Coronavirus and Avian Flu Tidbits # 296, May 26, 2024

Wastewater data:

Infections are growing, esp in Hawaii, Delaware, Nevada, and Minn

https://data.wastewaterscan.org/tracker/?

https://public.tableau.com/app/profile/sara.anne.willette/viz/USCompositeWastewaterData/NWSSData

Biobot data has disappeared, likely d/t loss of funding

We are flying blind: (as of May 1): US hospitals do not report Covid hospital admissions, hospital capacity, or hospital occupancy data.

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Major Study on Masking--An extensive review:

First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens.

Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption.

https://journals.asm.org/doi/10.1128/cmr.00124-23

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WHO's latest:

“#WearAMask when in crowded indoor spaces to help you stay safe from #COVID19, flu and other respiratory illnesses.”

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Alzheimer's:

The connection between SARS-CoV-2 and neurodegeneration www.thelancet.com/journals/lan... “ SARS-CoV-2 infection should be considered as a risk factor for Alzheimer’s disease, even though the distinction between causation versus disease acceleration is not clear.” - Eric Topol

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Survey for Covid and Novid patients:

https://covid-long.com/

Mask restrictions:

The North Carolina House of Representatives voted Wednesday not to concur with the Senate on a bill that would reinstate mask restrictions in North Carolina. It would eliminate an exception to the state’s ban on masking that’s been in place since the early days of the COVID-19 pandemic and has allowed people to wear masks for health and safety reasons.

https://www.cbs17.com/news/north-carolina-news/nc-house-votes-not-to-concur-with-bill-reinstating-mask-restrictions/

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Estimate of 43% rate of multidrug resistance in COVID patients

A meta-analysis of 173 studies involving nearly 900,000 COVID-19 patients in more than 50 countries finds that 42.9% were infected with multidrug-resistant organisms (MDROs), which the authors say underscores the urgent need for stronger antimicrobial stewardship strategies.

The study, led by Sun Yat-sen University researchers in China, was published in the Journal of Infection.

https://www.cidrap.umn.edu/covid-19/global-meta-analysis-estimates-43-rate-multidrug-resistance-covid-patients

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Avian Flu:

Important perspective:

Scientists call new measures to control bird flu in cows ‘a drop in the bucket’

So far, FDA has tested  (only ) 297 samples of milk and milk products such as cottage cheese and sour cream from 38 states. Samples that tested positive for the virus with PCR were then injected into embryonated chicken eggs to see whether any virus could be grown from it. (None did)

Scientists say much more could be done. “At milk processing plants, every incoming tanker load of milk is checked for adulterants, including antibiotics, and quality and safety standards,” says veterinarian Kay Russo, who played a key role in the first detection of H5N1 at dairy farms. Testing for H5N1 as well could reveal “the pervasiveness of this virus almost overnight.”

Virus can persist on milking equipment surfaces

The H5N1 avian influenza virus infecting dairy cows can persist and remain infectious in unpasteurized milk on milking equipment surfaces for a long period, researchers from the University of Pittsburgh and Emory University reported yesterday in a preprint study.

In experiments designed to help flesh out the risk to dairy workers, they examined the persistence of H5N1 in unpasteurized milk on surfaces found in milking equipment, including the inflation rubber liners and stainless steel, which make up the "claws" in milking machines that attach to udders.

The group noted steps involved in attaching the milking machine to the udders can spread contaminated milk to the workers at several points, including when the milk is stripped by hand—producing spatters and aerosols — before the machine is attached. Release of the machine at the end of milking can spray workers, and surrounding equipment can also release aerosols.

"Milking often takes place at human eye level, with the human workspace physically lower than the cows, which increases the potential for contact of infectious milk with mucus membranes. Currently, no eye or respiratory protection is required for dairy farm workers," they wrote.

Threat to workers, clues for cow-to-cow spread

They found that H5N1 remained infectious in unpasteurized milk on rubber liners and stainless steel for more than an hour.

https://www.cidrap.umn.edu/avian-influenza-bird-flu/h5n1-avian-flu-viruses-can-persist-milking-equipment-surfaces

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H5N1 avian flu case in Australia, involving a child who contracted the virus in India

https://www.cidrap.umn.edu/avian-influenza-bird-flu/australia-reports-imported-human-h5n1-avian-flu-case-and-unrelated-high

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Store-bought milk could be another way to track the bird flu outbreak in cows

Scientists from the University of Washington and the Fred Hutchinson Cancer Center have managed to generate a full genetic sequence of H5N1 virus from milk, a development they suggest means commercially purchased milk products could be used to monitor the progress of the bird flu outbreak in dairy cattle and to check for important changes in the virus over time.

With dairy farmers still reluctant to allow testing of their cattle, scientists trying to assess whether the outbreak is increasing or waning are in the dark. Likewise, their surveillance for important changes in the viruses — changes that would signal the virus is evolving to be better able to infect mammals — has been hampered by the limited data being shared by the U.S. Department of Agriculture.

Analyzing store-bought milk could provide a work-around, the University of Washington and Fred Hutchinson researchers suggested, similar to the efforts underway to analyze wastewater from around the country to check for presence of influenza A viruses. (H5N1 is a member of that large family of flu viruses.)

https://www.statnews.com/2024/05/21/bird-flu-virus-spread-scientists-monitor-h5n1-in-store-bought-milk/?

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No known dairy or poultry links in South Dakota cats

A few H5N1 detections in cats were reported earlier in the US dairy farm outbreaks, and some of the animals were known to have consumed raw milk from infected cows. However, officials have now reported two infections in domestic cats without links to poultry or dairy cow outbreak farms.

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“One study produced during the current outbreak, …showed the cells in cows' mammary glands can be infected by both avian and human influenza viruses, perhaps giving it opportunities to further adapt in ways that could one day facilitate human-to-human transmission.”

https://www.cbc.ca/news/health/bird-flu-in-u-s-cows-caught-scientists-by-surprise-canadian-research-has-seen-it-coming-since-1953-1.7212587

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In a May 10 response update, the CDC said more than 260 people have so far been monitored for H5N1 symptoms following exposure to infected or potentially infected animals. Of at least 33 who had flulike symptoms,

(now 2 cases w conjunctivitis)

https://www.cidrap.umn.edu/avian-influenza-bird-flu/wastewater-testing-finds-h5n1-avian-flu-9-texas-cities

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Other:

In a new JAMA Dermatology report, researchers describe 11 Trichophyton indotinea infections in New York City from May 2022 to May 2023. The fungus represents a new emerging public health threat that causes extensive tinea infections often unresponsive to terbinafine, a first-line oral antifungal.

https://www.cidrap.umn.edu/antimicrobial-stewardship/drug-resistant-trichophyton-fungus-represents-emerging-threat-us