https://www.cidrap.umn.edu/cov...

Study: Time to walk, drive to COVID vaccination sites may have deterred some
News brief Today at 11:59 a.m.
Mary Van Beusekom, MS
Topics COVID-19

The ability to quickly walk or drive to US COVID-19 vaccination sites in the first 2 years of the pandemic ranged widely by jurisdiction and urban or rural area, which may have led to missed opportunities for uptake, according to a new study in Emerging Infectious Diseases.

Researchers from the Centers for Disease Control and Prevention (CDC) assessed the accessibility of COVID-19 vaccination sites from December 2020 to March 2022.

The authors noted that the major barriers to vaccine coverage are transportation costs, opportunity costs, and time to travel to vaccination sites, per a previous governmental analysis. "The US Centers for Disease Control and Prevention (CDC) has provided recommendations to jurisdictions with regard to the planning of convenient COVID-19 vaccination sites… especially those with populations of homebound persons or persons living in remote places," they wrote.

Socially vulnerable areas had greater accessibility
Of the 131,951 total vaccination sites, 57,064 were pharmacies, 35,728 were medical practices, 10,606 were community health sites, 5,222 were hospitals, and 23,331 were of unknown or other type.

Nearly half of all physically able vaccine seekers (46.6%) could walk to COVID-19 vaccination sites within 15 minutes, while 74.8% could make the journey in 30 minutes, 82.8% could be there in 45 minutes, and 86.7% could do so within 60 minutes.

Walking time variations across jurisdictions and between urban/rural areas indicate that potential gains could have been made by improving walkability or making transportation more readily available.
In socially vulnerable areas, accessibility by walking was greater, at 55.3%, 81.1%, 86.7%, and 89.4%, respectively. Fifteen-minute walking accessibility in noncore urban areas ranged from 27.2% to 65.1%.

By car, accessibility ranged from 27.2% by 15 minutes to 52.7% by 60 minutes in noncore urban areas and 65.1% to 97.7%, respectively, in large cities.

"Knowledge of the functional proximity to vaccine sites for different populations is essential for effective planning and for ensuring equity of health resource access in public health emergencies," the researchers wrote. "Walking time variations across jurisdictions and between urban/rural areas indicate that potential gains could have been made by improving walkability or making transportation more readily available."

https://www.cidrap.umn.edu/cov...

EPISODE 155 OSTERHOLM UPDATE
Episode 155: Brighter Days Ahead
Dr. Osterholm
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April 18, 2024
In "Brighter Days Ahead," Dr. Osterholm and Chris Dall discuss the latest national and international COVID trends, recent research on long COVID, and measles cases in the U.S. Dr. Osterholm also shares the latest "This Week in Public Health History" segment and interviews two members of the podcast team.

Please fill out our Listener Feedback Survey!
Three studies spotlight long-term burden of COVID in US adults (Van Beusekom, CIDRAP News)
Lessons in persistence: new long COVID trials aim to clear lingering virus—and help patients in dire need (Couzin-Frankel, Science)
The pandemic's true death toll (The Economist)
Superbugs & You podcast
MORE EPISODES SUPPORT THIS PODCAS
Episode 155: Brighter Days Ahead
59:59

https://www.cidrap.umn.edu/cov...

Global health groups propose new terminology for pathogens that spread through the air
Lisa Schnirring 25 minutes ago.
COVID-19 MERS-CoV SARS Pandemic Influenza Business Preparedness Public Health

During the COVID-19 pandemic, health groups used and continue to use various terms such as "airborne," "airborne transmission," and "aerosol transmission" to describe the spread of the virus through the air, which can lead to misleading information and confusion about how the disease was circulating.

An international group has been grappling with the issue for more than 3 years, and today the experts laid out their deliberations in a report and proposed new agreed-on terminology for pathogens that transmit "through the air," which include not only SARS-CoV-2, but also influenza, measles, MERS-CoV (Middle East respiratory syndrome coronavirus), SARS (severe acute respiratory syndrome), and tuberculosis.

The group included the World Health Organization (WHO), consulting experts, and representatives from four major health groups: the Africa Centres for Disease Control and Prevention, the Chinese Center for Disease Control and Prevention, the European Centre for Disease Prevention and Control, and the US Centers for Disease Control and Prevention.

In the press release, the WHO said the terminology challenge stemmed from a lack of common terminology across several scientific disciplines, a problem that became more acute when experts across disciplines were tapped to weigh in with guidance and recommendations.

Jeremy Farrar, MD, the WHO's chief scientist, said, "We are pleased to have been able to address this complex and timely issue and reach a consensus." He added that agreed-on terminology for pathogens that spread through the air will help pave the way for new research agendas and to implement public health interventions designed to identify, communicate, and respond to current and new pathogens.

Umbrella term and 2 transmission descriptors
Along with the through-the-air terminology, the group introduced other common descriptors.

People infected with respiratory pathogens can generate and expel infectious particles while breathing, talking, singing, or coughing, for example. The group agreed that those particles should be called "infectious respiratory particles" (IRPs). Since IRPs have different sizes, the group steered away from defined cutoff points such as "droplets" and "aerosols" that scientists have used to distinguish larger particles from smaller particles.

The experts also proposed two descriptors to characterize transmission through the air, with "airborne transmission or inhalation" used when IRPs are expelled into the air and inhaled by another person no matter what the distance and "direct deposition" for when IRPs are directly deposited on the mouth, nose, or eyes of another person.

Steps for moving forward
Yuguo Li, PhD, who co-chaired the technical working group and a building environment expert in the department of mechanical engineering at the University of Hong Kong, said reaching consensus was unprecedented and wasn't easy. "Completing this consultation gives us a new opportunity and starting point to move forward with a better understanding and agreed principles for diseases that transmit through the air."

The WHO said the terminology discussions and agreement represent the first phase of discussions on the topic. I added that the next steps include more technical and multidisciplinary research and exploring the wider implications of using the updated terms.

Sticking points and practical implications
In the 52-page report, the group acknowledged some sticking points and concerns about practical implications regarding use of the new terms. They stopped short of recommending full airborne precautions to mitigate the risk of short-range airborne transmission.

And while discussions were based on the best available science, the group agreed on the importance of balancing scientific insights with availability, access, affordability, and other practical realities to minimize health inequity and avoid potential consequences, such as the ability to access personal protective equipment such as respirators.

Some experts not involved in the report have said the WHO is on the right path and are welcoming the terminology clarifications. Others, however, see a mixed picture and hope the groups are sincere when they say the report is a first step.

Joe Vipond, MD, an emergency department physician in Calgary, Alberta, and clinical assistant professor at the University of Calgary, said on X today that the report finally acknowledges that short-range airborne transmission is an integral part of all airborne transmission and explicitly says COVID is airborne. He is the cofounder of a Masks4Canada, a grassroots group with a goal of the Canadian government and public knowing about the critical role of masks for reducing COVID transmission.

"This is huge," he wrote, noting that the acknowledgement means workers, especially in healthcare, need respirators when caring for patients in concerning situations. (Respirators fit snugly to the face and filter out the smallest IRPs, as opposed to medical masks, which leave gaps.)

Vipond, however, noted several shortcomings, such as no mention of air filtration or sterilization in the list of suggested public health and social measure implementations. And though he praised the group for having airborne scientists on board, he said key disciplines should also include engineers and occupational hygienists. "We need all brains engaged on wicked problems."

In his other comments, he raised concerns about a lack of consensus on the use of the precautionary principle, which he said was also a problem during the SARS outbreak, and questioned the group's rationale that issues regarding equity preclude recommendations for respirator use. "Equity means everyone gets excellent protections. Not reducing protections to the lowest possible common denominator."

https://www.cidrap.umn.edu/ant...

Study highlights heavy global burden of infectious diseases
Chris Dall, MA 39 minutes ago.
Antimicrobial Stewardship HIV/AIDS Malaria Tuberculosis

A study published this week in The Lancet Infectious Diseases highlights the substantial impact of infectious diseases on global health.

The analysis of data from 204 countries by researchers with the Institute for Health Metrics and Evaluation estimates that 85 pathogens accounted for 704 million disability-adjusted life years (DALYs)—the number of years lost from ill health, disability, or early deaths—globally in 2019. That figure accounts for 28% of 2.54 billion DALYs attributed to all causes in the 2019 Global Burden of Disease (GBD) study.

The impact of these pathogens was disproportionately seen in children. Nearly 44% of the DALYs attributed to pathogens (309 million) in 2019 occurred in children under the age of 5 years.

According to the World Health Organization, one DALY represents the loss of the equivalent of one full year of health.

The study authors say their methodologic approach captures the full impact of pathogens on mortality and disability and is the most inclusive approach used to date. And they believe that their estimates, which they say highlight some pathogens that are being overlooked, can help global health leaders target areas where more research, funding, and action are needed.

"We urgently call for further research in drug development, vaccinology, and pathogen biology to innovate and accelerate drug and vaccine development for the broader group of pathogens highlighted in these rankings," they wrote.

TB, malaria, HIV had biggest impact
Of the total 704 million DALYs attributed to the 85 pathogens, bacterial infections were associated with 415 million, viral infections with 178 million, parasitic infections with 172 million, and fungal infections with 18.5 million.

The three pathogens with the largest observed impact were those causing tuberculosis (TB, 65.1 million DALYs), malaria (53.6 million), and HIV or AIDs (52.1 million). Malaria parasites were the leading pathogens for DALYs in children under 5 (37.2 million).

But the study also found a substantial burden associated with Streptococcus pneumoniae (38.1 million DALYs), Staphylocococcus aureus (34.5 million), and Klebsiella pneumoniae (31.1 million). In fact, S aureus was a leading pathogen according to DALY burden in 64 of the 204 countries included in the study and was associated with the sixth highest DALY burden in children under 5.

Others among the top 20 most burdensome pathogens were Escherichia coli, hepatitis B and C virus, Pseudomonas aeruginosa, influenza virus, Acinetobacter baumannii, Helicobacter pylori, invasive non-typhoidal Salmonella, rotavirus, respiratory syncytial virus, Salmonella enterica serovar Typhi, Bordetella spp (pertussis), group B Streptococcus, and fungi as a group.

We urgently call for further research in drug development, vaccinology, and pathogen biology to innovate and accelerate drug and vaccine development for the broader group of pathogens highlighted in these rankings.
The authors say that while the estimates support the amount of attention that TB, malaria, and HIV/AIDS receive from the global health community, the substantial health burden they observed for gram-negative bacteria suggests these pathogens deserve more focus and resources. Collectively, K pneumoniae, E coli, P aeruginosa, and A baumannii accounted for 114 million DALYs.

"Such a burden poses a substantial threat in health-care settings, leading to increased treatment costs, prolonged hospital stays, and elevated mortality rates, with the additional compounding effect of outbreaks in hospital settings that further contribute to the disease burden," they wrote. "Furthermore, these infections often occur in immunocompromised individuals, hospitalised patients, older individuals, or people with chronic illnesses, and are often caused by pathogenic species carrying various resistance genes."

Higher burden in poor countries
The impact from these pathogens was significantly larger in low- and middle-income countries (LMICs) than in high- and upper-middle-income countries, where non-communicable diseases like cancer and heart disease account for a greater proportion of DALYs.

When grouped by super-region, the highest fraction of pathogen-associated DALYs was seen in sub-Saharan Africa (314 million DALYs, 61.5% of 511 million total DALYs) and the lowest in the high-income super-region (31.8 million, 9.8% of 324 million DALYs). The fraction of DALYs associated with pathogens was also high in South Asia.

The authors say the discrepancy between poor and wealthy nations can be attributed to poor sanitation, limited access to clean water, and poor hygiene in LMICs, along with notable differences in healthcare infrastructure and access to essential medicines. They also note that, of the 85 pathogens analyzed, vaccines are available for only 22.

In an accompanying commentary, infectious diseases experts from South Africa and Tanzania say defining the burden of infectious diseases is just the first step. The next step is to understand how to sustainability reduce that burden, particularly in the places that are hardest hit.

"There is an urgent need to identify why well established interventions, such as the acceptability of vaccination, water, sanitation, and hygiene, and antimicrobial stewardship, are failing, whether interventions are implemented as intended, what dynamics within a country influence implementation, and how context might affect the outcomes," they wrote.

https://www.cidrap.umn.edu/cov...

COVID vaccination in kids protects against serious outcomes, but it wanes over time, new data show
Stephanie Soucheray, MA Today at 3:38 p.m.
COVID-19

Today in Morbidity and Mortality Weekly Report, researchers examine the durability of COVID-19 vaccination during Omicron circulation among kids 5 to 18 years and find that two doses of the original monovalent (single-strain) mRNA COVID-19 vaccine was 52% effective against pediatric COVID-19 hospitalization and 57% effective against critical illness, if the vaccine was administered no longer than 4 months preceding hospitalization.

Beginning in December 2021, US children ages 5 and older have been recommended to receive two doses of vaccine to protect against COVID-19–related hospitalizations. These original monovalent vaccines were available only before September 2022.

To examine durability, the study used a case-control design to evaluate vaccine effectiveness (VE) from December 19, 2021, to October 29, 2023, in participants enrolled in the Overcoming COVID-19 Network.

Case-patients were children who were hospitalized for acute COVID-19 and received a positive SARS-CoV-2 test result, and control patients were hospitalized for COVID-19–like illness but received a negative SARS-CoV-2 test result.

Efficacy drops after 4 months
A total of 3,348 patients were enrolled, including 1,551 (46%) case-patients and 1,797 (54%) control patients. Critical illness occurred in 294 case-patients (19%) and 322 control patients (18%), with critical illness defined as receipt of noninvasive or invasive mechanical ventilation, vasoactive infusions, extracorporeal membrane oxygenation, or illness resulting in death.

VE of the original monovalent vaccine against COVID-19–related hospitalizations was 52% (95% confidence interval [CI], 33% to 66%) when the most recent dose was administered less than 120 days before hospitalization, and 19% (95% CI, 2% to 32%) if the interval was 120 to 364 days, the authors found.

"Too few children and adolescents received bivalent [two-strain] or updated monovalent vaccines to separately evaluate their effectiveness," the authors wrote, so VE estimates were limited to two doses or more of the original monovalent vaccine.

Overall, VE of the original monovalent vaccine against COVID-19–related hospitalization was 31% (95% CI, 18% to 43%) if the last dose was received any time within the previous year.

For critical illness, VE was 57% (95% CI, 21% to 76%) when the most recent dose was received less than 120 days before hospitalization, 25% (95% CI, –9% to 49%) if it was received 120 to 364 days before hospitalization, and 38% (95% CI, 15% to 55%) if the last dose was received any time within the previous year.

Protection from original vaccines was not sustained over time, necessitating increased coverage with updated vaccines.
"Protection from original vaccines was not sustained over time, necessitating increased coverage with updated vaccines," the authors wrote. "Most children and adolescents in this analysis who were hospitalized with COVID-19 were unvaccinated, and few had received updated vaccine doses despite a high prevalence of underlying comorbidities associated with more severe disease."

https://arstechnica.com/scienc...

Hospital prices for the same emergency care vary up to 16X, study finds
Hospitals' "trauma activation fees" are unregulated and extremely variable.

https://www.cidrap.umn.edu/inf...

Adult vaccines offer substantial return on investment when considering full value, report says
Mary Van Beusekom, MS Today at 1:34 p.m.
Influenza Vaccines Pneumonia Respiratory Syncytial Virus (RSV) Varicella

Adult vaccination programs can return up to 19 times their initial government investment in healthcare savings and socioeconomic value, offering net benefits of up to $4,637 per full vaccination course, according to a new report from the Office of Health Economics (OHE).

Researchers from the OHE, a UK charity and independent health economics research organization, analyzed the full value of four adult vaccines (against influenza, pneumococcal disease, respiratory syncytial virus [RSV], and shingles) available in Australia, Brazil, France, Germany, Italy, Japan, Poland, South Africa, Thailand, and the United States.

The study was based on health economic modeling and a literature review on the burden of vaccine-preventable diseases in adults and the health, healthcare system, and socioeconomic benefits of vaccination. The report was commissioned by the International Federation of Pharmaceutical Manufacturers & Associations.

"Increasing pressures on ailing healthcare systems, such as ageing populations, are driving an urgent need to shift to a prevention-first mindset," Lotte Steuten, PhD, a report coauthor and OHE chief executive officer, said in an OHE news release. "Our report sets out a compelling case for adult immunisation programmes playing a key role in the shift to prevention."

Less healthcare use, higher productivity
The return on investment (ROI) of up to $4,637 per vaccination course translates to billions of dollars in net monetary benefits to society, the authors said. The findings, they added, suggest that adult vaccination programs can deliver ROIs on par with those of childhood programs, mitigate health and economic disparities, and help fight antimicrobial resistance by lessening the need for antibiotics.

Preventing illness reduces doctor and hospital visits, meaning valuable resources can be allocated elsewhere.
"Preventing illness reduces doctor and hospital visits, meaning valuable resources can be allocated elsewhere, and ensuring a healthy and active workforce throughout life can boost economic productivity," the authors wrote. "Evidence shows that adult immunisation is highly effective in preventing diseases, their sequelae, and mortality, particularly in older adults and those with chronic health conditions."

The researchers added that while the total value of vaccination is increasingly recognized, substantial evidence gaps still lead to underestimation of that value, as well as suboptimal policy decisions. Robust funding for adult vaccination programs, more effective data-collection systems, agreement on accepted research methods, and transparent/open data access are needed for future research.

"Governments are recommended to adopt a prevention-first mindset to help ease increasing pressures on health systems and society, with adult immunisation playing a crucial role in enabling us to live longer, healthier, and more productive lives," they concluded.

https://www.cidrap.umn.edu/cov...

US respiratory virus activity continues to tail off
News brief Today at 2:44 p.m.
Lisa Schnirring
Topics COVID-19 Influenza, General Respiratory Syncytial Virus (RSV)

Respiratory virus activity from flu, COVID-19, and respiratory syncytial virus (RSV) continues to decline across most of the country, with only two jurisdictions—North Dakota and Wyoming—reporting high activity, the Centers for Disease Control and Prevention (CDC) said in updates today.

fever thermometer
Leituvis1/ iStock
In its weekly FluView update, the CDC said key markers such as test positivity continue to fall, and only one region is above its regional baseline for outpatient visits for flulike illness: the northeast. All three viruses are circulating, with influenza A making up 62.4% of samples at public health labs. Of subtyped influenza A samples, about half were 2009 H1N1, and half were H3N2.

Hospitalizations continue to decline, but overall deaths were up slightly. The CDC received reports of 4 more pediatric flu deaths, raising the season's total to 142.

COVID wastewater detections minimal, highest in the Midwest
For COVID, the CDC's latest data updates show more declines for both severity indicators (hospitalizations and deaths) and early indicators (test positivity and emergency department visits). Wastewater SARS-CoV-2 detections, another early indicator, have declined to the minimal level and are currently highest in the Midwest.

In its weekly respiratory virus snapshot, the CDC said for RSV, all 10 regions are below the 3% epidemic threshold, suggesting that the season is ending. RSV hospitalizations remain low for all age-groups.

https://www.cidrap.umn.edu/mpo...

Report: Less than half of nursing home residents up to date on COVID vaccines
News brief Today at 2:17 p.m.
Stephanie Soucheray, MA

In this week's Morbidity and Mortality Weekly Report, researchers review COVID-19 activity and vaccination in US nursing homes from October 2023 through February 2024 and find up to 26% of nursing homes reported at least one case of COVID-19 during each week of the study period.

The study was based on information gathered as part of the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network.

Weekly rates of incident SARS-CoV-2 infection ranged from 61.4 per 10,000 nursing home residents during the week ending February 11, 2024, to 133.8 per 10,000 during the week ending December 3, 2023. The cumulative weekly SARS-CoV-2 infection rate was highest in the Midwest region (130.1 per 10,000 residents) and lowest in the South (93.1 per 10,000).

The same geographic pattern was seen among COVID hospitalizations: The cumulative weekly COVID-19–associated hospitalization rate was 5.8 per 10,000 residents and was highest in the Midwest (6.7 per 10,000) and lowest in the South (5.0 per 10,000), the authors said.

CDC recommends updated vaccines to older Americans
Nursing homes were the first epicenters of the pandemic in the United States in 2020, as those 85 years and older are the most likely to die from infections with the novel coronavirus. Despite the risk of severe infection from COVID-19, the study authors found that only 40.5% of residents were up to date with COVID vaccination by the end of the study period. Residents in the South had the lowest rate (32.4%), compared to residents in the Northeast, who had the highest (47.3%).

"This finding indicates that an important prevention tool is being underutilized in this population," the authors concluded.

This finding indicates that an important prevention tool is being underutilized in this population.
In February, the CDC recommended that all adults aged older than 65 years receive one additional dose of an updated 2023–2024 COVID-19 vaccine at least 4 months after the previous updated dose.

Long-COVID study reveals immunological improvement two years after infection

https://www.unsw.edu.au/newsro...

The project began last August of getting caught up-to-date on my vaccine history was completed today with the 2nd Shingrex vac. Soon it will be time for the annual booster of flu and also of COVID if that is recommended (pretty sure it will be). The more permanent and long- lasting vaccines are done. The pharmacist today said the latest info he's getting on the RSV is that it's going to be good for more than a year, so it may not be an annual recommendation. But for now, the best guardrails possible for an old man that are available are in place .

I was going to be shocked at the low rate of covid vax in nursing homes. But I realize they have many short term patients as well as long term, or maybe most are? so I guess it would be really hard to keep up with.

Has COVID set us up for a major heart disease epidemic? It's happened before

https://newatlas.com/health-we...

Congratulations, Donald!

sallyg said: I was going to be shocked at the low rate of covid vax in nursing homes. But I realize they have many short term patients as well as long term, or maybe most are? so I guess it would be really hard to keep up with.

That and it's logistical since they can't keep the vaccines on hand at the facilities. The residents have to be either transported off premises or someone has to come to the facility. Those are the valid reasons. In my experience, though, that was minor - very, very minor - compared to the complete lack of motivation or interest in obtaining the vaccine. Even with some residents or their families requesting it. For months I was given myriads of excuses for not arranging for administering the vaccine. Even getting her PCP to send an order to the facility for it and the RSV, it lagged 10 weeks AFTER they received the order. Good thing it wasn't insulin or something like that specific to a single resident, don't you think? That was one reason given and exactly how I responded - by asking out of all the residents they didn't have a single one that required an individual medication. Of course they did, so that line was dropped for something equally as feeble. It was absurd making it sound as if everyone there was on the same medical regiman and dosages. Corporate had a deal with Walgreen's presumably and didn't want any other provider giving the shots. Which wasn't the case in previous years. My personal and independent pharmacy came around and gave the vaccines one year. Wal-Mart pharmacy ended up coming over and doing this time. Corporate wanted it done where they got a cut and the facility just didn't want to bother with it. So I'm not shocked. People will likely die as result and it will just be a shrug of the shoulders to those in charge of operating the facility.

The H5N1 Outbreak Is Not a Test Run, It's a Warning Shot
— A true public health success would be preventing the virus from further adapting to humans

https://www.medpagetoday.com/o...

crawgarden said: The H5N1 Outbreak Is Not a Test Run, It's a Warning Shot
— A true public health success would be preventing the virus from further adapting to humans

https://www.medpagetoday.com/o...

Seems like it will only be a matter of time before it modifies and has the ability to spread more readily to and between humans. It's sure moved a long way beyond just the avian group and seems to be doing it at a faster rate.

Yes, think it is of great concern.

Humanity failed to learn from SARS-CoV-2, so H5N1 isn't going to be handled well either.

https://www.cidrap.umn.edu/avi...

USDA shares recent H5N1 avian flu sequences amid more dairy herd outbreaks
Lisa Schnirring Today at 1:04 p.m.
Avian Influenza (Bird Flu)

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) last night announced that it has shared 239 recent genetic sequences of the H5N1 avian flu virus from poultry, wild birds, and dairy cows, which will help scientists look for new clues about the spread of the virus.

In related developments over the past 3 days, APHIS reported four more H5N1 detections in dairy herds, along with more positive findings in wild birds and poultry. Also, the Centers for Disease Control and Prevention (CDC) posted a recent update on its actions to look for new human infections.

Eagerly awaited genetic sequences
As the outbreak nears the 1-month mark, it's still not known how the 2.3.4.4b H5N1 clade is now able to infect cows and exactly how it is spreading in dairy herds. With the virus still spreading across multiple world regions, veterinary experts are looking for answers to protect dairy cows and human health.

Some scientists have voiced frustration with the slow pace of sharing genetic sequences and other investigation details. Until yesterday, only a few genetic sequences were available from the recent outbreaks, including those from a few cows and cats that were detailed in a recent preprint paper from a team at Iowa State University.

In its statement, APHIS said it usually publishes sequences on GISAID, the Global Initiative on Sharing All Influenza Data, but for transparency and to speed research, it shared raw sequence data via the National Institutes of Health National Center for Biotechnology Information. It added that the sequences are from cattle, cats, chickens, skunk, racoon, grackle, blackbird, and goose and that it will continue to make the data available on a rolling basis.

Louise Moncla, PhD, assistant professor of pathobiology at the University of Pennsylvania School of Veterinary Medicine, today on X welcomed the posting of the raw genetic sequencing, but said analysis steps such as downloading and mapping will take time, and it will take a while before scientists can show how the viruses are related to each other.

More detections in cows, poultry, wild birds
Meanwhile, in updates over the last few days, APHIS reported 4 more H5N1 detections in dairy herds, which raise the total to 32. The latest positive samples were from cows in Kansas, Michigan, and Texas.

Also, APHIS reported two more H5N1 detections in poultry flocks, including an earlier announced outbreak at a commercial turkey farm in Michigan's Newaygo County and a third hatchery in New Mexico's Roosevelt County. The agency also reported about 30 more H5N1 detections in wild birds, including waterfowl, shorebirds, crows, and raptors. Most were from the eastern part of the country.

Virus susceptible to neuraminidase inhibitors
In other related developments, the CDC on April 19 posted an update in its response, which includes lab studies to better clarify the impact of antiviral drugs and candidate vaccine viruses.

The agency said it just completed susceptibility testing for seasonal flu antivirals. Tests on the H5N1 virus from the recent human case in Texas confirm that it is susceptible to all commercially available neuraminidase inhibitors. "Testing to confirm susceptibility to baloxavir marboxil, a different antiviral medication, takes longer and is ongoing," it said.

Testing to confirm susceptibility to baloxavir marboxil, a different antiviral medication, takes longer.
The CDC said it is studying blood samples from people to have been vaccinated against H5 avian flu to confirm that existing candidate vaccine viruses (CVV) protect against the H5N1 virus isolated from the patient in Texas. Earlier genetic analysis suggested that the CDC's two existing CVVs would protect against the subtype found in the Texas patient.

Among other actions, the CDC said it is designing an epidemiologic field study to better understand the outbreak. So far, its monitoring of emergency department and flu testing data in areas where H5N1 has been found in dairy cattle or other animals shows no unusual trends.