#USA, Confirmed #H5N1 #influenza #human case summary during 2024 #outbreak, by state and exposure source {as of Dec. 27 '24: 1 new case, total = 66}

 {Excerpt}

Exposure Source

[State - Exposure Associated with Commercial Agriculture and Related Operations: Dairy Herds (Cattle), Poultry Farms and Culling Operations - Other Animal Exposure† - Exposure Source Unknown‡ - State Total]

1) California - 36 - 0 - 0 - 1 - 37 {+1}

2) Colorado - 1 - 9 - 0 - 0 - 10

3) Iowa - 0 - 1 - 0 - 0 - 1

4) Louisiana - 0 - 0 - 1 - 0 - 1

5) Michigan - 2 - 0 - 0 - 0 - 2

6) Missouri - 0 - 0 - 0 - 1 - 1

7) Oregon - 0 - 1 - 0 - 0 - 1

8) Texas - 1 - 0 - 0 - 0 - 1

9) Washington - 0 - 11 - 0 - 0 - 11

10) Wisconsin - 0 - 1 - 0 - 0 - 1

-- Source Total - 40 - 23 - 1 - 2 - 66 {+1}

NOTE: One additional case was previously detected in a poultry worker in Colorado in 2022.

{†} Exposure was related to other animals such as backyard flocks, wild birds, or other mammals

{‡} Exposure source was not able to be identified

Probable human case summary during the 2024 outbreak, by state and exposure source {Seven Cases}

When a case tests positive for H5 at a public health laboratory but testing at CDC is not able to confirm H5 infection, per Council of State and Territorial Epidemiologists (CSTE) guidance, a case is reported as probable.

-- Probable cases with commercial poultry exposure (e.g., poultry farms or culling operations):

- Washington (3)

- Arizona (2)

-- Probable cases with commercial dairy (cattle) exposure:

- California (1)

-- Probable cases with exposure source unknown:

- Delaware (1)

Confirmed and probable cases are typically updated by 5 PM EST on Mondays (for cases confirmed by CDC on Friday, Saturday, or Sunday), Wednesdays (for cases confirmed by CDC on Monday or Tuesday), and Fridays (for cases confirmed by CDC on Wednesday and Thursday). Affected states may report cases more frequently.

(...)

Source: US Centers for Disease Control and Prevention, https://www.cdc.gov/bird-flu/situation-summary/?CDC_AAref_Val=https://www.cdc.gov/flu/avianflu/avian-flu-summary.htm

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Acute #respiratory #infections complicated by #malaria (previously undiagnosed disease) - #DRC

{Excerpts}

27 December 2024

Situation at a glance

This is an update to the Disease Outbreak News on Undiagnosed disease in the Democratic Republic of the Congo published on 8 December 2024 (now named acute respiratory infections complicated by malaria). 

It includes updated epidemiological investigation information and preliminary laboratory results. 

On 29 November, an alert was raised by local health zone authorities of Panzi health zone in Kwango province after an increase in deaths, particularly among children under five years of age, following febrile illness. 

Enhanced epidemiological surveillance was rapidly implemented, which in the absence of a clear diagnosis was based on the detection of syndromic cases of febrile illnesses with cough, body weakness, with one of a number of other symptoms compatible with acute respiratory and febrile illnesses. 

This resulted in a rapid increase in the number of cases meeting the definition, with a total of 891 cases reported as of 16 December. 

However, the weekly number of reported deaths (48 deaths reported over the period) has remained relatively stable. 

As of 16 December, laboratory results from a total of 430 samples indicated positive results for malaria, common respiratory viruses (Influenza A (H1N1, pdm09), rhinoviruses, SARS-COV-2, Human coronaviruses, parainfluenza viruses, and Human Adenovirus). 

While further laboratory tests are ongoing, together these findings suggest that a combination of common and seasonal viral respiratory infections and falciparum malaria, compounded by acute malnutrition led to an increase in severe infections and deaths, disproportionally affecting children under five years of age. 

Multidisciplinary rapid response teams have been deployed to investigate the event and strengthen the response. 

Efforts are ongoing to address the health needs in Panzi health zone. 

Enhanced surveillance in the community and within health facilities continues. 

The teams have also been providing support for diagnosis, the treatment of patients as well as with risk communication and community engagement. 

This event highlights the severe burden from common infectious diseases (acute respiratory infections and malaria) in a context of vulnerable populations facing food insecurity. It emphasizes the need to strengthen access to health care and address underlying causes of vulnerability, particularly malnutrition, given the worsening food insecurity.

Description of the situation

Since the last Disease Outbreak News on this event was published on 8 December 2024, 485 additional suspected cases and 17 additional deaths have been reported from Panzi health zone in Kwango Province, Democratic Republic of the Congo, across 25 out of the 30 health areas in Panzi. These cases were identified as a result of enhanced surveillance put in place following the report of deaths in the context of febrile illness with acute respiratory symptoms and anaemia, first reported on 29 November. While the number of reported cases was not deemed particularly unusual in a context of high burden of pneumonia, malaria and acute respiratory infections, particularly at the start of the rainy season, it is the increase in the number of deaths that triggered the alert on 29 November.

In the absence of diagnosis, a broad surveillance case definition was used, with the resulting case numbers reflecting the detection of any febrile illness occurring in Panzi and thus representing a range of diseases and clinical syndromes. The case definition includes: any person living in the Panzi health zone from September 2024 to date, presenting with fever, cough, body weakness, runny nose, with or without one of the following symptoms and signs: chills, headache, difficulty breathing, malnutrition, body aches. This was done to better understand the epidemiology and characteristics of deaths and to collect a range of clinical samples for laboratory testing.

Between 24 October and 16 December 2024, 48 deaths and a total of 891 cases across 25/30 health areas of Panzi health zone met the case definition. Children under five years of age are disproportionally affected, representing 47% of all cases and 54% of all deaths, while they represent around 18% of the population, likely reflecting the vulnerability of young children to severe disease and death in this context. The main symptoms associated with death include difficulty in breathing, anaemia, and signs of acute malnutrition.

A total of 430 samples including blood samples, oropharyngeal and nasopharyngeal swabs, urine and breastmilk samples were collected from suspected cases in Panzi health zone and transported to the laboratory at the INRB. 

Out of 88 rapid diagnostics tests for malaria performed in the field, 55 (62%) samples tested positive. In addition, out of 26 samples analyzed by PCR BioFire Global Fever Panel test (which tests 18 different pathogens including some of the viral hemorrhagic fevers), 17 (65%) samples tested positive for Plasmodium falciparum.  In addition, a total of 89 samples were tested at INRB Respiratory Disease Surveillance Laboratory. Of the 89 samples, 64 samples were positive for common respiratory viruses including Influenza A (H1N1, pdm09) (n=25), rhinoviruses (n=18), SARS-COV-2 (n=15), Human coronaviruses (n=3), parainfluenza viruses (n=2), and Human adenovirus (n=1).

Other laboratory tests on the collected samples, including virological and bacterial analysis, are still ongoing. The ongoing investigations and preliminary laboratory findings suggest that a combination of common viral respiratory infections and falciparum malaria, compounded by acute malnutrition led to an increase in severe infections and deaths.

Enhanced surveillance will continue, alongside response activities. The number of weekly reported suspected cases has remained steady with the exception of an increase in epidemiological week 50 (week ending 15 December 2024, Figure 1). While this may partly reflect an increase in transmission of respiratory viruses and malaria with the rainy season, it is driven by an increase in surveillance and case finding following the deployment of the rapid response teams. Notably, the increase in cases is not matched with a comparable increase in deaths.

(...)

There are proportionally more cases reported among females (58%, 514/889), particularly among adults (66% female, 173/262). While data is lacking to better understand this difference, it may stem from contact patterns of respiratory virus transmission within households, particularly a close interaction between mothers and children during acute respiratory illnesses. 

(...)

The affected area experienced deterioration in food security in recent months, with increasing levels of acute malnutrition. Between July and December 2024, which coincides with a drop in acute malnutrition, Kwango province was in Integrated Food Security Phase Classification (IPC) Acute Malnutrition (AMN) Phase 3 (Serious). Between January and June 2025, an increase in cases of malnutrition is projected in the province with a significant deterioration in the nutritional situation expected, moving to IPC AMN Phase 4 (Critical). Between July 2024 and June 2025, nearly 4.5 million children aged 6 to 59 months in the DRC are facing or expected to face acute malnutrition, including approximately 1.4 million cases of severe acute malnutrition and 3.1 million cases of moderate acute malnutrition. It is also estimated that 3.7 million pregnant and breastfeeding women are facing or expected to face acute malnutrition over the same period.[1]

Severe acute malnutrition is a life-threatening condition that requires medical treatment. In addition, disease and malnutrition combine to worsen each other. The area has low routine vaccination coverage. There is also very limited access to diagnostics and quality case management, and a lack of supplies and transportation, shortage of health staff in the area, as well as financial and geographical barriers to access to health care. Increasing malaria trends are expected with the start of the rainy season, however, malaria control measures in the area are very limited. Together, these factors may increase the severity of malaria, and common respiratory infections.

Overall, this event highlights the severe burden from common infectious diseases (acute respiratory infections and malaria) in a context of vulnerable populations facing food insecurity and emphasizes the need to strengthen access and quality of health care.

Public health response

1. Leadership and coordination:

Daily coordination meetings are being held at the national level, with provincial teams actively participating in ongoing planning and response.

National rapid response team (RRT) composed of experts from Ministry of Health (MoH), INRB and WHO deployed from Kinshasa on 7 December and arrived in Panzi on 10 December. Following the departure of the national team, a joint MoH-Africa CDC rapid response team has been deployed with support from WHO.

2. Surveillance:

A case definition has been developed based on clinical symptoms observed, guiding surveillance and reporting efforts.  

Active case search is continuing in health facilities and the community. 

Data collection is ongoing, focusing on preparing a line list and detailed epidemiological analysis.  

Community deaths are being investigated to better understand the context of deaths and vulnerability factors.

WHO is deploying a senior epidemiologist and a data manager to support the ongoing surveillance activities and improve data collection.

3. Case Management:

Provincial and national RRTs, including WHO, UNICEF and Médecins Sans Frontières, have been deployed to the affected areas and are strengthening case management in health facilities as well as providing medical supplies including medication. The teams carried medication and medical equipment to support case management and prevent more deaths.

Efforts are underway to strengthen the capacity of healthcare providers to ensure the best possible care for patients. 

Six oxygen concentrators are being installed at the Panzi General Referral Hospital and three hotspot health centers to support patient care.

4. Laboratory:

Laboratory equipment was transported to collect samples from cases and send samples for testing at the INRB in Kinshasa. Additionally, RDTs for malaria and COVID-19 have been provided to assist in diagnosis. 

Laboratory reagents have been procured to continue facilitating the ongoing testing at INRB.

5. Risk communication and community engagement:

Key messages were developed to enhance public awareness and encourage general preventive behaviors. These messages are being disseminated through community engagement, with sensitization campaigns underway. 

6. Infection prevention and control:

Infection prevention and control measures are being reinforced. Health workers have been briefed on key practices, including the proper use of masks, hand washing, and gloves, to reduce the risk of transmission of respiratory and other pathogens. 

7. Logistics

Logistical support is being provided for effective case management, including the transportation of samples to INRB Kinshasa for laboratory testing. Health facilities and hospitals in the most affected health areas are being supplied with appropriate medications and sampling kits to support the response. 

Medical kits for malaria, IPC kits, blood transfusion kits as well as additional medical supplies to support treatment efforts have been provided.

A mobile internet kit is being deployed to address some of the telecommunication challenges in the affected health zone. 

WHO risk assessment

Symptoms such as fever, cough, headache, and body aches have been observed since 24 October, primarily through health worker reports, and an uptick in deaths was observed in epi week 47, which triggered the signal. Since the alert was reported, there has not been any significant increase in reported deaths.

The epidemiological information together with the early laboratory result indicate an event triggered by an increase in acute respiratory virus cases associated with malaria, with a background of a worsening of the nutritional situation in Panzi, disproportionally affecting young children. 

The WHO African Region accounts for about 94% of all malaria cases and 95% of deaths globally (World Malaria Report 2024). Children under five account for about 76% of all malaria deaths in the Region. Over half of these deaths occurred in four countries: Nigeria (30.9%), the Democratic Republic of the Congo (11.3%), Niger (5.9%) and United Republic of Tanzania (4.3%). Support is being provided for laboratory diagnosis and strengthening case management including the treatment of malaria cases with appropriate medication.

An increase in common respiratory viruses and malaria is expected at this time of year in Panzi with the rainy season, however it is the increase in deaths that triggered the initial signal. There has been an increase in influenza and SARS-CoV-2 activity reported from Kinshasa through sentinel sites since mid-October. WHO and UNICEF estimates of national immunization coverage for 2023 show DTP3 and PCV3 coverage at 60% and 59%, respectively, however, no data is currently available for the affected health zone, leading to uncertainties about vaccine-derived population immunity.

The Integrated Food Security Phase Classification (IPC) for acute food insecurity levels in Kwango province increased from IPC 1 (acceptable) in April 2024 to IPC 3 (Crisis Level) in September 2024. This suggests a significant phase of increase in food insecurity and risk of severe acute malnutrition. In Addition, the IPC acute malnutrition classification currently classifies Panzi health zone as IPC acute malnutrition phase 3 (serious), projected to move to phase 4 (critical) from January 2025.

While mortality from common infectious diseases is expected to increase as transmission increases, this event highlights that mortality from known and expected infectious diseases can be high in a context of vulnerability and malnutrition, emphasizing the need to strengthen malaria control, clinical management, improve access to care and reduce the prevalence of malnutrition.

Gaps in case management have also been identified. Stock-outs of medications for treating common diseases frequently occur, and care is not provided free of charge, which could limit access to treatment for vulnerable populations and increase severity and mortality of known and treatable infections.

The affected area’s remoteness and logistical barriers, including a two-day or longer road journey from Kinshasa due to the rainy season affecting the roads and limited telecommunication network coverage across the health areas, have hampered the rapid deployment of response teams and resources. Furthermore, there is no functional laboratory in the health zone or province, requiring the collection and shipment of samples to Kinshasa for analysis. This has delayed diagnosis and can continue to impact the ongoing response efforts. 

Insecurity in the region adds another layer of complexity to the response. The potential for attacks by armed groups poses a direct risk to response teams and communities, which could further disrupt the response. 

Based on the above rationale, the overall public health risk level to the affected communities is assessed as high, and requires an integrated public health approach to reduce mortality from infections, improve nutritional status and strengthen malaria control, among others.

At the national level, the risk is considered low due to the localized nature of the event and that it is caused by a range of illnesses whose severity is compounded by the vulnerability of the population in the local context. However, many other areas of DRC are seeing increasing levels of malnutrition, and what has been witnessed in Panzi could also happen elsewhere in the country.

As such, efforts need to continue to prevent similar situation in other vulnerable parts of the country.  At the regional and global levels, the risk remains low at this time.  

WHO advice

To reduce the impact of the ongoing event in the Panzi health zone, WHO advises the following measures:  

-- Strengthening coordination mechanisms at all levels—national, provincial, zonal, and local—is critical for a unified response. Enhanced communication infrastructure, such as satellite phones, is required to overcome the limited network coverage in affected areas.

-- Improving surveillance efforts is a priority to better understand disease trends and mortality. Active case searches should continue in both health facilities and communities, with a particular focus on areas reporting deaths and family clusters. Community-based surveillance must be strengthened to ensure early case detection and rapid response.

-- Careful characterization of the clinical syndrome and outcomes and an improved case definition based on the information collected will be necessary to understand the situation. In particular, data which clarify possibility of coinfection and multiple pathologies, and uncertainties in outcomes among vulnerable groups should be collected. The WHO has established the Global Clinical Platform to provide rapid turnaround of structured data analysis using anonymized case records; its use is recommended in the detailed capture of patient syndromes and outcomes. 

-- Effective case management requires ensuring an adequate supply of essential medications, access to oxygen therapy, and training of healthcare workers including basic emergency and critical care to support treatment and prevent more deaths. RDTs for malaria should be distributed to facilitate early diagnosis and prompt treatment. Long-term laboratory capacity strengthening, and decentralization will be important in provision of diagnostic capability in the affected health zone and detect cause of deaths early.  

-- Infection prevention and control measures must be reinforced across all health facilities. Healthcare workers should receive training on best practices, including the proper use of personal protective equipment such as masks and gloves, as well as strict hand hygiene protocols. These measures will reduce transmission risks within health facilities and improve the safety of healthcare delivery.  

-- The role and added value of the health sector during food crises is crucial to prevent, reduce and reverse the causal relationship between poor nutrition, disease and death – before, during and after the onset of severe food shortages. As needs and vulnerabilities during food crises are complex, interlinked and multidimensional, intersectoral coordination and collaboration, especially between the health, nutrition, water, sanitation and hygiene (WASH) and food security clusters, should be stepped up as part of the overall humanitarian response. Data collection and analysis should be strengthened to inform the overall response.

-- Risk communication and community engagement are essential to raising public awareness. Targeted messages should be disseminated to educate the public on respiratory illness symptoms, preventive measures, and the importance of seeking care early. Community leaders must be engaged to build trust and encourage adherence to public health guidance. Addressing misinformation and fears within the community is critical to ensuring effective collaboration in the response.  

-- Logistical and security challenges also require attention. Strengthening logistical support for the deployment of teams and supplies will ensure timely access to affected areas. Contingency plans should be developed to address potential insecurity posed by armed groups, safeguarding response personnel and maintaining continuity in response activities.  

(...)

Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON547

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#USA, Novel #Influenza A #H5N1 Virus: Five New Cases reported in Week 51/2024 {3 in #California, 1 in #Wisconsin, 1 in #Iowa}

{Excerpts}

-- Five confirmed cases of influenza A(H5) were reported to CDC this week. 

-- To date, human-to-human transmission of influenza A(H5) virus has not been identified in the United States.

Three of these cases were reported by the California Department of Public Health. The cases occurred in workers aged ≥18 years at commercial dairy cattle farms in an area where highly pathogenic avian influenza (HPAI) A(H5N1) viruses had been detected in cows. The individuals had mild symptoms, which they reported to local health department officials. There have now been 37 total confirmed cases and one probable case in California during the 2024-2025 influenza season.

One case was reported by the Wisconsin Department of Health. This case occurred in an individual aged ≥18 years who worked at a poultry facility where HPAI A(H5N1) virus had been identified in birds. This individual developed respiratory symptoms during Week 50. Specimens were collected from the individual and initially tested at the state public health laboratories using the CDC influenza A(H5) assay before being sent to CDC for further testing. Influenza A(H5) virus was confirmed at CDC. This is the first influenza A(H5) case in Wisconsin.

One case was reported by the Iowa Department of Health and Human Services. This case occurred in an individual aged ≥18 years who worked at a poultry facility where HPAI A(H5N1) virus had been identified in birds. This individual developed conjunctivitis and respiratory symptoms during Week 50. Specimens were collected from the individual and initially tested at the State Hygienic Laboratory at the University of Iowa using the CDC influenza A(H5) assay before being sent to CDC for further testing. Influenza A(H5) virus was confirmed at CDC. This is the first influenza A(H5) case in Iowa.

Notification to WHO of the cases reported by the Wisconsin and Iowa departments of health was initiated per International Health Regulations (IHR). More information regarding IHR can be found at http://www.who.int/topics/international_health_regulations/en/. 

No additional notification to WHO of the cases exposed to dairy cows in California is required per International Health Regulations (IHR).

The CSTE position statement, which includes updated case definitions for confirmed, probable, and suspected cases is available at http://www.cste.org/resource/resmgr/position_statements_files_2023/24-ID-09_Novel_Influenza_A.pdf

An up-to-date human case summary during the 2024 outbreak by state and exposure source is available at www.cdc.gov/bird-flu/situation-summary/index.html

Information about avian influenza is available at https://www.cdc.gov/flu/avianflu/index.htm.

Interim recommendations for Prevention, Monitoring, and Public Health Investigations are available at https://www.cdc.gov/bird-flu/prevention/hpai-interim-recommendations.html.

The latest case reports on avian influenza outbreaks in wild birds, commercial poultry, backyard or hobbyist flocks, and mammals in the United States are available from the USDA at https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/animal-disease-information/avian/avian-influenza/2022-hpai.

(...)

Source: US Centers for Disease Control and Prevention, https://www.cdc.gov/fluview/surveillance/2024-week-51.html

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Highly Pathogenic Avian #Influenza Contributes to the #Population Decline of the Peregrine #Falcon (Falco peregrinus) in the #Netherlands

Abstract

Highly pathogenic avian influenza (HPAI) epizootics have caused repeated mass mortality events among wild birds. The effect of the infection is potentially detrimental for a variety of bird species, including the Peregrine Falcon (Falco peregrinus). The numbers of wintering and breeding Peregrine Falcons in the Netherlands have recently declined. We investigated the changes in population trends in relation to HPAI H5 virus outbreaks. For this purpose, we analyzed variations in annual numbers of wintering and breeding birds, the virology of reported dead birds, and the presence of the HPAI H5 virus in unhatched eggs. We showed that significant mortalities of Peregrine Falcons had occurred in 2016–2017 and 2020–2023, years of major HPAI H5 virus outbreaks. In particular, the highest rates of bird mortality and HPAI virus infection were reported in 2023. In this year, over 80% (28/32) of the tested birds were positive for HPAI H5 virus. No HPAI H5 virus was present in the eggs. Based on these findings, we concluded that HPAI represents a serious threat to the Peregrine Falcon population in the Netherlands, and, in combination with anthropogenic factors, may contribute to the decline of this species. Targeted HPAI surveillance and disease mitigation measures are necessary for the conservation of this species.

Source: Viruses, https://www.mdpi.com/1999-4915/17/1/24

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#USA, #Monitoring for Avian #Influenza A(#H5) Virus In #Wastewater (Dec. 27 '24)

{Excerpt}

Time Period: December 15 - December 21, 2024

-- H5 Detection: 52 sites (17.4%)

-- No Detection:  246 sites (82.6%)

-- No samples in last week:  87 sites

(...)

Source: US Centers for Disease Control and Prevention, https://www.cdc.gov/bird-flu/h5-monitoring/index.html

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Evidence of an emerging triple- #reassortant #H3N3 avian #influenza virus in #China

Abstract

The H3 subtype of avian influenza virus (AIV) stands out as one of the most prevalent subtypes, posing a significant threat to public health. In this study, a novel triple-reassortant H3N3 AIV designated A/chicken/China/16/2023 (H3N3), was isolated from a sick chicken in northern China. The complete genome of the isolate was determined using next-generation sequencing, and the AIV-like particles were confirmed via transmission electron microscopy. Subsequent phylogenetic analyses revealed that HA and NA genes of the H3N3 isolate clustered within the Eurasian lineage of AIVs, exhibiting the closest genetic relationship with other H3N3 AIVs identified in China during 2023. Interestingly, the HA and NA genes of the nove H3N3 isolate were originated from H3N8 and H10N3 AIVs, respectively, and the six internal genes originated from prevalent H9N2 AIVs. These findings indicated the novel H3N3 isolate possesses a complex genetic constellation, likely arising from multiple reassortment events involving H3N8, H9N2, and H10N3 subtype influenza viruses. Additionally, the presence of Q226 and T228 in the HA protein suggests the H3N3 virus preferentially binds to α-2,3-linked sialic acid receptors. The HA cleavage site motif (PEKQTR/GIF) and the absence of E627K and D701N mutations in PB2 protein classify the virus as a characteristic low pathogenicity AIV. However, several mutations in internal genes raise concerns about potential increases in viral resistance, virulence, and transmission in mammalian hosts. Overall, this study provides valuable insights into the molecular and genetic characterization of the emerging triple-reassortant H3N3 AIVs, and continued surveillance of domestic poultry is essential for monitoring the H3N3 subtype evolution and potential spread.

Source: BMC Genomics, https://bmcgenomics.biomedcentral.com/articles/10.1186/s12864-024-11152-x

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The #evolution of #hemagglutinin-158 and #neuraminidase-88 #glycosylation sites modulates antigenicity and #pathogenicity of clade 2.3.2.1 #H5N1 avian #influenza viruses

Abstract

Clade 2.3.2.1 of the H5N1 avian influenza virus (AIV) evolved into several subclades. However, the effect of glycosylation on the biological characteristics of hemagglutinin (HA) and/or neuraminidase (NA) from H5N1 AIVs remains unclear. Here, we determined that the global prevalence of clade 2.3.2.1 H5N1 AIVs with deglycosylated residue 158 on HA (HA158-) and glycosylated residue 88 on NA (NA88+) were predominant via multiple sequence analysis. The deglycosylation of residue on NA 88 (NA88-) was observed in clade 2.3.2.1a (new) and clade 2.3.2.1e H5N1 AIVs. Interestingly, NA88- was coupled with the acquisition of 158 glycosylation sites on HA (HA158+) in clade 2.3.2.1e H5N1 AIVs from China, and clade 2.3.2.1a (new) H5N1 AIVs exhibiting the HA158-NA88- pattern were predominant in Bangladesh. Meanwhile, the temporal distribution of strain HA158+ NA88- was highly consistent with the implementation of Re-6 vaccine in China. The recombinant H5N1 AIVs constructed using a reverse genetic system showed that the acquisition of the HA158 glycosylation site facilitated viral evasion from Re-6 antisera, and the virus lacking glycosylation sites at HA158 and NA88 resulted in reduced NA activity, replication in mammalian cells, and pathogenicity in both chickens and mice compared to that of the viruses with alternative glycosylation patterns. Therefore, the acquisition of HA158+ in clade 2.3.2.1e H5N1 AIVs enables evasion of Re-6 vaccination pressure, and the virulence of clade 2.3.2.1 H5N1 AIVs is modulated by the absence of glycosylation sites at HA158 and NA88. Our finding highlighted the importance of epidemiological surveillance and timely updating vaccines of H5 AIVs.

Source: Veterinary Microbiology, https://www.sciencedirect.com/science/article/abs/pii/S0378113524003559?via%3Dihub

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#DRC, #Kwango province affected by #influenza {A #H1N1} virus in #Panzi health zone

The flu caused by the Influenza virus, associated with malaria on a ground of malnutrition, is the unknown disease that has been decimating the population in the health zone of Panzi, in the province of Kwango, for more than a month.

This is what the diagnosis made by the INRB reveals after in-depth analyses. 

The governor of Kwango province, Willy Bitwisila, officially declared on Wednesday night, December 5, this epidemic which has caused around thirty deaths and more than 400 cases in this part of the Kasongolunda territory.

"This is the epidemic that is causing deaths in the previously unidentified Panzi health zone. 

''After a rigorous investigation, the results from the INRB laboratory have just confirmed that it is influenza caused by the Influenza AH1N1 virus, {rhinovirus, SARS-CoV-2, edited, in the article the terms are unreadable}, associated with malaria on the ground of malnutrition. 

''An epidemic that I am now officially declaring. I would therefore like to reassure each and every one of you that all necessary measures are being taken to slow the spread of this virus," said Willy Bitwisila.  

Source: Radio Okapi, https://www.radiookapi.net/2024/12/26/actualite/sante/la-province-du-kwango-affectee-par-le-virus-influenza-dans-la-zone-de

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Avian #Influenza Virus #Infections in #Felines: A Systematic Review of Two Decades of Literature

Abstract

As an avian influenza virus (AIV) panzootic is underway, the threat of a human pandemic is emerging. Infections among mammalian species in frequent contact with humans should be closely monitored. One mammalian family, the Felidae, is of particular concern. Domestic cats are susceptible to AIV infection and provide a potential pathway for zoonotic spillover to humans. Here, we provide a systematic review of the scientific literature to describe the epidemiology and global distribution of AIV infections in felines reported from 2004 – 2024. We identified 607 AIV infections in felines, including 302 associated deaths, comprising 18 countries and 12 felid species. We observed a drastic flux in the number of AIV infections among domestic cats in 2023 and 2024, commensurate with the emergence of H5N1 clade 2.3.4.4b. We estimate that this phenomenon is underreported in the scientific literature and argue that increased surveillance among domestic cats is urgently needed.

Source: MedRxIV, https://www.medrxiv.org/content/10.1101/2024.04.30.24306585v2

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Highly Pathogenic Avian #Influenza A(#H5N1) Virus: Interim #Recommendations for #Prevention, #Monitoring, and Public Health #Investigations

{Summary as of December 26 '24}

What to know

-- This guidance outlines CDC’s recommendations for preventing human exposures to highly pathogenic avian influenza (HPAI) A(H5N1) viruses and infection prevention and control measures, including the use of personal protective equipment, testing, antiviral treatment, patient investigations, monitoring of exposed persons, and antiviral chemoprophylaxis of exposed persons.

Summary

The purpose of this guidance is to outline CDC's recommendations for preventing exposures to highly pathogenic avian influenza (HPAI) A(H5N1) viruses, infection prevention and control measures including the use of personal protective equipment, testing, antiviral treatment, patient investigations, monitoring of exposed persons (including persons exposed to sick or dead wild and domesticated animals and livestock with suspected or confirmed infection with highly pathogenic avian influenza (HPAI) A(H5N1) virus), and antiviral chemoprophylaxis of exposed persons. These recommendations are based on available information and will be updated as needed when new information becomes available.

(...)

Source: US Centers for Disease Control and Prevention, https://www.cdc.gov/bird-flu/prevention/hpai-interim-recommendations.html

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#Genetic #Sequences of Highly Pathogenic Avian #Influenza A(#H5N1) Viruses Identified in a Person in #Louisiana

What to know

-- CDC has sequenced the influenza viruses in specimens collected from the patient in Louisiana who was infected with, and became severely ill from HPAI A(H5N1) virus. 

-- The genomic sequences were compared to other HPAI A(H5N1) sequences from dairy cows, wild birds and poultry, as well as previous human cases and were identified as the D1.1 genotype. 

-- The analysis identified low frequency mutations in the hemagglutinin gene of a sample sequenced from the patient, which were not found in virus sequences from poultry samples collected on the patient’s property, suggesting the changes emerged in the patient after infection.

Background

This is a technical summary of an analysis of the genomic sequences of the viruses identified in two upper respiratory tract specimens from the patient who was severely ill from an infection with highly pathogenic avian influenza (HPAI) A(H5N1) virus in Louisiana. 

The patient was infected with A(H5N1) virus of the D1.1 genotype virus that is closely related to other D1.1 viruses recently detected in wild birds and poultry in the United States and in recent human cases in British Columbia, Canada, and Washington State. 

This avian influenza A(H5N1) virus genotype is different from the B3.13 genotype spreading widely and causing outbreaks in dairy cows, poultry, and other animals, with sporadic human cases in the United States. 

Deep sequencing of the genetic sequences from two clinical specimens from the patient in Louisiana was performed to look for changes associated with adaptation to mammals. 

There were some low frequency changes in the hemagglutinin (HA) gene segment of one of the specimens that are rare in people but have been reported in previous cases of A(H5N1) in other countries and most often during severe infections. 

One of the changes found was also identified in a specimen collected from the human case with severe illness detected in British Columbia, Canada, suggesting they emerged during the clinical course as the virus replicated in the patient. 

Analysis of the N1 neuraminidase (NA), matrix (M) and polymerase acid (PA) genes from the specimens showed no changes associated with known or suspected markers of reduced susceptibility to antiviral drugs.

CDC Update

December 26, 2024 – CDC has sequenced the HPAI A(H5N1) avian influenza viruses in two respiratory specimens collected from the patient in Louisiana who was severely ill from an A(H5N1) virus infection. 

CDC received two specimens collected at the same time from the patient while they were hospitalized for severe respiratory illness: a nasopharyngeal (NP) and combined NP/oropharyngeal (OP) swab specimens. 

Initial attempts to sequence the virus from the patient's clinical respiratory specimens using standard RNA extraction and multisegment-RTPCR (M-RTPCR)1 techniques yielded only partial genomic data and virus isolation was not successful. 

Nucleic acid enrichment was needed to sequence complete genomes with sufficient coverage depth to meet quality thresholds. 

CDC compared the influenza gene segments from each specimen with A(H5N1) virus sequences from dairy cows, wild birds, poultry and other human cases in the U.S. and Canada. 

The genomes of the virus (A/Louisiana/12/2024) from each clinical specimen are publicly posted in GISAID (EPI_ISL_19634827 and EPI_ISL_19634828) and GenBank (PQ809549-PQ809564).

Summary of amino acid mixtures identified in the hemagglutinin (HA) of clinical specimens from the patient.

Overall, the hemagglutinin (HA) sequences from the two clinical specimens were closely related to HA sequences detected in other D1.1 genotype viruses, including viruses sequenced from samples collected in November and December 2024 in wild birds and poultry in Louisiana. 

The HA genes of these viruses also were closely related to the A/Ezo red fox/Hokkaido/1/2022 candidate vaccine virus (CVV) with 2 or 3 amino acid changes detected. 

These viruses have, on average, 3 or 4 amino acid changes in the HA when compared directly to the A/Astrakhan/3212/2020 CVV sequence. 

These data indicate the viruses detected in respiratory specimens from this patient are closely related to existing HPAI A(H5N1) CVVs that are already available to manufacturers, and which could be used to make vaccines if needed.

There were some differences detected between the NP/OP and the NP specimens. 

Despite the very close similarity of the D1.1 sequences from the Louisiana human case to bird viruses, deep sequence analysis of the HA gene segment from the combined NP/OP sample detected low frequency mixed nucleotides corresponding to notable amino acid residues (using mature HA sequence numbering):

-- A134A/V [Alanine 88%, Valine 12%];

- N182N/K [Asparagine 65%, Lysine 35%]; and

- E186E/D [Glutamic acid 92%, Aspartic Acid 8%].

The NP specimen, notably, did not have these low frequency changes indicating they may have been detected from swabbing the oropharyngeal cavity of the patient. 

While these low frequency changes are rare in humans, they have been reported in previous cases of A(H5N1) in other countries and most often during severe disease2345. 

The E186E/D mixture, for example, was also identified in a specimen collected from the severe human case detected in British Columbia, Canada67.

This summary analysis focuses on mixed nucleotide detections at residues A134V, N182K, E186D as these changes may result in increased virus binding to α2-6 cell receptors found in the upper respiratory tract of humans. 

It is important to note that these changes represent a small proportion of the total virus population identified in the sample analyzed (i.e., the virus still maintains a majority of 'avian' amino acids at the residues associated with receptor binding). 

The changes observed were likely generated by replication of this virus in the patient with advanced disease rather than primarily transmitted at the time of infection. 

Comparison of influenza A(H5) sequence data from viruses identified in wild birds and poultry in Louisiana, including poultry identified on the property of the patient, and other regions of the United States did not identify these changes. 

Of note, virus sequences from poultry sampled on the patient's property were nearly identical to the virus sequences from the patient but did not have the mixed nucleotides identified in the patient's clinical sample, strongly suggesting that the changes emerged during infection as virus replicated in the patient. 

Although concerning, and a reminder that A(H5N1) viruses can develop changes during the clinical course of a human infection, these changes would be more concerning if found in animal hosts or in early stages of infection (e.g., within a few days of symptom onset) when these changes might be more likely to facilitate spread to close contacts. 

Notably, in this case, no transmission from the patient in Louisiana to other persons has been identified. 

The Louisiana Department of Public Health and CDC are collaborating to generate additional sequence data from sequential patient specimens to facilitate further genetic and virologic analysis.

Additional genomic analysis

The genetic sequences of the A(H5N1) viruses from the patient in Louisiana did not have the PB2 E627K change or other changes in polymerase genes associated with adaptation to mammals and no evidence of low frequency changes at critical positions. 

And, like other D1.1 genotype viruses found in birds, the sequences lack PB2 M631L, which is associated with viral adaptation to mammalian hosts, and which has been detected in >99% of dairy cow sequences but is only sporadically found in birds. 

Analysis of the N1 neuraminidase (NA), matrix (M) and polymerase acid (PA) genes from the specimens showed no changes associated with known or suspected markers of reduced susceptibility to antiviral drugs. 

The remainder of the genetic sequences of A/Louisiana/12/2024 were closely related to sequences detected in wild bird and poultry D1.1 genotype viruses, including poultry identified on the property of the patient, providing further evidence that the human case was most likely infected following exposure to birds infected with D1.1 genotype virus.

Follow Up Actions

Overall, CDC considers the risk to the general public associated with the ongoing U.S. HPAI A(H5N1) outbreak has not changed and remains low. 

The detection of a severe human case with genetic changes in a clinical specimen underscores the importance of ongoing genomic surveillance in people and animals, containment of avian influenza A(H5) outbreaks in dairy cattle and poultry, and prevention measures among people with exposure to infected animals or environments.

(...)

Source: US Centers for Disease Control and Prevention, https://www.cdc.gov/bird-flu/spotlights/h5n1-response-12232024.html

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Recurring #incursions and #dissemination of novel #Eurasian-origin #H5Nx avian #influenza viruses in Atlantic #Canada

Abstract

Wild birds are important hosts of influenza A viruses (IAVs) and play an important role in their ecology. The emergence of the A/goose/Guangdong/1/1996 H5N1 (Gs/GD) lineage marked a shift in IAV ecology, leading to recurrent outbreaks and mortality in wild birds from 2002 onwards. This lineage has evolved and diversified over time, with a recent important derivative being the 2.3.4.4b sub-lineage, which has caused significant mortality events in wild bird populations. An H5N1 clade 2.3.4.4b virus was transmitted into North America from Eurasia in 2021, with the first detection being in Newfoundland and Labrador in Atlantic Canada, and this virus and its reassortants then spread broadly throughout North America and beyond. Following the first 2021 detection, there have been three additional known incursions of Eurasian-origin strains into Atlantic Canada, a second H5N1 strain in 2022 and two H5N5 strains in 2023. In this study, we document a fifth incursion in Atlantic Canada that occurred in 2023 by another H5N5 strain. This strain spread throughout Atlantic Canada and into Quebec, infecting numerous species of wild birds and mammals. Genomic analysis revealed mammalian-adaptive mutations in some of the detected viruses (PB2-E627K and PB2-D701N) and mutations in the hemagglutinin (HA) and neuraminidase (NA) genes that are associated with enhanced viral fitness and avian transmission capabilities. Our findings indicate that this virus is continuing to circulate in wildlife, and confirms Atlantic Canada is an important North American entry point for Eurasian IAVs. Continued surveillance and genomic analysis of IAVs detected in the region is crucial to monitor the evolution of these viruses and assess potential risks to wildlife and public health.

Source: Virus Evolution, https://academic.oup.com/ve/article/10/1/veae111/7926332

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Introducing a #framework for within-host dynamics and #mutations modelling of #H5N1 #influenza #infection in #humans

Abstract

Avian influenza A(H5N1) poses a public health risk due to its pandemic potential should the virus mutate to become human-to-human transmissible. To date, reported influenza A(H5N1) human cases have typically occurred in the lower respiratory tract with a high case fatality rate. There is prior evidence of some influenza A(H5N1) strains being a small number of amino acid mutations away from achieving droplet transmissibility, possibly allowing them to be spread between humans. We present a mechanistic within-host influenza A(H5N1) infection model, novel for its explicit consideration of the biological differences between the upper and lower respiratory tracts. We then estimate a distribution of viral lifespans and effective replication rates in human H5N1 influenza cases. By combining our within-host model with a viral mutation model, we determine the probability of an infected individual generating a droplet transmissible strain of influenza A(H5N1) through mutation. For three mutations, we found a peak probability of approximately 10-3 that a human case of H5N1 influenza produces at least one virion during the infectious period. Our findings provide insights into the risk of differing infectious pathways of influenza A(H5N1) (namely avian-human vs avian-mammal-human routes), demonstrating the three-mutation pathway being a cause of concern in human cases.

Source: MedRxIV, https://www.medrxiv.org/content/10.1101/2024.09.01.24312235v2

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#Detection and #Phylogenetic Characterization of #Influenza D in Swedish #Cattle

Abstract

Increased evidence suggests that cattle are the primary host of Influenza D virus (IDV) and may contribute to respiratory disease in this species. The aim of this study was to detect and characterise IDV in the Swedish cattle population using archived respiratory samples. This retrospective study comprised a collection of a total 1763 samples collected between 1 January 2021 and 30 June 2024. The samples were screened for IDV and other respiratory pathogens using real-time reverse transcription quantitative PCR (rRT-qPCR). Fifty-one IDV-positive samples were identified, with a mean cycle threshold (Ct) value of 27 (range: 15–37). Individual samples with a Ct value of <30 for IDV RNA were further analysed by deep sequencing. Phylogenetic analysis was performed by the maximum likelihood estimation method on the whole IDV genome sequence from 16 samples. The IDV strains collected in 2021 (n = 7) belonged to the D/OK clade, whereas samples from 2023 (n = 4) and 2024 (n = 5) consisted of reassortants between the D/OK and D/660 clades, for the PB2 gene. This study reports the first detection of IDV in Swedish cattle and the circulation of D/OK and reassortant D/OK-D/660 in this population.

Source: Viruses, https://www.mdpi.com/1999-4915/17/1/17

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#USA, #Birdflu tightens grip on #California as #human cases rise

 {Excerpts}

SACRAMENTO, the United States -- California's battle against avian influenza A (H5N1) intensified amid spreading infections across dairy farms and a growing number of human infection, including two newly confirmed cases in Stanislaus and Los Angeles counties.

The virus, commonly known as bird flu, has infected 659 of California's 984 dairy operations since August, with one-quarter of these cases emerging in the past month alone, according to California authorities.

The rapid spread through the state's dairy industry prompted Governor Gavin Newsom to declare a state of emergency last week to protect agricultural workers and public health.

(...)

The outbreak's human impact has grown increasingly severe, with California reporting at least 36 confirmed cases -- more than half of the nation's total of 65, according to the latest report by the U.S. Centers for Disease Control (CDC) on Tuesday, though the actual count is likely higher as recent local confirmations may not yet be reflected in federal data.

Two new cases were confirmed Monday in California's Los Angeles County and Stanislaus County. Both individuals were exposed to livestock infected with bird flu at a worksite, and both had mild symptoms and were treated with antiviral medications, according to the two counties' health departments.

Public health officials have been monitoring wastewater across the state, detecting the virus in several Bay Area locations, including San Francisco, Napa, and San José. However, California State Epidemiologist Erica Pan explained to ABC30 that these detections might be primarily due to "residential or other commercial milk dumping down in the sinks."

Although health officials said the risk remains low for the general public, the virus kills 90 percent to 100 percent of infected poultry and about 1 percent to 2 percent of cows. California State Veterinarian Annette M. Jones noted that infected cows may never fully recover.

As the country's largest dairy producing state, California faced a heavy economic toll from the bird flu outbreak. The virus has led to quarantines and increased testing requirements. The authorities said the state is now testing its 1.7 million cows weekly.

California's milk production dropped 9.2 percent in November from the same month last year, the most significant decline recorded, according to the monthly Milk Production Report released by the U.S. Department of Agriculture (USDA) on Dec. 19. Meanwhile, California's reduced output has led to a 1 percent decrease in national milk production, raising concerns over U.S. dairy product availability and costs.

The state's poultry operations have also been hit hard. The California Department of Food and Agriculture reported that 51 commercial poultry operations and nine backyard flocks across the state had been affected.

The virus has also appeared in unexpected places, with Los Angeles County confirming two cases in domestic cats that consumed contaminated raw milk.

(...)

Source: China Daily, https://www.chinadaily.com.cn/a/202412/26/WS676cb951a310f1265a1d503b.html

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#USA, #Oregon: Morasch #Meats of #Portland Voluntary #Recall of Northwest Naturals Brand 2lb #Feline #Turkey Recipe Raw & Frozen #Pet #Food Due to #HPAI {#H5N1} Contamination

The Oregon Department of Agriculture (ODA) is alerting pet owners that samples of Northwest Naturals brand 2lb Turkey Recipe raw & frozen pet food tested positive for a H5N1 strain of the Highly Pathogenic Avian Influenza (HPAI) virus. 

Testing conducted by the U.S. Department of Agriculture’s (USDA) National Veterinary Services Laboratories (NVSL) and the Oregon Veterinary Diagnostic Laboratory (ODVL) at Oregon State University confirmed a house cat in Washington County contracted H5N1 and died after consuming the raw frozen pet food. 

Tests confirmed a genetic match between the virus in the raw and frozen pet food and the infected cat.

“We are confident that this cat contracted H5N1 by eating the Northwest Naturals raw and frozen pet food,” said ODA State Veterinarian Dr. Ryan Scholz. 

“This cat was strictly an indoor cat; it was not exposed to the virus in its environment, and results from the genome sequencing confirmed that the virus recovered from the raw pet food and infected cat were exact matches to each other.”

Northwest Naturals, a Portland, Oregon-based company, is voluntarily recalling its Northwest Naturals brand 2lb Feline Turkey Recipe raw & frozen pet food. 

The recalled product is packaged in 2-pound plastic bags with “Best if used by” dates of 05/21/26 B10 and 06/23/2026 B1. 

The product was sold nationwide through distributors in AZ, CA, CO, FL, GA, IL, MD, MI, MN, PA, RI and WA in the United States, and British Columbia in Canada. 

Customers who have purchased the recalled product should immediately discard the product and contract the place of purchase for a full refund. 

For additional information or questions, customers may contact Northwest Naturals of Portland at info@nw-naturals.net or 866-637-1872 from 7:00 AM to 3:30 PM PST, Monday through Friday

The Oregon Health Authority (OHA) and local public health officials are monitoring household members who had contact with the cat for flu symptoms. 

To date, no human cases of HPAI have been linked to this incident, and the risk of HPAI transmission to humans remains low in Oregon. 

Since 2022, OHA has partnered with ODA through a One Health approach to investigate human exposures to animal outbreaks of avian influenza.

To avoid the spread of disease, including HPAI, state, and federal experts strongly encourage people and their pets to:

-- Avoid consuming raw or undercooked meat products

-- Avoid consuming raw dairy

-- Limit contact with sick or dead animals

-- Wash your hands after handling raw animal products or contact with sick/dead animals

-- Report sick or dead birds to ODA at 503-986-4711

-- Keep pets or poultry away from wild waterfowl

This case reminds us that feeding raw meat products to pets or consuming them yourself can lead to severe illness. 

Raw meat may contain harmful pathogens, including Salmonella, Listeria, E. coli, and H5N1. These pathogens are destroyed when meat is thoroughly cooked. 

Raw milk, which has not been pasteurized, can also carry harmful germs. Pasteurization of milk eliminates disease-causing pathogens, including HPAI.

Although Oregon has reported one confirmed human case of HPAI, there are no confirmed cases of the virus in dairy cows or cow milk. 

As a precautionary measure, ODA announced on December 11 that it will test milk from every commercial dairy across the state. Neighboring states such as Idaho, Nevada, and California have reported HPAI cases in dairy cattle herds, contributing to over 700 confirmed cases in 16 states nationwide.

Source: Department of Agriculture, https://apps.oregon.gov/oregon-newsroom/OR/ODA/Posts/Post/morasch-meats-voluntary-recall-feline-raw-pet-food-hpai

#Mpox #mRNA-1769 #vaccine inhibits #orthopoxvirus #replication at intranasal, intrarectal, and cutaneous sites of inoculation

Abstract

We previously reported that mice immunized twice with a lipid nanoparticle vaccine comprising four monkeypox viral mRNAs raised neutralizing antibodies and antigen-specific T cells and were protected against a lethal intranasal challenge with vaccinia virus (VACV). Here we demonstrated that the mRNA vaccine also protects mice against intranasal and intraperitoneal infections with monkeypox virus and bioluminescence imaging showed that vaccination greatly reduces or prevents VACV replication and spread from intranasal, rectal, and dermal inoculation sites. A single vaccination provided considerable protection that was enhanced by boosting for at least 4 months. Protection was related to the amount of mRNA inoculated, which correlated with neutralizing antibody levels. Furthermore, immunocompetent and immunodeficient mice lacking mature B and T cells that received serum from mRNA-immunized macaques before or after VACV challenge were protected. These findings provide insights into the mechanism and extent of mRNA vaccine-induced protection of orthopoxviruses and support clinical testing.

Source: npj Vaccines, https://www.nature.com/articles/s41541-024-01052-2

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#Recommendations for the #surveillance of #influenza A(#H5N1) in #cattle

Summary 

Beyond domestic poultry, influenza A(H5N1) of clade 2.3.4.4b has spread to almost all regions, infecting a wide range of wild birds, marine and terrestrial mammals, and recently, cattle in the United States of America. When an influenza virus is circulating in both avian and mammalian populations, the likelihood of spillover to humans and risk to public health may increase. The reported events of the influenza A(H5N1) virus among terrestrial and marine mammals in several countries, including the recent cases detected in the United States of America, have made it necessary to improve virus detection in cattle and other susceptible mammals and closely monitor virus evolution and adaptation to extraordinary hosts. These recommendations aim to support countries in planning surveillance for influenza A(H5N1) in cattle to enhance early detection, to generate evidence-based information to mitigate the impacts of spillover from birds to cattle, and to prevent transmission between cattle herds. Additionally, these recommendations aim to assist countries, especially low- and middle-income countries, in optimizing the use of limited resources to achieve their surveillance objectives through leveraging existing surveillance programmes. The Food and Agriculture Organization of the United Nations (FAO) recommends that all countries maintain passive surveillance for A(H5N1) to rapidly detect spillover events in non-avian species, using an appropriate case definition alongside education and outreach to relevant stakeholders to improve awareness of this emerging disease. Additionally, countries may choose to use other surveillance approaches to leverage routine and opportunistic sampling to evaluate the health of cattle populations. Event-based surveillance may also be a helpful tool in early detection. For at-risk countries,1 targeted or risk-based surveillance approaches can be used to more closely assess cattle health at the interface with poultry or wild birds, investigate suspected outbreaks in cattle, and demonstrate freedom from infection. These recommendations have a broad application to other susceptible farmed mammals.

(...)

Source: FAO, https://openknowledge.fao.org/items/4c29fcb1-67e2-4a37-a780-cb4fe0c9f253

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#USA, #California: Public #Health Confirms #Human #H5 #Birdflu Case in #LA County

 {Excerpt}

{December 23 '24}

The Los Angeles County Department of Public Health has confirmed a human case of H5 bird flu in an adult who was exposed to livestock infected with H5 Bird flu at a worksite. 

This is the first human case of H5 bird flu detected in LA County. 

The person had mild symptoms, has been treated with antivirals, and is recovering at home. 

The overall risk of H5 bird flu to the public remains low.

There is currently no evidence of person to person spread of this virus. 

Close contacts of the infected person and other workers exposed at the worksite are being monitored for symptoms and have been offered personal protective equipment, testing and antiviral prophylaxis. 

No additional cases have been identified at this time. 

Public Health is working closely with the Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CDPH) on the ongoing investigation.

“People rarely get bird flu, but those who interact​ with infected livestock or wildlife ​have a greater risk of infection. This case reminds us to take basic precautions to prevent being exposed,” said Muntu Davis, MD, MPH, Los Angeles County Health Officer. 

“People should avoid unprotected contact with sick or dead animals including cows, poultry, and wild birds; avoid consuming raw or undercooked animal products, such as raw milk; and protect pets and backyard poultry from exposure to wild animals. It is also important for everyone to get the seasonal flu vaccine, which can help prevent severe seasonal flu illness and lower the risk of getting both seasonal and bird flu infections at the same time if exposed.”

(...)

Source: Los Angeles County Public Health Department, http://publichealth.lacounty.gov/phcommon/public/media/mediapubHPdetail.cfm?cur=cur&prid=4915&row=25&start=1

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Natural #infection of common #cranes (Grus grus) with highly pathogenic avian #influenza #H5N1 in #Serbia

{Abstract}

Introduction: 

The late autumn epizootic of the highly pathogenic avian influenza virus (HPAIV) subtype H5N1 in Serbia in 2023 caused massive mortality in the migratory population of common cranes (Grus Grus). This is the first time HPAIV has been identified in the common crane in Serbia, leading to mass mortality of this bird species.

Methods: 

To understand the pathological impact of HPAIV in cranes, we evaluated the pathological changes in the tissues of common cranes. Additionally, we report genomic characterization of HPAI/H5N1. In total, 14 juvenile common crane carcasses were examined.

Results: 

Infected birds primarily exhibited neurologic signs, including ataxia and incoordination. Grossly, necrotizing pancreatitis was the most common finding, while microscopic lesions included necrosis, inflammation and hemorrhages in the lungs, spleen, brain, liver and kidneys. Based on RT-PCR, all birds were infected with the HPAI H5N1 virus, as viral RNA was detected in all 14 selected tissues. Genetic analysis revealed that our H5N1 isolate could be grouped with highly pathogenic avian influenza clade 2.3.4.4b, subgroup DA, and is very closely related to the H5N1 strains isolated from the common crane and turkey from Croatia, the common crane from Italy and the Ural owl from Slovakia.

Discussion: 

Our findings showed that common cranes are highly susceptible to natural infection with the HPAI H5N1 virus of clade 2.3.4.4b and may serve as bio-sentinels for the presence of the HPAI virus in wildlife.

Source: Frontiers of Veterinary Science, https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1462546/full

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