Re: 7% of dairy workers at infected farms seropositive for the dairy virus

On 11/7/2024 7:58 PM, RonO wrote:

On 11/7/2024 3:38 PM, RonO wrote:

https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm?s_cid=mm7344a3_w
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Michigan and Colorado did a "convenience" sampling (without regard to the person showing symptoms at infected dairy farms.  115 people were tested and 8 of them were found to be more seropositive than the Missouri case (positive for 2 of the 3 assays instead of just one).  If you have been following my posts on this subject I have contended since early in the dairy epidemic that around 5% dairy workers infected could account for the spread between herds and to poultry flocks.  These workers would be shedding virus, and it would not have to survive on equipment (only infective for 24 hours) or skin and clothing (infective for less than 30 minutes).  The contact tracing in California just demonstrated that it was likely the dairy workers were taking the virus to other dairies and poultry farms.  Now these test results indicate that they should have been running contact tracing from the very beginning as I have always claimed.
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It should be noted that the first Michigan survey that got negative seropositive testing biased their sample to those dairy workers that had not exhibited symptoms.  They also did not include the positive control of the known infected dairy worker.
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QUOTE:
This finding supports the need to identify and implement strategies to prevent transmission among dairy cattle to reduce worker exposures and for education and outreach to dairy workers concerning prevention, symptoms, and where to seek medical care if the workers develop symptoms.  Timely identification of infected herds can support rapid initiation of monitoring, testing, and treatment for human illness, including mild illness, among exposed dairy workers.
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This is what I have always claimed, and what the CDC and USDA have refused to recognize from the beginning of the dairy epidemic.  Both agencies refused to attempt to identify all the infected herds.  It is sad that it has taken this long for them to admit that they have been wrong, and that there should be an effort to identify all the infected herds to decrease the risk of infection of dairy workers.  The more workers infected the more likely the virus will become the next pandemic virus.  The poultry industry has lost millions of birds to the dairy virus, and there is the possibility that egg prices will go up like they did last time because the CDC and USDA would not act and do what should have been done.  It isn't wild birds this time, but dairy cattle and dairy workers spreading the virus.  Infected dairy workers explains how dairy herds in states that did not get cattle were infected, and they knew that dairy workers could be infected and shed live virus from the first human case in Texas where they were able to isolate live virus and culture it.
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It also should be noted that months ago research was put out that 2 out of 14 Texas dairy workers tested seropositive for the dairy virus, but the CDC has never recognized those individuals as having been infected. Both seropositive workers came from the same farm and one of them did not have contact with cattle (the person worked in the dairy cafeteria) raising the possibility that there was human to human transmission.
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Ron Okimoto

 The CDC is admitting that some of the positive workers did not show symptoms and had an asymptomatic infection.  It turns out that this study excluded workers that were exhibiting symptoms.  It may mean that if they started testing all the workers that had symptoms.  California may have found over 50% of those tested with symptoms were positive, and the positive poultry workers were tested because they had symptoms.  As crazy as it may seem no other state tested the dairy workers with symptoms before California started to do it.  Even Colorado only tested a few workers.  There hasn't been any systematic testing.
 It sounds like the CDC wants to start testing all Dairy workers at infected farms whether they show symptoms or not and get them treatment. This means that they will have to start routine testing of dairy farm workers, but first they have to identify all the infected dairy herds. They need start testing herds in Washington and Oregon, and other states that had poultry flocks like Florida that had poultry flocks go down with the dairy virus and they will likely find positive herds like Utah just did.
 https://apnews.com/article/bird-flu-dairy-workers- h5n1-20d6a20ea9e1047ad7a92f9da31709f8
 Ron Okimoto
 

https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm#T3_down
In reviewing the CDC report it looks like the actual number of past dairy virus infections could be much higher than 7%.  They used the Texas virus to look for neutralizing antibodies, but we know that the Texas virus has a couple amino acid substitutions in it relative to the virus isolated from the Michigan dairy worker, and the Colorado dairy strain was most closely related to the one isolated from one of the Michigan dairy workers.  The Missouri patient was infected with a virus with 2 amino acid substitutions in the H5 gene that decreased the neutralizing ability 10 to 100 fold, and the CDC had to make a synthetic H5 gene with those two mutations in order to test for neutralizing antibodies.  The test essentially failed and only one test out of the three indicated prior infection.  The conclusion was that even though this person had been producing virus they did not mount an effective immune response.  They need to use the actual H5 gene that the Michigan and Colorado dairy workers were exposed to in order to get a more accurate test result.  They again did not include known infected workers as controls.  The Missouri patient may have totally failed if the Texas H5 sequence had been used to test for neutralizing antibodies.
Table 3 indicates symptoms.  26 of the negative workers reported eye related symptoms (the most common symptom reported by virus positive workers).  3 of the 4 workers reported eye related symptoms and were positive.  California started testing workers with symptoms and they were getting more than 50% positives.  They only claimed to have tested 39 workers when 21 had been confirmed to be positive.  It looks like antibody testing may have missed a lot of past infections.  It is of interest that one of the positive workers claimed to have had diarrhea (the same symptom that the CDC refuses to acknowledge as one of the symptoms for H5N1 infection that the Missouri patient exhibited).  6 others that reported diarrhea tested negative, and it should be noted that the Missouri patient evaluation was essentially a fail, the CDC does not acknowledge the close contact that had the same single test positive result as being a second case of infection in Missouri.
It looks like gut infection could be a possiblity as it was in Missouri, so the FDA really should reevaluate their milk testing to make sure that the virus is not surviving pasteurization.  The Missouri patient and their close contact could have shared the same bottle of milk.  For the CDC it is the stupid lie of omission.  They repeatedly have claimed that the Missouri patient did not exhibit the usual symptoms for influenza infection, but they keep leaving out that the patient had symptoms associated with H5N1 human infections in Asia.
Ron Okimoto