Like the number of people infected with bird flu rise in the US, continued restrictions on testing could pose a problem as these cases emerge.
Commercial laboratories are now developing tests that will be available on prescription, but the tests will still only be recommended for people in close contact with animals and animal products – even as cases in Missouri remains a mystery and wild bird migration and extreme heat could increase flooding opportunities, officials say.
Blood tests have a second person in them Missouri exposed to bird flu with no known contact with animals, officials from the US Centers for Disease Control and Prevention (CDC) told reporters on Thursday.
This person lives in the same household as the patient who tested positive for H5N1 a few weeks ago, and both people developed symptoms at the same time. The second infection was discovered after the first patient tested positive and officials began to test only for symptomatic contact with serology.
Five health care workers who developed symptoms after caring for the first patient tested negative for H5N1 on blood tests, and a sixth health care worker tested negative through a PCR test after developing symptoms, officials said.
That means the two positive Missourians don’t appear to have spread the virus to health care workers. But it’s not clear how either of them got sick in the first place.
Since the two positive people developed symptoms at the same time, health officials believe they were likely exposed to a source at the same time — although it is possible for patients to develop symptoms at different times in the course of illness, especially since one patient had significant health issues.
In particular, the original source of their infection has not yet been identified. The patients may have had contact with animals or animal products that were not detected on extended health questionnairesofficials said.
Quest Diagnostics announced Wednesday that its test for H5N1 will soon be available with a prescription from a medical provider, and other commercial labs are also developing tests for the public. But the tests will only be recommended for people with close contact with animals or animal products such as raw meat or milk.
In “the lion’s share of situations,” most people with flu symptoms do not need an H5N1-specific test, said Nirav Shah, principal deputy director at the CDC. “It’s really when there is an epidemiologic exposure history that points to H5, where the H5 test would be warranted.”
None of the Missouri cases would be found with limitations like these. However, the CDC still recommends that states routinely check positive influenza A tests for H5N1, which is how the first Missouri case was found.
The first human cases of H5N1 were also identified in Washington among workers who were killing H5-infected poultry. The state now has two confirmed and five more suspected bird flu cases in humans.
It is not clear why so many people were infected, or whether antiviral medication was provided to the workers before they had contact with the sick birds. These drugs are one of the most effective ways to prevent infections from occurring, but they do not appear to be widely rolled out for workers in very close contact with H5N1-positive animals.
“The uptake of Tamiflu has been strong, but there is still more work we can do,” Shah said. He emphasized the importance of using personal protective equipment, such as respirators and goggles, and made changes to how sick birds are culled.
to newsletter promotion
“A lot of these outbreaks are happening in places where there are cramped conditions, with poor ventilation, with a lot of birds, feathers, dust flying around,” Shah said. “Improving this can reduce the risk to confident workers.”
That’s a particular concern because the Washington outbreak may have been spread by migratory birds, he said. It is now the autumn migration season, and officials are concerned about new cases emerging among poultry – and the workers in close contact with them – in particular.
So far in the US, there have been 31 confirmed human cases of bird flu, as well as the five suspected cases in Washington and the newly confirmed case in Missouri, which will not be included in official counts because that exposure has only been verified in one. type of blood test.
None of the new human cases in Missouri, Washington or California were serious or required hospitalization, officials said.
Almost half – 15 – of the human cases were traced to 13 different dairy farms in California.
Crystal Heath, a veterinarian, took photos and videos of dead cows with X’s across their udders on a massive farm with H5N1 cases in California’s Central Valley. The cows were lying on the ground near the road, Heath said, raising concerns about biosecurity and the treatment of potentially sick animals.
Eric Deeble, deputy undersecretary for marketing and regulatory programs at the U.S. Department of Agriculture, said an investigation is ongoing into the death rates of H5-infected cows in California, and he said several factors could be at play, including excessive heat, management practices, and the density and proximity of the animals.
