.
Traditional wastewater monitoring relies on testing samples from local sewage infrastructure, which serves homes and apartment buildings. SARS-CoV-2infected people shed maximum viral RNA levels in fecal matter at the beginning of infection and for up to 7 months following the initial infection. Previous studies have shown wastewater samples have predicted when COVID-19 activity has spiked in a location, and identified variants of concerns.
To capture those changes among homeless people, researchers needed to sample waterways near encampments, and not traditional sewage lines. In the present study, water near encampments outside Las Vegas was sampled from December 2021 through July 2022.
Scientists collected the water from flood-control infrastructure that is known to be affected by homeless populations, the authors said.
They found that, of 57 samples obtained, 15 (26.3%) contained detectable levels of SARS-CoV-2 RNA, with highest concentrations in January and February 2022, which corresponded to peak Omicron activity in Las Vegas.
"These results demonstrate that environmental water samples from flood control channels impacted by unsheltered individuals appear to contain the same SARS-CoV-2 variants circulating in the broader community with some intermittent signals from previously circulating variants," the authors wrote.
These results demonstrate that environmental water samples from flood control channels impacted by unsheltered individuals appear to contain the same SARS-CoV-2 variants circulating in the broader community.
In subsequent whole-genome sequencing, the authors identified the SARS-CoV-2 variants in the waterways. Almost all variants matched what was seen in traditional sewage infrastructure. "However, we also detected 10 of 22 mutations specific to the Alpha variant in the environmental water samples collected during January 2022one year after the Alpha infection peak," they noted.
Analysis of viral sequences uncovered three novel viral spike protein mutations, but the authors said there was not enough information to determine if the mutations changed clinical outcomes for COVID-19 patients in the encampments.
"Due to a lack of clinical surveillance data for unsheltered individuals, we were unable to directly compare variant prevalence for the environmental water samples with this particular population," the authors said.
Two of the countrys top researchers on post-COVID conditions, commonly known as long COVID, have new clues as to who may be at risk for developing lingering symptoms, according to a recent study published in the American Journal of Medicine.
Dr. Harlan Krumholz and Akiko Iwasaki of the Yale School of Medicine found that being middle aged, female, and having had a severely acute COVID-19 infection is associated with long COVID. The question is why.
What was it about peoples age, sex, race, ethnicity how was that associated with long COVID? Krumholz said.
Researchers know that more women than men develop autoimmune diseases like lupus. Krumholz said further research is needed to find out whether long COVID is also an autoimmune disorder.
Meanwhile, long COVID patients and advocates are frustrated by how much even experts dont know about their condition.
Diana Berrent, founder of Survivor Corps, an online support group for long COVID patients nationally and in Connecticut, said patients need an Operation Warp Speed like approach to conducting randomized controlled trials and are instead being left to crowdsource off-label options via social media.
She said researchers should begin trialing antivirals, monoclonal antibodies, Vax-plasma, nicotine, low dose Naltrexone, vagus nerve stimulation and more.
We should be throwing the spaghetti at the wall, she said. Instead, we are ignoring the tremendous pain people are in, many of whom are celebrating their fourth year being bed bound.
The Yale study was based on self-reported COVID infections among 134,000 people in data from the 2022 Behavioral Risk Factor Surveillance System and the 2022 National Health Interview Survey.
The researchers found that individuals living in rural areas and people without college degrees had an increased risk of developing long COVID.
It could be that people who were more educated had better access to antiviral drugs like Paxlovid, Krumholz said.
Black Americans and non-Hispanic Asians were also less likely to report long COVID compared to non-Hispanic white people. Krumholz said thats a problem around health care access it could be that fewer Blacks and Asians had a doctor that they could reach.
Dr. Manisha Juthani, commissioner of the Connecticut Department of Public Health, said the paper utilized robust public health datasets and provides additional insights into how certain demographic risk factors and severity of COVID infection are associated with long COVID.
However, there was no data on up-to-date vaccinations and its protective factor against long COVID.
Other emerging evidence suggests that up-to-date COVID vaccination can be protective from long COVID, Juthani said.
OVER the past few years, I have noticed an increasing number of people sharing their experiences of feeling anxious, whether it is celebrities opening up in interviews or friends chatting over a drink. This got me thinking: are more people feeling anxious these days or are they just more willing to talk about it?
This apparent uptick seems to be seen in studies of anxiety prevalence but dig into the details and the picture isnt so clear. As for what is behind this possible rise, the covid-19 pandemic is an obvious cause, yet it isnt the only one: economic and political factors may also play a role.
Lets look at the pandemic first. It was a phenomenon that none of us had experienced, a global issue that understandably caused a huge amount of stress, says David Smithson at the charity Anxiety UK. Who wouldnt be worried?
Levels of anxiety rose at the start of the pandemic, with the World Health Organization reporting a 25.6 per cent increase in anxiety disorders in 2020 as lockdowns and other restrictions were brought in and people grappled with an unknown virus and its impact on their lives. But this rise didnt persist, according to a review of 177 studies looking at people in high-income countries, with levels falling as the pandemic continued.
This chimes with Smithsons experience. We saw that rise through demand for our support services from the start of the pandemic for about two years, he says. We have seen, in the last 12 months or so, that demand has dipped down
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Junior Associate Professor Kazuo Takayama (Department of Cell Growth and Differentiation) and a collaborative team of researchers in Japan recently characterized SARS-CoV-2 collected from a persistent COVID-19 patient to identify critical factors responsible for generating new mutant strains.
The COVID-19 pandemic, caused by the SARS-CoV-2, was in part due to rapid viral evolution that continuously generated new variants. While multiple factors are known to contribute to the rapid emergence of mutant strains, the principal contributing factors remain unclear.
In this study, accepted for publication in iScience, the researchers collected serum samples and viral isolates from an immunocompromised patient who was persistently infected by the SARS-CoV-2 omicron variant BF.5 over several months to track its evolution and potentially identify crucial factors responsible for the widespread effects of this respiratory virus.
Due to the patient's chronic immunosuppression as part of the treatment for eosinophilic fasciitis, the researchers detected only low antibody levels against SARS-CoV-2 in the samples. Conversely, although they detected cytolytic granules in the sera collected from the patient, suggesting that NK (natural killer) and CD8+ T cells were likely functional, the research team concluded that these immune cells alone, without sufficient antibody production by B cells, were incapable of successfully eliminating the virus from the patient.
The researchers next analyzed the viral genomes isolated from the swab samples by next-generation sequencing methods. Remarkably, whereas the viral genome mutated at 10 locations between the first and two sampling time points (days 0 and 17), it changed at 27 and 37 locations, respectively, during the second and third intervals between sample collection (days 1856 and 57119), suggesting the virus could acquire mutations quicker when left unchecked for more than two months.
Utilizing their expertise in organoid technology, the researchers examined the viruses' replicative capacity and their effects on host cells by infecting human iPS cell-derived lung organoids with each viral isolate. They detected similar viral gene expression and production levels across isolates, demonstrating that infectivity was generally unaltered during the entire course of a persistent SARS-CoV-2 infection.
In addition, the researchers examined the sensitivity to the antiviral drug, remdesivir, and anti-spike protein antibody therapy, sotrovimab, using lung organoids. All viral isolates showed high susceptibility to remdesivir treatment but were largely resistant to the antibody therapy, as they all contained spike protein mutations (G339D or R346T) known to render them resistant to sotrovimab. These findings indicate that infectivity and sensitivity to antiviral treatments remained mostly unchanged despite acquiring multiple mutations during the persistent infection.
To determine whether studying the viral isolates from a patient suffering from persistent SARS-CoV-2 infection can help predict viral evolution, the researchers focused on the S protein amino acid sequence and performed comparative phylogenetic analysis with emergent SARS-CoV-2 strains arising in the real world.
Notably, several mutations (D574N, S975N, S1003I, and A1174V), relatively rare before the appearance of BF.5, were acquired during persistent infection, indicating that they may be more likely to emerge from the BF.5 strain. The research team thus tested this idea by examining the frequency of these mutations in strains appearing after the BF.5 strain.
Remarkably, the D574N and S1003I mutations were detected in greater than 1% of descendant strains emerging from BA.5 (BA.5.24, BA.5.2.36, CG.1, BF.7.26, and BQ.1.1.21), thus demonstrating the potential and real-world implication of analyzing viral evolution in persistently infected patients.
In summary, the study illustrates the potential of studying how viruses change over time in patients with persistent infections as a parallel to predict how they may evolve in the real world. However, it is crucial to note that additional persistently infected patients must be included to determine the general applicability of such findings because individual differences could potentially skew viral evolution.
More information: Hiroki Futatsusako et al, Longitudinal analysis of genomic mutations in SARS-CoV-2 isolates from persistent COVID-19 patient, iScience (2024). DOI: 10.1016/j.isci.2024.109597
Journal information: iScience
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