Share this page!

Enter URL or ID to Unroll

You can paste full URL like: https://x.com/threadreaderapp/status/1644127596119195649
or just the ID like: 1644127596119195649

How to get URL link on X (Twitter) App

  1. On the Twitter thread, click on or icon on the bottom
  2. Click again on or Share Via icon
  3. Click on Copy Link to Tweet
  4. Paste it above and click "Unroll Thread"!
  5. More info at Twitter Help
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
@celinegounder
Apr 29 • 8 tweets • 3 min read • Read on X
1/ There are still lots of unanswered questions re: H5N1 bird flu

🔹How quickly is the virus mutating and evolving?

A PB2 E627K mutation was found in the human case in Texas, but not seen in birds or cows.
(1:04:50)astho.org/education/hpai…
2/ The PB2 E627K mutation has been seen in other human cases of H5N1.

It is one step towards mammalian (but NOT human) adaptation in experimental studies. (h/t @RickABright)
3/ The PB2 E627K mutation may have developed in the human Texas case.

It has not been seen in Texas dairy cattle or birds, nor in wild birds or poultry.
4/ What's concerning is that the PB2 E627K mutation appeared quickly:
🔸the virus mutated in this individual
or
🔸there was evolutionary pressure selecting for this mutation from among sub-dominant species.
5/
 🔹A lot more research is needed to understand the viral evolution.

Not only how the virus is evolving in birds, cows, & cats but also in other mammals:
nature.com/articles/s4200…
6/ A dolphin in Florida was found to have H5N1 avian flu with a S246N neuraminidase substitution leading to reduced inhibition by neuraminidase inhibitor oseltamivir (i.e. resistance to Tamiflu).
nature.com/articles/s4200…
7/
🔹How common is it for asymptomatic cows to have virus in the lungs?
aphis.usda.gov/sites/default/…
Image
8/
🔹How much is the H5N1 bird flu virus spreading among beef cattle & non-lactating dairy cows?

Testing is being focused on dairy cattle being moved across state lines.

🔹But what's happening within states?
Image
Image

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Céline Gounder, MD, ScM, FIDSA 🇺🇦

Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @celinegounder

Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 29
1/ H5N1 bird flu candidate vaccine viruses have been identified:
(jump to 1:33)
🔹2 are "well-matched" to H5N1 infecting dairy cattle
🔹but how "well-matched" are they really? this conclusion is based on ferret dataastho.org/education/hpai…Image
2/
 🔹Candidate vaccine viruses are used to make antigen (i.e. the target you want the immune system to see) for vaccines.
🔹Adjuvant has also been stockpiled.
🔹Adjuvants help strengthen the immune response to antigen in vaccines. Image
3/
🔹100s of thousands of doses of candidate antigen + adjuvant have been manufactured for use in clinical studies.
🔹2 safety/immunogenicity studies are being conducted.
🔹@ASPRgov is working with @US_FDA & industry to figure out a regulatory pathway for the use of these doses.
Read 4 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 25
1/ Stemming the spread of H5N1 bird flu
🔹The federal government is ramping up testing of dairy cows
🔹Cows will now have to be tested before being transferred to another state
🔹H5N1 viral fragments detected in grocery store milk
🔹The risk to humans remains low at this time
2/ Remember PCR tests from COVID?

They can be positive even after you’ve recovered because they’re picking up dead virus.

Some PCR tests on pasteurized milk from grocery stores have come back positive for bird flu... but that could just be dead virus.
3/ Pasteurization has worked for over a hundred years to protect consumers from bacteria and viruses.

There’s no reason to think pasteurization won’t also work to kill the bird flu virus, but scientists are confirming that with testing anyway.
Read 16 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 23
1/ H5N1 bird flu has been detected in the milk supply




We currently believe the milk supply to be safe.

Some other key points:washingtonpost.com/health/2024/04…
nytimes.com/2024/04/23/hea…
fda.gov/food/alerts-ad…
2/ The levels of virus fragments being found in milk by PCR are high.

Milk from different cows is combined into big vats.

You wouldn't see such high levels of virus if only a couple cows were infected... it would be diluted down.

This implies many cows have been infected.
3/ I suspect there's been a ton of asymptomatic transmission among cows.

They've only been testing symptomatic cows.
Read 8 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 2
1/ The 2nd human case of H5N1 bird flu was reported in the US yesterday.

This case was in Texas & likely involved transmission from an infected cow🐄 to this individual.

The 1st case was reported in Colorado in 2022.

with @tonydokoupil @GayleKing @nateburleson
2/ The person in Texas became ill with H5N1 bird flu after direct contact with infected dairy cattle🐄.

The patient's primary symptom was conjunctivitis (i.e. pink eye).

The patient is isolating & is being treated with an antiviral for flu... as are their close contacts.
3/ The risk to the general public is believed to be low at this time.

Risk factors for H5N1 bird flu:
🔹Close contact with animals suspected of having H5N1 bird flu
🔹Close contact with someone infected with H5N1 bird fluImage
Read 23 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Mar 18
1/ Health workers fear it's profits before protection as CDC revisits airborne transmission by @KFFHealthNews' @amymaxmen

So incredibly brave of Dr. @sonyastoked to speak out:
nbcnews.com/health/health-…
Image
2/ Image
3/ Image
Read 7 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Mar 12
1/ U.S. Healthcare System Reels from Cyberattack

with @CBSNews' @errolbarnettcbsnews.com/news/change-he…Image
2/ The February 21st cyberattack on a medical payment processing company Change Healthcare, a unit of insurance giant UnitedHealth Group's Optum division, is the worst cyberattack on the U.S. healthcare system in history.
3/ Change Healthcare company processes 15B health care transactions annually & touches 1 in every 3 patient records.

Change Healthcare controls providers’ ability to process claims for payment, patient billing & patient cost estimation services.
Read 11 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

Send Email!

:(