Sudhir Bhatia’s Post

The recent emergence of H5N1 bird flu in various mammals has sparked global concerns. In a worrying development, house mice in New Mexico were found to be infected, raising the possibility of the virus spreading more easily to humans. Experts fear that these common rodents, which live in close proximity to human dwellings, could increase transmission. Additionally, the unknown origin of the infection in the mice highlights the potential risks associated with unpasteurized dairy products. #H5N1 #BirdFlu #PublicHealth Taking a proactive approach, Finland has become the first country to offer vaccinations to high-risk groups like poultry farmers and veterinarians. This aims to protect those most likely to come into contact with the virus. The chosen vaccine targets a similar strain and is thought to offer some protection against H5N1. However, experts caution that broader efforts to control animal-to-animal transmission and improved use of protective gear on farms remain crucial. #Vaccination #Prevention #Finland While Finland's initiative is a positive step, scientists emphasize the need for vigilance. The limited data on the vaccine's effectiveness in humans and the potential role of mink farms in facilitating mutations in the virus underscore the importance of continued research and a multi-pronged approach to prevent a potential human pandemic. #StayInformed #Research #PandemicPreparedness

Today, the New England Journal of Medicine published a report about a dairy farmworker infected with Highly Pathogen Avian Influenza A H5N1 virus (“bird flu”) who wore gloves but not eye protection. (See https://t.co/5nxgVPb36f) Farmworkers are at higher risk for contracting bird flu. Doing more to protect them (with appropriate personal protective equipment, up-to-date flu vaccination, and antiviral treatment, when needed) protects us all by lowering risk of pandemic influenza. Focusing on protecting farmworkers from bird flu in a way that involves them in the response (e.g. educating each other, looking for symptoms amongst their co-workers) could also help address other critical factors in controlling the outbreak. It could help strengthen trust to (1) increase testing; (2) facilitate seroprevalence studies and epidemiological investigations; and should we at some point have sustained human-to-human transmission, (3) help increase uptake of vaccines and treatments early in an outbreak. I saw this work when coordinating the White House #birdflu response between February 2022 - June 2023. Protecting poultry farmworkers meant they could implement biosecurity measures (see the comments for a page from the USDA’s "Defend the Flock" Biosecurity resources: https://lnkd.in/erinYdid). And then #birdflu spread between commercial poultry farms dropped. US Department of Agriculture’s (USDA) dashboard, shows the number of such farms with #birdflu were lower in April 2023 and April 2024 compared to April 2022. (See https://lnkd.in/eyDyrS_7) So, while we continue to better understand #birdflu in birds, cows, and mammals and improve pandemic readiness with vaccines, tests, and treatments, we must do all we can now to protect farmworkers. Protecting farmworkers to protect their farms protects us all.

The opinion that we are underprepared for an avian flu pandemic is reflected in 2 New York Times articles published this week (links in comments): *It’s unclear if we have the right tools to fight a human H5 pandemic. It is uncertain if the (limited) stockpile of influenza antivirals will be effective against the actual pandemic strain. Vaccine development efforts have started, but finalizing a vaccine, and manufacturing and distributing sufficient quantities will still present challenges. *Cats are getting sick from H5N1 after drinking raw (unpasteurized) milk of infected cows or preying on infected birds, with a 67% mortality rate among felines – reiterating that dairy products pose a threat if not properly treated to mitigate risk. While part of the influenza pandemic preparedness strategy can be to do more of what we already know (i.e., vaccines and antivirals), it should be complemented by innovation. The prophylactic intranasal spray we have in development to protect against influenza may enable public health to add something new to the toolbox of preparedness. #influenza #pandemicpreparedness #avianflu

Bravo #CEPI.  However that does not change our team’s posture.  We socialized the critical warning indicators in April.  Should the unlikely/unpredictable happen, we will be on our own at least for the first wave of contact, which means #infectionprevention and hospital #emergencymanagement will need to be prepared. TTX recommended. #H5N1 

U.S. is 'flying blind' with bird flu, repeating mistakes of COVID, health experts say It's not just the United States, I'm afraid. Globally, we don't seem to have applied what we have learned to prevent or mitigate the impact of future pandemics. The second article summarizes how the disease is not spreading via the airborne route but it does happen. "Experiments done in labs offer some clues. They have shown mammals can pass on this version of H5N1, and even offer some preliminary evidence suggesting limited airborne transmission." The article cites several research publications, including Canada's National Microbiology Laboratory, that provide data into how this virus spreads. "They also found evidence the virus had spread through the air between ferrets in different cages, but they didn't see severe illness in the animals who were infected in this way. It's possible there wasn't enough virus being transmitted to overcome the immune barriers that would prevent infection." The third article describes how one can protect themselves against the virus. It mentions that, "avian influenza viruses can spread through animal feces and secretions (such as mucus and saliva). Human infections can happen when the virus gets into a person's mouth, nose or eyes, or is inhaled. This can happen when the virus is in the air in droplets, or possibly through dust or feathers, and a person breathes it in." When public health officials use the word "droplets," this signals to me that they think it drops onto other items where it is picked up. This seems to be supported by the fourth reference, which was published last month. The authors discuss that their "studies show that the A/mink (H5N1) virus transmitted efficiently by direct contact, with 75% of contact animals infected, and inefficiently via the airborne route with 37.5% of respiratory contact animals developing an infection." The authors detailed how they evaluated the reproducibility of airborne influenza virus transmission. They used the same technique that demonstrated a "100% airborne transmission of the 2009 pandemic H1N1 virus" and "25% airborne transmission of an avian H1N1." The authors do warn that, "collectively, experimental data indicate that some clade 2.3.4.4b viruses of both the North American and Eurasian lineages transmit between ferrets that are in direct contact and that these viruses possess potential for limited airborne transmission. These findings emphasize the pandemic potential of clade 2.3.4.4b H5N1 viruses." #diseaseprevention #h5n1 Sources: 1) https://lnkd.in/eZF-SHdq 2) https://lnkd.in/eJNcCUjr 3) https://lnkd.in/eE6aG36B 4) https://lnkd.in/eYnEqrd7

Potential for Bird flu pandemic and lessons from COVID-19 I posted a week ago highlighting what is going on in the USA in the bird flu scene. Here is a helpful piece from Times. Titled "How to Stop Bird Flu From Becoming the Next Pandemic" this draws on some of the erros USA made in the early stages of the COVID-19 pandemic and warns that this should not be repeated. Some striking lines from this piece. "We find ourselves in a situation reminiscent of early 2020, when the U.S. stood on the brink of the COVID-19 pandemic and hesitated to take decisive action, restricting testing to only those with epidemiological links to China". "We must stop flying blind. Regular and widespread testing is our only way to detect H5N1 and stop the virus from spreading". The US Federal government holds influenza antiviral Tamiflu as well as personal protective equipment (PPE) in its Strategic National Stockpile. The question this for us this side of the pond do we have the same. I am sure we do. The author ends with this enlightening paragraph. "Success in public-health prevention is difficult to spot, and success in preventing a pandemic can be misconstrued as a failure or a misappropriation of funds. It’s nearly impossible to recognize the absence of a pandemic that never happens, but would have if not for aggressive and early efforts. However, tracking detections and documenting actions taken will help. The cost of inaction far outweighs the cost of prevention. We risk losing all the lessons learned from COVID-19 if we don't apply them now". https://lnkd.in/gWFiBQx9

Announcing the publication of my latest article, 'Fractional Order Model For Evolution Of Bovine Tuberculosis With Vaccination And Contaminated Environment'. Read it here: https://lnkd.in/eWqaB-4p #PublishedWithHindawi @Hindawi

April 29, 2024 H5N1 is not your run of the mill seasonal flu virus. If you think COVID-19 is bad, H5N1 may be a lot worse. Excerpts from Helen Branswell, “There’s never a good time to drink raw milk. But now’s a really bad time as bird flu infects cows.” https://lnkd.in/d5YUg3Bd  “...drinking raw milk that is infected with H5N1 could deliver a whopping dose of virus to a person’s system — enough to trigger a fatal infection in lab studies where small animals are experimentally infected with H5N1.” We think of flu viruses as pests that plague our upper and sometimes lower respiratory tracts, causing congestion, sneezing, fever, coughing, and in some cases triggering pneumonia. Because of their biology, the influenza A viruses that routinely transmit among people — H1N1 and H3N2 — are effectively limited to infecting the cells in the respiratory tract, said Florian Krammer, an influenza virologist at the Icahn School of Medicine at Mount Sinai in New York. But H5N1 has more tricks up its sleeve than seasonal flu viruses do; it can infect organs other than the lungs. Kuiken noted that the virus has been seen to move into the liver, the central nervous system and the brain, among other tissues. He saw the latter when he experimentally infected cats in the mid-2000s. Similar results were seen when baby goats were infected with the virus on a Minnesota farm in March. Ten of the kids died; necropsies on five of them showed virus in the brains and other organs. Many of the animal species infected in the wild have been reported to sustain damage outside of the respiratory tract. It’s believed these animals — bears, raccoons, seals, foxes, and a raft of other mammals — became infected by eating sick or dead wild birds or poultry infected with the virus. “So many, many species, they get a brain infection and brain disease, not a pulmonary disease,” Kuiken said. “In some cases the disease is missed because people are expecting pneumonia. If the animal is found dead, they don’t see the neurologic signs, and they forget to test the brain.” Human infection with flu occurs when people breathe viruses emitted by others into their upper respiratory tracts. But the shared real estate of the top of the respiratory and gastric tracts make it impossible to rule out the possibility that ingestion of food or drink that contained high levels of viable H5N1 virus could trigger infection, scientists said.   Kuiken’s study of H5N1 in cats. Milk acts as a buffer, “It’s the perfect fluid for [virus] reaching the intestine in an infectious state.” “In a way, we think we know H5, but the cow trick was completely new and we don’t know what the virus would do when it goes into humans. Maybe it does something very unexpected. There’s just not enough data to say anything conclusive. So I think people should just be watchful,” he said.

The ongoing spread of avian flu among animals has increased the urgency of developing products that could prevent infection in the event of an H5N1 pandemic. We’re excited to announce our publication of a new study in Nature Portfolio Scientific Reports showing that the CR9114 antibody can protect intranasally at low dosages against H5N1 in vivo.   The study found that CR9114, delivered intranasally, fully protected against H5N1 infection in vivo. By contrast, vaccination with the seasonal quadrivalent influenza vaccine with H1, H3, B/Yam and B/Vic antigen, did not cross-protect mice from H5N1 challenge. Furthermore, CR9114 neutralized 10 different strains of H5 influenza in vitro, further confirming its breadth of potential protection.    Broad protection is critical amid pandemic situations, when there’s no way to know in advance which strain will predominate. CR9114 uniquely targets a highly conserved epitope of flu viruses allowing this broadly protective quality. At Leyden Labs, we remain focused on the discovery, optimization, and development of antibodies that can deliver broad and immediate protection to combat respiratory viral threats. Read the full publication here: https://bit.ly/48laZdF   #biotechnology #avianflu #birdflu #H5N1 #influenza #flu