Post by RonOhttps://www.aphis.usda.gov/sites/default/files/dairy-cattle-hpai-tech-
brief.pdf
The USDA has released their sequence results for the D1.1 genotype H5N1
influenza that has infected dairy cattle in Nevada.
Genotype D1.1 is a reassorted virus (recombinant between multiple viral
strains). It is derived from the Asian H5N1, but has recombined with
North American influenza virus. It continues to have the H5N1 antigen
designation, but the N1 gene comes from a North American virus. Only
the HA, PB1, M and NS segments (chromosomes or genes) come from the
Asian H5N1 virus. This likely means that the currently available H5N1
vaccine that they have stockpiled will be ineffective against this virus.
The antigen designations are pretty worthless in describing antibody
binding ability. They have maintained the designations for decades and
even though they are antigen type designations that are still used to
describe the virus the sequences of the various genotypes and clades
within subtypes can be so different that they do not have to have
antibody crossreactivity. The H5 just indicates that it is the same
lineage, descended from, the first H5 designated antigen sequence of the
HA gene. The Missouri patient infected with the dairy virus had enough
mutations in the H5 gene to decrease antibody binding by around 100 fold
and they needed to make a synthetic H5 sequence with those amino acid
substitutions in it to test for H5 antibodies in the patients blood, and
still 2 out of the 3 antibody tests failed when they knew that the
patient had been infected.
They really do need to start making up a vaccine for the D1.1 genotype
because 2 patients infected that were in critical condition (one died)
both had developed the mutations needed to make the virus more infective
to humans. I would likely make sure that their viral sequences where in
the vaccine.
It turns out that they are finding a change that allows the D1.1 virus
to more efficiently replicate in mammals among the dairy herds in
Nevada. This mutation in the PB2 gene has not been found in wild
strains of the virus. It turns out that poultry workers infected with
H5N1 in Washington were infected with D1.1 and had respiratory symptoms,
but, had only mild symptoms. This means that the dairies could be being
infected by infected poultry farms due to shared workers between farms,
and would indicate how it has spread in Nevada if there wasn't an
exchange of cattle. Like the B3.13 genotype the D1.1 may use dairy
workers as a vector for transmission to other farms.
They do need to start testing all the dairy workers, and get them
treated as quickly as possible. They need to keep the mutations that
put the two patients into critical condition from occurring again. They
already know that the mutations have occurred twice.
Ron Okimoto
https://www.cnn.com/2025/02/08/health/bird-flu-variant-nevada-human-case/index.html
This CNN article reviews the D1.1 results. The CDC is still in denial
of what this new genotype means in terms of the possible start of the
next pandemic. The D1.1 virus has already killed one person and left
another in critical condition before recovery. That the CDC is still
claiming that the risk is minimal is crazy. They know that a lot of
dairy workers are likely getting infected by this new virus that work at
the infected dairy farms, but they still refuse to implement dairy
worker testing and treatment of infected workers. This virus mutated
into a form that would better infect humans in the two critical cases.
This means that since the virus is a respiratory infection in those
cases that the needed mutations to start the next pandemic were likely
selected for in the infected tissues of those individuals. It isn't
likely that the required mutations just occurred and took over the
infections of two individuals thousands of miles apart without positive
selection for those mutations during the infection.
The CDC needs to minimize human infections with this virus. The more
humans infected the more chance that these mutations will happen again
and be selected for again. They were lucky enough to contain the
infections in the two known cases, but that would not be guaranteed with
migrant dairy workers reluctant to admit to being infected.
It turns out that some of the Poultry workers infected in Washington
were infected by D1.1 virus and only had mild respiratory symptoms when
they were detected (because they were tested due to the poultry flock
infection). The Nevada dairies did not report symptoms, and a
respiratory infection would not be detected in the milk until the
infection somehow spread to the mammary gland. For the B3.13 genotype
the infection is not respiratory, but it infects the eyes, and mammary
glands of the cattle. It also infects the gut, but nasal swabs are
often negative for both humans and cattle. The D1.1 genotype should be
detectable by nasal swabs before it is detected in the milk.
They need to be testing cattle with respiratory symptoms at all Nevada
dairies because the virus has already spread to, at least, 4 dairies.
The infection may have spread from one dairy because the infected
dairies have a mutation that improves the ability of the virus to
replicate in mammals. This mutation is not found among the wild birds
in Nevada. This likely means that this version of D1.1 has spread via
the same transmission vectors as the B3.13 dairy virus. Cattle and
humans are taking this virus to other farms. Just like all the other
states most dairy workers work at more than one dairy farm and some of
them also work at poultry farms. It may be that the D1.1 virus came
from an infected poultry farm via a dairy worker that worked at both the
poultry farm and a dairy. Infected people and cattle have been taking
the 3.13 virus to other farms, and the same thing is likely occurring
with the D1.1 genotype.
The USDA and CDC have been in denial of dairy worker transmission from
the start of the dairy epidemic and that denial has to end, and dairy
workers have to be subjected to contact tracing and testing in order to
determine how the virus has spread among the Nevada dairies. How did
the same mutation get to all 4 dairies? If they start contact tracing
like they did in California they might find more Nevada herds infected.
They need to identify the infected herds as quickly as possible and get
the workers tested and infected workers placed on anti-virals as quickly
as possible to prevent the next pandemic. They might also issue
anti-virals to all the workers at the infected dairies working with the
sick cows. They know for an absolute fact that a significant percentage
of the workers will get infected working with infected poultry and
cattle. They should be acting on that fact.
Ron Okimoto