[Health] The Infectious Diseases Thread

[Smoove_B]

We are absolutely at the brink of another problem (emphasis added):

The Louisiana Department of Health (LDH) has detected the first presumptive positive human case of highly pathogenic avian influenza (HPAI), or H5N1, in Louisiana. The individual is a resident of southwestern Louisiana and is currently hospitalized.

LDH's Office of Public Health is coordinating with the Centers for Disease Control and Prevention (CDC) on the epidemiologic investigation. The investigation identified that the individual had exposure to sick and dead birds that are suspected to have been infected with H5N1.

Just a matter of time.

[Isgrimnur]

Just one mutation can make H5N1 bird flu a threat to humans, California researchers say

The scientists began their research by accessing a global influenza database and locating the genetic sequence for A/Texas/37/2024 — the strain of H5N1 bird flu found in a Texas dairy worker.

They then examined the hemagglutinin proteins, or spikes, on the outer surface of the virus, since those enable it to latch onto the cell membrane of its host. Animals such as birds and humans have different docking stations on their cells — known as sialic acid receptors. In order for a flu virus to open a door into a cell and begin replicating, it needs just the right spike, or key.
...
In order to figure out what it would take for the virus to gain the right docking equipment to unleash a human pandemic, Paulson, Wilson and their team looked at previous flu outbreaks that had jumped the bird-human divide, including the influenza outbreaks of 1918, 1957, 1968 and 2009 — as well as some earlier research.

They “selected a number of positions” on the hemagglutinin protein “to mutate, one at a time” with amino acids they knew had been implicated in previous pandemics.

Then they attempted to bind these altered “H” proteins with human and bird receptor analogues.

Lo and behold, when they switched a glutamine to a leucine at position 226, it no longer bound to the bird receptors, but instead exclusively to those of humans.

Paulson said it was especially interesting because this mutation had occurred before in earlier strains of H5N1, including one from around 2010 — but “at that time, that single mutation was not sufficient to change receptor specificity. So, the unexpected thing is that virus has changed in subtle ways — evolved, if you will — so that now that single mutation does change the receptor specificity.”

[Smoove_B]

For those keeping track (I know there's a lot going on), it was Malaria in the Congo:

Democratic Republic of the Congo, Dec 17 (Reuters) - Democratic Republic of Congo's health ministry said on Tuesday that a previously unidentified disease circulating in the country's Panzi health zone is a severe form of malaria.

Earlier this month, local authorities said the disease had killed 143 people in the southwestern Kwango province in November.

"The mystery has finally been solved. It's a case of severe malaria in the form of a respiratory illness... and weakened by malnutrition," the health ministry said in a statement.

It also said that 592 cases had been reported since October with a fatality rate of 6.2%.

Mosquitoes - still a killer.

[Isgrimnur]

Dr. Thomas O’Brien, visionary who addressed dangers of antimicrobial resistance, dies at 95

With insight few possessed decades ago, Dr. Thomas F. O’Brien sounded the alarm about the increasing danger of antimicrobial resistance in a world growing ever more connected. Drug-resistant strains of bacteria, viruses, and germs could emerge in far-flung places and hitch a ride on an unwitting tourist, who then headed home and spread the infection thousands of miles away.

If perils like that weren’t daunting enough, the imprecise use of antibiotics in treatment could give rise to yet more deadly, drug-resistant superbugs. “An attempt to cure one patient may eventually prevent cure of another,” Dr. O’Brien wrote in 2001.

To address these threats, he helped pioneer the use of databases that let doctors respond quickly to outbreaks of antibiotic resistance. Traveling the world, often to small hospitals in developing nations, he cultivated a network of physicians, researchers, and technicians whose observations and testing became part of a larger effort.

[Smoove_B]

More information about the H5N1 case in Louisiana, and it's not good:

A patient has been hospitalized with a severe case of avian influenza A(H5N1) virus ("H5N1 bird flu") infection in Louisiana. This marks the first instance of severe illness linked to the virus in the United States. The case was confirmed by the Centers for Disease Control and Prevention (CDC) on Friday, December 13. Since April 2024, there have been a total of 61 reported human cases of H5 bird flu reported in the United States.

Partial viral genome data of the H5N1 avian influenza virus that infected the patient in Louisiana indicates that the virus belongs to the D1.1 genotype related to other D1.1 viruses recently detected in wild birds and poultry in the United States and in recent human cases in British Columbia, Canada, and Washington state. This H5N1 bird flu genotype is different than the B3.13 genotype detected in dairy cows, sporadic human cases in multiple states, and some poultry outbreaks in the United States. Additional genomic sequencing and efforts to isolate virus from clinical specimens from the patient in Louisiana are underway at CDC.

So in short, the person here in Louisiana has the same variant of H5N1 as the hospitalized teenager in British Columbia, Canada. With no common contact, it suggests (to me) that this is moving through wild bird populations and spreading either directly to humans -or- through some type of intermediate host. They might be able to detect what animals (if any) with additional genomic sequencing - the same way they traced Sars-CoV-2 to the wet market (yeah, I fucking said it) in China.

Either way, this newly detected D1.1 variant has now caused illness in humans severe enough that requires hospitalization. For those keeping track, two of the three elements are now in place for a pandemic. The first is spread from animal to human; the second is causes severe illness. The last (and arguably the most critical) is that it spreads easily from human to human. Thankfully that's not the case, but without monitoring more people (and birds) to get an idea of how widespread it is (beyond randomly showing up in Canada and the United States), we're just passing the time as nature rolls dice.

Happy Wednesday everyone!

[LordMortis]

If no one reports it as such and there is no one to report to and track such things, there will be no evidence of wide spread human to human transmission. So we have nothing to worry about it.

[Smoove_B]

If it doesn't spread easily from human to human, that's sort of what it will look like. Random people will be hospitalized with "severe flu-like symptoms" and perhaps a doctor will be motivated to try and figure out more as part of the treatment protocol. At that point, they discover it's H5N1 and (hopefully) additional follow up is done to sequence the variant. But how much of that happens and how quickly is indeed going to vary by state given out patchwork system.

I'm confident we're passively monitoring for it; I'm not confident resources have been provided nationally to aggressively proactively monitor.

[Smoove_B]

Do not use bat guano as fertilizer for plants, especially if you plan on smoking them:

The first man, who was 59-years-old, had purchased guano online to use as fertilizer for his cannabis plants. The other man, 64, was intending to fertilize his cannabis plants with guano he'd found in his attic following a "heavy" bat infestation.

The men developed an array of symptoms from their infections, including fever, chronic cough, extensive weight loss, blood poisoning and respiratory failure. Despite being hospitalized and treated with antifungal medication, both men died of their illnesses, according to a report of their cases, published Dec. 4 in the journal Open Forum Infectious Diseases.

The doctors who treated them said that their deaths should serve as a warning about the potential dangers of using bat guano as a fertilizer for any plants. This may be a particular issue for cannabis growers.

"Given the recent legalization and an expected increase in home cultivation of cannabis, along with the promotion of bat guano for this purpose, it is important to raise public awareness about the potential risk of using bat guano as fertilizer," the case report authors wrote. The authors added that they found numerous articles calling bat guano a "natural superfood" for cannabis plants due to its high concentration of nitrogen and phosphorus.

[Max Peck]

So what you're saying is that using bat guano for fertilizer isn't just crazy...

[Isgrimnur]

We didn't pass the Guano Islands Act of 1856 because it wasn't what plants crave.

[Isgrimnur]

Norovirus outbreaks reported on 3 cruise ships this month, sickening hundreds

The CDC has logged outbreaks in 2024 on 14 cruise voyages, but three ships were hit in December. This is the only month this year when the CDC has reported three confirmed norovirus outbreaks on cruise ships and there's still more than a week to go before the month ends. In all, 301 passengers and crew members fell ill during the December outbreaks, health officials said.

Those on Princess Cruises' Ruby Princess, on a trip around Hawaii's island, and Holland America's Rotterdam and Zuiderdam voyages, both in the Caribbean, mostly dealt with diarrhea and vomiting.

[gilraen]

Noro is worse in winter. All it takes is one passenger boarding the ship while sick. Heck, there's a noro outbreak going around in Denver right now.

[Smoove_B]

Here we call it Norovirus, but over in Europe it's known as "Winter Vomiting Sickness". I respect the efficiency.

[Max Peck]

I guess freezing doesn't neutralize the H5N1 virus.

Pet food recalled over bird flu contamination after cat dies

A voluntary recall was issued for a line of raw and frozen pet food after a cat died of bird flu, a case that Oregon officials connected to the feline's contaminated food.

Northwest Naturals told consumers Tuesday to toss their Feline Turkey Recipe raw frozen pet food if its sell-by date falls between May 21, 2026, and June 23, 2026. The company's website said the batch, which was sold across the United States, tested positive for highly pathogenic avian influenza (HPAI), more commonly known as bird flu.

Consumers can call 866-637-1872 for information on a refund.

The Oregon Agriculture Department also issued a notice about the recall, which followed tests by its lab and a veterinary diagnostic laboratory at Oregon State University.

State Veterinarian Dr. Ryan Scholz said the department was confident that the cat's bird flu was contracted from the Northwest Naturals food.

"This cat was strictly an indoor cat; it was not exposed to the virus in its environment, and results from the genome sequencing confirmed that the virus recovered from the raw pet food and infected cat were exact matches to each other," he said.

[Max Peck]

It sounds like H5N1 hits cats hard.

Bird flu kills 20 big cats at US animal sanctuary

Twenty big cats - including a Bengal tiger and four cougars - have died of bird flu over the past several weeks at an animal sanctuary in the state of Washington.

"This tragedy has deeply affected our team, and we are all grieving the loss of these incredible animals," the Wild Felid Advocacy Center of Washington wrote in a post on Facebook.

The devastating viral infection, carried by wild birds, spreads primarily through respiratory secretions and bird-to-bird contact and can also be contracted by mammals that ingest birds or other products.

The sanctuary is under quarantine and is closed to the public to prevent the spread of the virus, the statement said.

The animals died between late November and mid-December, the sanctuary's director, Mark Mathews, told the New York Times.

"We've never had anything like it; they usually die basically of old age," he said. "Not something like this, it's a pretty wicked virus."

The news comes as bird flu continues to spread among cattle and poultry in the US, while also severely infecting at least one human.

The sanctuary said it had lost five African serval cats, four bobcats, two Canada lynx and a Bengal tiger, among others. Only 17 cats now remain at the Center.

"Cats are particularly vulnerable to this virus, which can cause subtle initial symptoms but progress rapidly, often resulting in death within 24 hours due to pneumonia-like conditions," the sanctuary said in its Facebook statement on Friday.

[Kraken]

Hope I can avoid risk by not buying poultry-flavored canned food. My cats prefer fish flavors exclusively, but I know that the name of the flavor only loosely reflects the ingredients.

[Victoria Raverna]

Hope I can avoid risk by not buying poultry-flavored canned food. My cats prefer fish flavors exclusively, but I know that the name of the flavor only loosely reflects the ingredients.

Worry about virus in canned food?

[Max Peck]

Hope I can avoid risk by not buying poultry-flavored canned food. My cats prefer fish flavors exclusively, but I know that the name of the flavor only loosely reflects the ingredients.

Worry about virus in canned food?

Canned food is cooked and heat-treated to prevent spoilage, so even if an ingredient came from an infected animal the virus would be neutralized.

[Kraken]

Ah, I missed "raw and frozen." No danger of my boys getting that. Never mind.