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As fall and colder weather approaches across the United States, officials are taking steps to prevent the spread of the H5N1 bird flu virus — and to prevent the emergence of a hybrid flu virus that could easily infect humans.
Both influenza and other flu viruses are active during the fall and winter months for HIV. Although most human infections in the current epidemic are mild and self-limiting, each new host presents an opportunity for the virus to infect humans.
“Frankly, we don't have any data yet that this virus can easily infect humans or spread easily between people,” said Dr. Jennifer Nuzzo, director of the Center for Epidemiology at Brown University School of Medicine. Public health. “If he had those skills, we'd be in a pandemic.
“The second we know that one person has given it to another person relatively easily, it's a new epidemic, and it's probably going to be around the world in a matter of weeks,” Nuzzo said at a seminar organized by the Health Coverage Fellowship.
The concern is that scientists are urgently trying to solve the mystery of how a person in Missouri who had no contact with animals contracted bird flu.
Few details have been released. Dr. Nirav Shah, deputy director of the US Centers for Disease Control and Prevention, said Thursday that the man had “significant underlying medical conditions” that made him vulnerable to the disease.
In the year After being admitted to the hospital on August 22, the patient tested positive for the flu, was treated with antiviral drugs, and has since recovered. He returned home.
Further testing at the Missouri State Public Health Laboratory confirmed that the individual had the H5 flu strain, a rare subtype. Only 13 other H5 infections It has been reported in humans This year in America. Except for the Missouri case, all were among farm workers who had direct contact with infected birds or cows.
The CDC confirmed the Missouri case was an H5 infection and is now trying to determine whether the rest of the virus's genome is related to those infecting poultry and dairy cattle. It is unclear whether the agency's scientists were successful because there was little virus to work with in the patient's sample. So far, CDC scientists have only been able to sequence the genetic material of the virus.
“The data we have and have generated so far shows that the H5 virus is closely related to the H5 virus circulating among dairy cows,” Shah said.
Investigators have also interviewed the patient and are looking for his next of kin. There is no indication that the person has passed the infection on to another person, and there is no unusual flu activity in the area where the person lives, Shah said.
Nuzo said, “One person in the hospital was infected with HIV. “It raises concerns not only for farm workers, who are most vulnerable to infection, but that we are allowing this virus to develop new capabilities,” he said.
H5N1 caught scientists by surprise when it broke out in March in US dairy cattle. New cases have slowed in the summer, when dairy cows are moving, partly because of the heat and partly because of a drop in demand for milk during the summer, when school is out, said Dr. Eric Dable, deputy assistant secretary for marketing and regulatory programs at the U.S. Department of Agriculture. Agriculture, there is in August. But this change begins in the fall, when farmers move cows to graze on the recently harvested leftovers.
High cattle activity for HIV
“It's always a concern when people move animals,” Dibble said.
The USDA mandates that dairy cows be inspected before moving between states, but there is no requirement for cattle moving within the same state.
The order does not require testing every animal in large groups, and there are concerns that cows caught without symptoms could be moved undetected.
That concern has increased after three dairy herds in California's Central Valley. Tested positive last month for H5N1. The total number of infected herds in California since Sept. 12 has risen to eight, Deble said Thursday.
California is home About 1.7 million Dairy cows, about One sixth of the national totalIt makes it the largest milk producing state in the country.
How and when the virus traveled to California is still under investigation. But genetic testing by the USDA's National Veterinary Service laboratories shows that the virus infecting the California herds is closely related to viruses infecting more than 200 herds from 13 other states, Deble said.
In late March, cattle in Texas and Kansas were infected with HIV. Evolutionary biologists believe the cows were infected months ago, possibly earlier in the year by migrating birds carrying the virus.
Finding that the virus infecting flocks in California is genetically related to these initial infections is important because it certainly means they are not the result of another cross-over event involving birds migrating to cows. Instead, the virus made its way to California through cow-to-cow transmission, which is still uncontrolled.
“So at the beginning of this epidemic, we were dealing with one type,” Deble told . “This information was shared back to California, and so they continued their epidemiological investigation by hand.”
Dr. Marlene Wolff, an assistant professor of environmental health at Emory University and director of the WastewaterScan program, said wastewater testing in California has been picking up H5 viruses since March 18, a nonprofit monitoring network led by researchers at Stanford and Emory universities and funded by Verily, Google's parent company.
California is one of nine states — out of 40 regulated in the network — where H5 viruses have been found in wastewater.
Testing of wastewater can pick up viruses with H5 proteins, but it is not possible to tell if the viruses came from birds, cows, other animals, or discarded milk that entered the sewage system. To date, however, most H5 proteins have been reported to be recovered in wastewater.
“So far eight of these states have reported outbreaks in cattle. “Arkansas is one state that has not had an H5N1 cattle outbreak,” Wolff wrote in an email.
The increase in animal activity comes as seasonal influenza viruses are gaining steam in the U.S., which increases the risk of someone — perhaps a farm worker — contracting both bird flu and seasonal flu at the same time.
One of the most amazing ways that influenza viruses can change is called an event Reassignment.
Flu viruses are small like Tinkertoys; They put their genes in easy-to-recognize units. When two influenza viruses occupy the same cell and come into close contact, they can simply exchange these parts to produce viruses with sometimes surprising new characteristics.
A reassortment event that produces a new strain of flu virus is rare but not unheard of. The recombination of flu viruses in pigs, which have the same flu receptor as humans, is believed to have led to the creation of the H1N1 virus. 2009 outbreakexample. Reclassified types of flu It is also considered. It caused epidemics in 1957 and 1968.
Since 2010, the CDC has Recommended Annual flu shots for people 6 months of age and older. Still, less than half of adults and children in the US got a flu shot last year, he says CDC data.
Flu shots are especially important this year for people who work directly with farm animals to try to prevent a reintroduction event, the agency said.
The agency asked states with infected herds to submit plans for educating farm workers and how to get vaccines to those who need them. On Thursday, the CDC said it hopes to begin these intensified awareness efforts for farmworkers in October.
Bethany Alkauter, director of research and public health programs at the National Center for Farmers' Health, said increasing vaccination rates among farmers would be high.
“What we are hearing everywhere is the number of farms and the number of dairy workers they are getting. [personal protective equipment] And about bird flu information, access to accurate information is really in the minority,” Alcauter said.
This is true for a variety of reasons, starting with agricultural culture. Some businesses, such as construction, require safety training. It is not the same in agriculture.
“Health and safety training is not that common in agriculture,” Alcauter said. Because many dairy operations are small, they are usually not covered by the state agency that oversees worker safety, the Occupational Safety and Health Administration, or OSHA.
Alcauter's organization was given nearly $4 million by the CDC to spread the word. She said it is taking applications from community groups and health centers to educate agricultural professionals about bird flu and encourage vaccination. She estimated it could support 40 to 50 organizations.
As with any population, there will be some individuals who are hesitant about vaccination, but in general, farm workers receive vaccinations, as they often come from countries with large national vaccination campaigns, such as Mexico and Guatemala.
Farmer advocates say that while it's a reasonable idea to give these workers a seasonal flu shot, those shots still don't protect against viruses they might get from chickens or cows.
Even if the government orders it. About 5 million sizes While the H5N1 vaccine is packaged and ready for use, there are no plans to give these doses to anyone, including farm workers, who are at risk.
This policy stands in contrast to Finland, which has seen past H5N1 outbreaks on fur farms. That country announced that it would begin protecting its farm workers against H5N1. This summer.
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