7% of dairy workers at infected farms seropositive for the dairy virus

[RonO]

https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm?s_cid=mm7344a3_w

Michigan and Colorado did a "convenience" sampling (without regard to
the person showing symptoms at infected dairy farms. 115 people were
tested and 8 of them were found to be more seropositive than the
Missouri case (positive for 2 of the 3 assays instead of just one). If
you have been following my posts on this subject I have contended since
early in the dairy epidemic that around 5% dairy workers infected could
account for the spread between herds and to poultry flocks. These
workers would be shedding virus, and it would not have to survive on
equipment (only infective for 24 hours) or skin and clothing (infective
for less than 30 minutes). The contact tracing in California just
demonstrated that it was likely the dairy workers were taking the virus
to other dairies and poultry farms. Now these test results indicate
that they should have been running contact tracing from the very
beginning as I have always claimed.

It should be noted that the first Michigan survey that got negative
seropositive testing biased their sample to those dairy workers that had
not exhibited symptoms. They also did not include the positive control
of the known infected dairy worker.

QUOTE:
This finding supports the need to identify and implement strategies to
prevent transmission among dairy cattle to reduce worker exposures and
for education and outreach to dairy workers concerning prevention,
symptoms, and where to seek medical care if the workers develop
symptoms. Timely identification of infected herds can support rapid
initiation of monitoring, testing, and treatment for human illness,
including mild illness, among exposed dairy workers.
END QUOTE:

This is what I have always claimed, and what the CDC and USDA have
refused to recognize from the beginning of the dairy epidemic. Both
agencies refused to attempt to identify all the infected herds. It is
sad that it has taken this long for them to admit that they have been
wrong, and that there should be an effort to identify all the infected
herds to decrease the risk of infection of dairy workers. The more
workers infected the more likely the virus will become the next pandemic
virus. The poultry industry has lost millions of birds to the dairy
virus, and there is the possibility that egg prices will go up like they
did last time because the CDC and USDA would not act and do what should
have been done. It isn't wild birds this time, but dairy cattle and
dairy workers spreading the virus. Infected dairy workers explains how
dairy herds in states that did not get cattle were infected, and they
knew that dairy workers could be infected and shed live virus from the
first human case in Texas where they were able to isolate live virus and
culture it.

It also should be noted that months ago research was put out that 2 out
of 14 Texas dairy workers tested seropositive for the dairy virus, but
the CDC has never recognized those individuals as having been infected.
Both seropositive workers came from the same farm and one of them did
not have contact with cattle (the person worked in the dairy cafeteria)
raising the possibility that there was human to human transmission.

Ron Okimoto

[RonO]

Post by RonO
https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm?s_cid=mm7344a3_w
Michigan and Colorado did a "convenience" sampling (without regard to
the person showing symptoms at infected dairy farms.  115 people were
tested and 8 of them were found to be more seropositive than the
Missouri case (positive for 2 of the 3 assays instead of just one).  If
you have been following my posts on this subject I have contended since
early in the dairy epidemic that around 5% dairy workers infected could
account for the spread between herds and to poultry flocks.  These
workers would be shedding virus, and it would not have to survive on
equipment (only infective for 24 hours) or skin and clothing (infective
for less than 30 minutes).  The contact tracing in California just
demonstrated that it was likely the dairy workers were taking the virus
to other dairies and poultry farms.  Now these test results indicate
that they should have been running contact tracing from the very
beginning as I have always claimed.
It should be noted that the first Michigan survey that got negative
seropositive testing biased their sample to those dairy workers that had
not exhibited symptoms.  They also did not include the positive control
of the known infected dairy worker.
This finding supports the need to identify and implement strategies to
prevent transmission among dairy cattle to reduce worker exposures and
for education and outreach to dairy workers concerning prevention,
symptoms, and where to seek medical care if the workers develop
symptoms.  Timely identification of infected herds can support rapid
initiation of monitoring, testing, and treatment for human illness,
including mild illness, among exposed dairy workers.
This is what I have always claimed, and what the CDC and USDA have
refused to recognize from the beginning of the dairy epidemic.  Both
agencies refused to attempt to identify all the infected herds.  It is
sad that it has taken this long for them to admit that they have been
wrong, and that there should be an effort to identify all the infected
herds to decrease the risk of infection of dairy workers.  The more
workers infected the more likely the virus will become the next pandemic
virus.  The poultry industry has lost millions of birds to the dairy
virus, and there is the possibility that egg prices will go up like they
did last time because the CDC and USDA would not act and do what should
have been done.  It isn't wild birds this time, but dairy cattle and
dairy workers spreading the virus.  Infected dairy workers explains how
dairy herds in states that did not get cattle were infected, and they
knew that dairy workers could be infected and shed live virus from the
first human case in Texas where they were able to isolate live virus and
culture it.
It also should be noted that months ago research was put out that 2 out
of 14 Texas dairy workers tested seropositive for the dairy virus, but
the CDC has never recognized those individuals as having been infected.
Both seropositive workers came from the same farm and one of them did
not have contact with cattle (the person worked in the dairy cafeteria)
raising the possibility that there was human to human transmission.
Ron Okimoto

The CDC is admitting that some of the positive workers did not show
symptoms and had an asymptomatic infection. It turns out that this
study excluded workers that were exhibiting symptoms. It may mean that
if they started testing all the workers that had symptoms. California
may have found over 50% of those tested with symptoms were positive, and
the positive poultry workers were tested because they had symptoms. As
crazy as it may seem no other state tested the dairy workers with
symptoms before California started to do it. Even Colorado only tested
a few workers. There hasn't been any systematic testing.

It sounds like the CDC wants to start testing all Dairy workers at
infected farms whether they show symptoms or not and get them treatment.
This means that they will have to start routine testing of dairy farm
workers, but first they have to identify all the infected dairy herds.
They need start testing herds in Washington and Oregon, and other states
that had poultry flocks like Florida that had poultry flocks go down
with the dairy virus and they will likely find positive herds like Utah
just did.

https://apnews.com/article/bird-flu-dairy-workers-h5n1-20d6a20ea9e1047ad7a92f9da31709f8

Ron Okimoto

[RonO]

Post by RonO

Post by RonO
https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm?s_cid=mm7344a3_w
Michigan and Colorado did a "convenience" sampling (without regard to
the person showing symptoms at infected dairy farms.  115 people were
tested and 8 of them were found to be more seropositive than the
Missouri case (positive for 2 of the 3 assays instead of just one).
If you have been following my posts on this subject I have contended
since early in the dairy epidemic that around 5% dairy workers
infected could account for the spread between herds and to poultry
flocks.  These workers would be shedding virus, and it would not have
to survive on equipment (only infective for 24 hours) or skin and
clothing (infective for less than 30 minutes).  The contact tracing in
California just demonstrated that it was likely the dairy workers were
taking the virus to other dairies and poultry farms.  Now these test
results indicate that they should have been running contact tracing
from the very beginning as I have always claimed.
It should be noted that the first Michigan survey that got negative
seropositive testing biased their sample to those dairy workers that
had not exhibited symptoms.  They also did not include the positive
control of the known infected dairy worker.
This finding supports the need to identify and implement strategies to
prevent transmission among dairy cattle to reduce worker exposures and
for education and outreach to dairy workers concerning prevention,
symptoms, and where to seek medical care if the workers develop
symptoms.  Timely identification of infected herds can support rapid
initiation of monitoring, testing, and treatment for human illness,
including mild illness, among exposed dairy workers.
This is what I have always claimed, and what the CDC and USDA have
refused to recognize from the beginning of the dairy epidemic.  Both
agencies refused to attempt to identify all the infected herds.  It is
sad that it has taken this long for them to admit that they have been
wrong, and that there should be an effort to identify all the infected
herds to decrease the risk of infection of dairy workers.  The more
workers infected the more likely the virus will become the next
pandemic virus.  The poultry industry has lost millions of birds to
the dairy virus, and there is the possibility that egg prices will go
up like they did last time because the CDC and USDA would not act and
do what should have been done.  It isn't wild birds this time, but
dairy cattle and dairy workers spreading the virus.  Infected dairy
workers explains how dairy herds in states that did not get cattle
were infected, and they knew that dairy workers could be infected and
shed live virus from the first human case in Texas where they were
able to isolate live virus and culture it.
It also should be noted that months ago research was put out that 2
out of 14 Texas dairy workers tested seropositive for the dairy virus,
but the CDC has never recognized those individuals as having been
infected. Both seropositive workers came from the same farm and one of
them did not have contact with cattle (the person worked in the dairy
cafeteria) raising the possibility that there was human to human
transmission.
Ron Okimoto

The CDC is admitting that some of the positive workers did not show
symptoms and had an asymptomatic infection.  It turns out that this
study excluded workers that were exhibiting symptoms.  It may mean that
if they started testing all the workers that had symptoms.  California
may have found over 50% of those tested with symptoms were positive, and
the positive poultry workers were tested because they had symptoms.  As
crazy as it may seem no other state tested the dairy workers with
symptoms before California started to do it.  Even Colorado only tested
a few workers.  There hasn't been any systematic testing.
It sounds like the CDC wants to start testing all Dairy workers at
infected farms whether they show symptoms or not and get them treatment.
This means that they will have to start routine testing of dairy farm
workers, but first they have to identify all the infected dairy herds.
They need start testing herds in Washington and Oregon, and other states
that had poultry flocks like Florida that had poultry flocks go down
with the dairy virus and they will likely find positive herds like Utah
just did.
https://apnews.com/article/bird-flu-dairy-workers-
h5n1-20d6a20ea9e1047ad7a92f9da31709f8
Ron Okimoto

https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm#T3_down

In reviewing the CDC report it looks like the actual number of past
dairy virus infections could be much higher than 7%. They used the
Texas virus to look for neutralizing antibodies, but we know that the
Texas virus has a couple amino acid substitutions in it relative to the
virus isolated from the Michigan dairy worker, and the Colorado dairy
strain was most closely related to the one isolated from one of the
Michigan dairy workers. The Missouri patient was infected with a virus
with 2 amino acid substitutions in the H5 gene that decreased the
neutralizing ability 10 to 100 fold, and the CDC had to make a synthetic
H5 gene with those two mutations in order to test for neutralizing
antibodies. The test essentially failed and only one test out of the
three indicated prior infection. The conclusion was that even though
this person had been producing virus they did not mount an effective
immune response. They need to use the actual H5 gene that the Michigan
and Colorado dairy workers were exposed to in order to get a more
accurate test result. They again did not include known infected workers
as controls. The Missouri patient may have totally failed if the Texas
H5 sequence had been used to test for neutralizing antibodies.


Table 3 indicates symptoms. 26 of the negative workers reported eye
related symptoms (the most common symptom reported by virus positive
workers). 3 of the 4 workers reported eye related symptoms and were
positive. California started testing workers with symptoms and they
were getting more than 50% positives. They only claimed to have tested
39 workers when 21 had been confirmed to be positive. It looks like
antibody testing may have missed a lot of past infections. It is of
interest that one of the positive workers claimed to have had diarrhea
(the same symptom that the CDC refuses to acknowledge as one of the
symptoms for H5N1 infection that the Missouri patient exhibited). 6
others that reported diarrhea tested negative, and it should be noted
that the Missouri patient evaluation was essentially a fail, the CDC
does not acknowledge the close contact that had the same single test
positive result as being a second case of infection in Missouri.

It looks like gut infection could be a possiblity as it was in Missouri,
so the FDA really should reevaluate their milk testing to make sure that
the virus is not surviving pasteurization. The Missouri patient and
their close contact could have shared the same bottle of milk. For the
CDC it is the stupid lie of omission. They repeatedly have claimed that
the Missouri patient did not exhibit the usual symptoms for influenza
infection, but they keep leaving out that the patient had symptoms
associated with H5N1 human infections in Asia.

Ron Okimoto