Credit CDC
#18,295
Details on Missouri's H5 case have been slow in coming, and yesterday the CDC revealed that sequencing of the virus was not going well, and a full genomic analysis (including sub-typing) may not be possible.
Today, the CDC published a small update in their weekly FluView report which carried a previously undisclosed tidbit; that a second person (in contact with the identified case) was ill, but was not tested for the virus.
Why we are just learning about this now, more than a week after the initial report, is unclear.
Hopefully serological studies will be performed (assuming the contact is willing) to see if that illness was from an H5 infection. These types of studies must usually wait until several weeks after the illness, for peak antibody detection.
First the statement (emphasis mine), after which I'll have a postscript.
Novel Influenza A Virus:
One new human infection with a novel influenza A virus was reported by the Missouri Department of Health and Senior Services. The patient was infected with an influenza A(H5) virus.
The patient is >18 years and has multiple underlying medical conditions. The patient developed symptoms during the week ending August 24, 2024, was hospitalized, and has since recovered. A respiratory specimen collected from the patient tested positive for influenza A at the hospital. The specimen was then forwarded to the Missouri State Public Health Laboratory (MSPHL) with the Department of Health and Senior Services as part of routine influenza surveillance. CDC confirmed the infection was caused by an influenza A (H5) virus. A subsequent investigation by state and local public health officials did not find any known direct or indirect contact with wild birds, domestic poultry, cattle (including no consumption of raw dairy products), or other wildlife prior to the patient’s illness onset. One close contact of the patient was also ill at the same time, was not tested, and has since recovered.
During the 2023-2024 influenza season, a total of 14 cases of human infection with influenza A (H5) virus have been reported in the United States. Four of these occurred in individuals working with dairy cows, nine in individuals associated with poultry depopulation and disposal, and one in an individual with an unknown source of exposure. An ongoing outbreak of H5N1 continues in domestic dairy cows and poultry, and monitoring for additional human cases is ongoing.
Seven variant influenza virus cases were also reported during the 2023-2024 season (four A(H1N2)v, two A(H3N2)v, and one A(H1N1)v virus), for a total of 20 novel influenza A virus cases reported this season.
Information about avian influenza is available at https://www.cdc.gov/flu/avianflu/index.htm.
Interim recommendations for Prevention, Monitoring, and Public Health Investigations are available at https://www.cdc.gov/bird-flu/prevention/hpai-interim-recommendations.html.
The latest case reports on avian influenza outbreaks in wild birds, commercial poultry, backyard or hobbyist flocks, and mammals in the United States are available from the USDA at https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/animal-disease-information/avian/avian-influenza/2022-hpai.
Additional information on influenza in swine, variant influenza virus infection in humans, and guidance to interact safely with swine can be found at www.cdc.gov/flu/swineflu/index.htm.
I won't make any assumptions about who is responsible for the decision to slow-roll the release of this important detail - since it could have occurred at the local, state or federal level - but it does little to inspire confidence in the investigation or the agencies involved.
For six months, we've seen HPAI H5 treated as more of an economic or political problem, than a potential public health concern, and that should give everyone pause.
If things go badly, and the HPAI H5 threat escalates, public health are going to need the trust and support of an already pandemic-weary and skeptical public.
And public trust is an asset that is far-too-easily squandered by trying to `manage' the facts.
