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Blood test of several people who had contact A patient in Missouri H. Two sources with knowledge of the investigation.
It is H5N1. A type of influenza that is rare in humans but highly contagious and deadly in a variety of animal species, including poultry and dairy cattle, raises concerns about the possibility of a human virus.
The special blood tests, conducted by scientists at the US Centers for Disease Control and Prevention in Atlanta, looked for immune proteins called antibodies, which are made in response to infection. These antibodies confirm that a person is infected with a specific pathogen. The results were widely shared with public health officials, scientists and the media during a series of calls hosted by health officials Thursday morning.
The tests were carried out in a Missouri patient – the first case of HIV in the United States. Until now, the H5N1 virus has not been able to spread easily between people. Infectious disease experts fear that if the virus gains that capacity, it could trigger a new pandemic.
Although the results do not definitively rule out human-to-human transmission of the virus, they suggest that it is not common or widespread and that it was not in a health care setting where caregivers were in close physical contact. patients, CDC officials said. Even if someone in the patient's family is positive, the CDC suggests the timing of their illness suggests they both had a shared exposure rather than catching it from each other.
Around the United States, More than two dozen people have died of HIV this year. According to the CDC.
The results of the new study show that health care workers – doctors who showed signs of respiratory illness while caring for the patient – are more likely to be infected with HIV. However, a person who lived in the same household as the patient and became ill at the same time has antibodies to H5N1 infection.
In a briefing Thursday, CDC officials said the family connection was not considered an official case because they did not test positive in at least two of the three ways to diagnose the infection approved by the CDC and the World Health Organization.
Dr. Demetrius Daskalakis, director of the CDC's National Center for Immunization and Respiratory Diseases, said the agency's experiment is like using sonar on a ship to find something underwater.
“We know there's something down there, and the issue and domestic exposure to HIV,” Daskalakis said.
Infectious disease experts with knowledge of the findings said it was a relief to see the results.
“It gives me more confidence that the health care workers are not positive and that this is not going to spread between people in an ongoing way,” said Dr. Jennifer Nuzzo, who is leading the outbreak. Center at Brown University School of Public Health.
At the same time, Nuzzo said, data gaps limit what a patient and a family member can learn about how they got sick.
Experts agree with the CDC's findings that because both people started showing symptoms at the same time, they are more likely to share a common exposure rather than one person giving it to the other, but in that case it is transmitted from person to person. It cannot be completely removed.
“We still have all these questions,” said Dr. Michael Osterholm, director of the Center for Infectious Disease Research at the University of Minnesota. “Was the source the same? Man to man?”
Another question is related to symptoms. Neither of the people who tested positive for H5N1 had typical flu symptoms. Instead, they had gastrointestinal problems, including diarrhea, leading investigators to suspect that food poisoning may have been the cause of their concurrent illnesses.
Osterholm said it's unclear whether the H5N1 virus is causing those symptoms or whether they had more than one infection at the same time.
“I've seen this happen,” he said.
Both the Missouri patient and their family member were interviewed several times about possible exposure to the virus. They did not report having had any raw milk or other raw dairy products, and could not recall any contact with potentially infected animals, including “direct or indirect contact with wild birds, domestic poultry, cats, cattle, not consuming raw dairy products.” Other wildlife in the case and in close contact,” Lisa Cox, spokeswoman for the Missouri Department of Health and Senior Services, said in an email. That agency has been leading the investigation with help from the CDC.
Experts said the test results shed some light on how both men contracted the virus.
“I don't think we're going to get good information from it,” said immunology and vaccine researcher Dr. Rick Bright, who previously headed the Biomedical Advanced Research and Development Authority.
He said it is important to flag when similar situations appear that indicate the virus is causing unusual symptoms or possibly infecting people through an as-yet-unknown route of exposure.
Although the CDC has done a thorough job looking for antibodies in the case, Bright said, “There are so many strange things, I don't think we can put too much weight on it.” He said it was “convincing and comforting” that the health care workers did not test positive.
To get these test results, the CDC had to reconstruct the exact virus carried by the patient in Missouri to look for antibodies that could capture the unique structure. The agency explained in a recent news release that it is taking these additional steps to eliminate false negative or false positive results.
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The extra effort gave the agency confidence in its research, but it also caused another delay that took weeks to identify and investigate the case. The patient was first admitted to the hospital on August 22.
While the delays are probably unavoidable, if H5N1 infections become widespread, H.
“I'm very happy that we finally have the data that should have been shared weeks ago. I think every case, every human case of H5 is an important case. All are valid and all have value. [blood testing]Dr. Erin Sorrell, a senior scholar at Johns Hopkins, said that because this virus should not be in humans and we need to understand it better to prevent human-to-human transmission. Health Security Center.
“Every data point is important in this process,” Sorrell said. “So I think that delay is a big, big deal.”
On Thursday, health officials announced that H5N1 testing will soon be available at many commercial laboratory companies including Quest Diagnostics. These tests are available to patients with a prescription.
The CDC said it is working with health care providers to educate people about conditions that may qualify a person for bird flu testing, such as a dairy worker with bird flu symptoms.