Possible cluster of human bird-flu infections expands in Missouri | Hacker News Reader

Possible cluster of human bird-flu infections expands in Missouri

nytimes.com

104 pointsctoth35 comments

From Stat (via another submission):

The fact that the Missouri Department of Health and Senior Services is still finding such individuals weeks after the H5N1 patient was released from hospital is raising concerns about the rigor of the investigation that the state is running. The CDC cannot send investigators to a state unless its help is requested, and that hasn’t happened.

<https://www.statnews.com/2024/09/27/bird-flu-missouri-four-m...>

One of the factors that strongly contributed to a previous pandemic's early spread was exceedingly poor track-and-trace epidemiological surveillance. Finding that particular failure being repeated so soon afterwards is indeed distressing.

This seems worth watching.

“A/H5N1 virus can also infect mammals (including humans) that have been exposed to infected birds; in these cases, symptoms are frequently severe or fatal.[2]”

“Due to the high lethality and virulence of HPAI A(H5N1), its worldwide presence, its increasingly diverse host reservoir, and its significant ongoing mutations, the H5N1 virus is regarded as the world's largest pandemic threat.[16]”

https://en.m.wikipedia.org/wiki/Influenza_A_virus_subtype_H5...

Yes. Not all H5N1 is created equal, but several strains have shown a frighteningly high severity.

Thinking of established seasonal flu as reference could easily be very misleading.

If indeed it's human-to-human transmission, it doesn't mean it's likely to be as transmissible as Covid, or even other flu strains. What really set Sars-CoV-2 apart was its high transmissibility right off the bat.

The most important thing is tracing and isolating the carriers before it spreads, and before it's had a chance to evolve and become more transmissible yet. Influenza in general is one of the hardest pathogens to contain.

> To date a total of seven people who were in contact with the confirmed case have been identified as having been ill — a household member and six health care workers. One of the health workers tested negative for influenza when he or she was ill.

If all cases of illness are from the flu, that sounds pretty transmissable to me.

We know they were in contact, but we don't know the extent of the contact. Did they just walk into the room once and leave after 2 minutes? In early 2020 in Wuhan that would have been enough.

The OG strain was much less transmissible than D614G or Delta/Omicron. Most transmission chains died out and R0 was < 1. That was offset by superspreaders (or superspreading events) where one person could infect dozens of people. Typically, this happened with prolonged (1+ hour) contact with someone that was projecting their voice (restaurants, choir practice). There were documented cases of much more casual contact producing transmission, but this wasn't common. Later variants were more inherently transmissible, but it has never reached the level that you suggest.

And all that is needed for a pandemic like SARS-CoV-2 is for an R0 of around 2-3, so one person infecting 2-3 others, on average. If we really have a cluster of 6 health care workers, that is enough to get extremely alarmed.

It's true that Covid superspreading was a thing, but the R0 for WT was 2.66 [1], which is >> 1 even without superspreaders. Heck, Rt was often > 1 during lockdowns in Europe and the US when there were zero superspreading events. It took an unprecedented 12-week lockdown to put it out in Wuhan/Hubei. One person per household was only allowed to leave the house once every two days. [2]

It's also true that Omicron required much less contact to spread. Instead of being in the room for 2 minutes like in my WT example, 10 or 20 seconds might be enough. [3]

I do agree that what we know about H5N1 is plenty enough to be alarmed.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9517346/

[2] https://en.wikipedia.org/wiki/COVID-19_lockdown_in_China

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713573/

> the R0 for WT was 2.66

That number includes superspreading events which inflates it.

> What really set Sars-CoV-2 apart was its high transmissibility right off the bat.

...

Pun unintended. Freudian slip? OK, right off the Pangolin then.

4 infected trained professionals from a bit of contact by is high

Missouri passed an ag gag law back in 2012, so a lot of fog has been cast around how dangerous chicken is right now for legal reasons.

They really need to use positive-pressure helmets or full face masks of some sort. SCBA or PAPR.

> Because the initially identified patient had no known exposure to infected animals, he or she may have acquired the virus from another person who was infected.

well that's absolutely terrifying.

> The CDC continues to characterize the risk posed to the general public by the H5N1 outbreak as “low.”

I can’t take such statements seriously after what happened during COVID, with various organizations initially downplaying the issue, then taking it to new heights of hysteria, changing stances on masks, not seriously pursuing the lab leak theory, seeking to censor/oppress different opinions, etc. I am concerned that statements like this look just like what happened at the start of COVID.

> The fact that the Missouri Department of Health and Senior Services is still finding such individuals weeks after the H5N1 patient was released from hospital is raising concerns about the rigor of the investigation that the state is running.

> As of Friday, 239 herds in 14 states have tested positive for H5N1, though that is believed to be an underestimate of the true scope of the outbreak. Missouri is not among the states that reported infected dairy herds.

Are we once again going to take it less seriously than we should only to then swing to the other extreme later?

But what about the poor farmers?

What occurred during the SARS-CoV-2 pandemic was a classic instance of high-stakes decisionmaking and guidance under constraints both of certainty and of available interventions.

When the virus first broke out, we knew very little about it, applied knowledge from prior incidents, and tried very very hard to acquire new, relevant, knowledge.

At the same time, for numerous reasons, countermeasures, mitigations, and prophylactics were limited and due to supply-chain concentration could not be rapidly ramped up.

What's staggering about the COVID-19 pandemic is that we did learn amazingly quickly, had sequenced the full genome within a few weeks, and proceeded to develop the first mRNA vaccine candidates were developed within days. It then took months to both assess those vaccines and ramp up production.[1]

The other side of pandemic response related to public health and isolation measures, which remain the most effective means to control infectious disease. Initial presumptions about low airborne transmissibility proved false and guidelines rapidly changed. Effective masks were among the prophylactics which were in limited supply, and for which caregiver and first-responder access was prioritised. As understanding, supply, and manufacturing capacity evolved, mask mandates were extended.

And yet ... public response, in numerous countries and for numerous reasons, often directly rejected or attacked these highly-effective measures. Some countries, most notably to my mind New Zealand, fared exceedingly well. Others were and remain global embarrassments.

But diligent caregivers and policy leaders around the world were making good-faith best-effort consequence-balanced guidance as to how best to respond, and changed advice rapidly given changing circumstances.

The fact that this record continues to be distorted and mistated is utterly disappointing.

________________________________

Notes:

1. Wikipedia has a good history: <https://en.wikipedia.org/wiki/History_of_COVID-19_vaccine_de...>.

Disappointing and astonishing it is, how much of post-hoc rationalization, memory-holing, wishful thinking and general newspeak was squeezed into that post.

Lies, even repeated very often, do not become truth.

Did you have any particular points to make?

Generalized potshots aren't very constructive.

We'll merge that one hither.

COVID-24?

influenza isn't a coronavirus, so no.

My uncle works for Nintendo. He says Bird Flu is going to start getting real bad in two weeks, like REAL BAD.

Reply on news.ycombinator.com