Louisiana H5N1 patient died

https://www.washingtonpost.com/health/2025/01/06/bird-flu-first-human-death-us/
Only two human patients have been infected with the H5N1 genotype D1.1 avian influenza virus, but it may be just as deadly as the Asian H5N1 virus that had a 50% mortality associated with human infections.
The D1.1 genotype is a reassorted virus and has parts of it's genome that are different from the H5N1 Asian strain, but the two human infections acquired the mutations needed to change the wild virus into one that would better infect humans.  The claim is that the wild birds in the area did not have those mutations in the D1.1 influenza sequence, so they occurred during the infection of the two humans.
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The Louisiana patient’s death does not change the overall assessment by the Centers for Disease Control and Prevention of the immediate risk to the public’s health from H5N1 bird flu, which remains low. The CDC has expanded its recommendations for testing and treatment of bird flu during the past few months for anyone with high-risk exposure, primarily farm workers.
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This is just stupid denial on the CDC's part.  Not only that, but nothing has come out of testing, and no results have have been published of the effort to test more dairy workers and poultry workers.  The additional testing was supposed to start 2 months ago, but a renewed claim came in early December that more testing was going to be done. In early November the USDA was supposed to start testing all the herds in states that were known to have infected dairies, and the CDC was supposed to start testing dairy workers, but neither of those things happened.  Now the USDA is supposed to be working on their Silo study, but it hasn't produced any results, and neither has the CDC's claims to test more workers.  They admitted that they needed to test the workers so that they could start treating them and decrease the chance that the mutations that would make the virus more lethal would occur in a human patient.
The CDC is also not making a distinction between the genotype D1.1 infections and the B3.13 infections.  For the B3.13 infections the CDC should have been running tests on dairy workers and contact tracing from day one, and all the infected dairy herds should have been looked for and detected by now.  To prevent dairy worker infections they needed to identify infected dairies and mandate the use of protective gear on infected farms.  Instead the never searched for the infected dairies and only recommended protective gear be worn on dairies known to be infected.  The B3.13 dairy infection is being spread among dairy cattle and poultry farms by dairy workers.  There can be transfer of infected cattle, but after the first infected farms are found most states have restricted cattle movements, but they refuse to restrict dairy worker movements.  Wild birds have about zero to do with the current dairy epidemic.
It is different for the D1.1 virus.  It is coming from wild birds, and the humans seem to be getting it by having their poultry infected by the wild birds.  What the CDC needs to do in this case is try to limit exposure to the virus.  This is very difficult because D1.1 is likely already infecting repiratory tissue.  When birds get infected they can start shedding infective virus on their feather dander (feather dust). Everyone should understand that poultry workers are very susceptible to being infected by infected birds.  Colorado had 9 poultry workers infected with the dairy virus and Washington had 11.  Colorado only claimed 1 infected dairy worker, and Washington hasn't looked for infected dairies.  Anyone that has worked with poultry knows that you can't keep from breathing in feather dust when working with birds unless you are in a hazmat suit or have a tight fitting gas mask.  You can't keep the dust out of your eyes by wearing ventilated goggles.  You again need a hazmat suit or gas mask.
They need to know which populations of wild birds are harboring the D1.1 genotype and they need to know where so that they can warn people to start taking precautions.  It may be too late, but as soon as their pet birds start looking sick they need to call the authorities and have them checked and they need to minimize their contact.  The CDC should be thinking about vaccinating the people with likely bird contact against the D1.1 genotype.  The two cases so far tell us that we do not want anyone else to be infected.  Both cases likely produced a possible next pandemic virus that could spread through the human population.  Both cases had the mutations needed to make the virus more likely to infect humans.  Two of these mutation make it so the virus likely cannot infect birds any longer and it adapts them to the most common receptor found in mammals.
Ron Okimoto