Sewage Signals: H5N1 Found in Nine Cities. Is it From Cows, Cats or Humans?
Amidst the ebb and flow of urban life, a revelation sends ripples of concern through the scientific community. A groundbreaking study exposes a chilling truth: highly pathogenic avian influenza virus, has been silently entering into the wastewater of nine cities across Texas. This discovery serves as a stark reminder of the ever-present threat posed by H5N1 bird flu and underscores the urgent need for vigilance in containing this potential pandemic before it spirals out of control.
A new study presents a comprehensive examination of the detection of highly pathogenic avian influenza virus, H5N1 (bird, cow, cat) influenza, within wastewater samples from nine cities across Texas with a total catchment population that is in the millions, during the spring of 2024. The H5 and H7 subtypes of Influenza A, are notorious for their virulence in avian and feline species and the significant economic toll they have exacted through mass killing of infected poultry. However, the government and farms are not killing infected cattle. Most cows have been recovering.
Animal and Plant Health Inspection Service (APHIS) reported yesterday that 6 more dairy herds were infected with H5N1, raising the total to 42. These herds are in the states where previously infected herds have been identified so the state total remains 9. There are 4 more infected herds in Michigan, 1 in Colorado, and 1 in Idaho.
The human mortality rate has been around 50%, but that is very likely to drop if we implement random testing to find mild and asymptomatic cases. We simply don’t know what the mortality rate will end up being but even if it drops to between 5% and 10%, we are still looking at a catastrophic situation.
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Drawing upon a rich history of H5N1 lineage evolution since 1955, the research elucidates the dominance of the A/goose/Guangdong/1996 H5N1 lineage within poultry populations, often implicated in zoonotic transmissions to humans. Within this lineage, the emergence of the 2.3.4.4b clade has been spreading globally and infiltrating North America via wild bird populations as early as December 2021. The first human case was in 2022, and the second was in Texas this year.
We can see from Nextstrain, below, that H5N1 evolution has been picking up pace, infecting more species, including mammals at increasing rates. It has infiltrated into farm animals and even our cats. The odds of it evolving to infect humans more easily and to transmit from human to human are increasing at an exponential rate.
“Wastewater in nine Texas cities, with a total catchment area population in the millions, over a two-month period from March 4th to April 25th, 2024. Sequencing reads uniquely aligning to H5N1 covered all eight genome segments, with best alignments to clade 2.3.4.4b”
The study started detecting H5N1 in the wastewater in March 2024, as H5N1 outbreaks are concurrently identified in Texas dairy cattle herds, mirroring similar occurrences in Michigan and Kansas. Subsequently, the first human case of 2024 was detected in Texas, with the infected individual reportedly exposed to symptomatic cattle. This human infection marks a concerning escalation in the spread of H5N1, showing the potential for direct transmission from animals to humans.
H5N1 is the red in the graph. We can see that it starts increasing in early April, through till the end of April when the study period ended.
Hospitalizations continued to decrease during this period, suggesting that either people aren’t infected or that those who are infected aren’t spreading the virus and have manageable symptoms. Farm workers may be able to gain access to treatment like Tamiflu early enough to avoid serious complications. It could also be that people are drinking milk with inactivated virus and that’s showing up in the wastewater. We simply don’t know for sure at this point, other than that it is in the wastewater.
The Texas Epidemic Public Health Institute (TEPHI) has emerged as a player, leveraging hybrid-capture sequencing to scrutinize wastewater samples since May 2022. This ongoing surveillance effort has yielded insights into various human and animal viruses, with notable correlations observed between wastewater findings and clinical case data for SARS-CoV-2 and influenza.
Remarkably, despite the routine monitoring conducted by TEPHI, H5N1 remained elusive in wastewater samples until March 2024. However, the sudden emergence of H5N1 in samples collected between March 4th and April 25th, 2024, from multiple cities across Texas, paints a sobering picture of the virus's dissemination within the environment.
Sequencing analyses offer a glimpse into the genetic makeup of the detected H5N1 strains, with alignments to all eight genome segments, including critical genes like PB2, HA, and NA. These genetic signatures predominantly align with the 2.3.4.4b clade of H5N1 and exhibit mutations suggestive of avian or cattle origin, but humans could not be excluded.
“A variant analysis suggests avian or bovine origin but other potential sources, especially humans, could not be excluded."
In conclusion, the widespread detection of H5N1 in wastewater samples underscores the urgency of proactive surveillance and containment measures. Failure to curb the spread of H5N1 poses a tangible risk of human-to-human transmission, potentially catalyzing the onset of a devastating flu pandemic in the near future. As such, wastewater monitoring emerges not only as a sentinel surveillance tool for early detection of viral threats but also as a critical component in safeguarding public health and mitigating the risk of a new bird flu pandemic.
This information, combined with the information that both dairy and beef cows have human and bird receptors in their brains, respiratory tract, and utter, continues to raise the risk of viral evolution to transmit from human to human. This needs to be taken seriously and it needs to be contained ASAP.
We’ll end with some good news. The FDA announced the completion of testing on 297 retail dairy samples and all were found to be negative for viable H5N1 highly pathogenic avian influenza (HPAI) viruses. The preliminary results were announced last week showing negative results for viable virus. The FDA said it would continue to fund surveillance and research on the safety of commercial milk.
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Share your thoughts, questions, concerns, or insights you may have.
This is the (pre-print) study discussed in this article.
"Virome Sequencing Identifies H5N1 Avian Influenza in Wastewater from Nine Cities." (May 10, 2024)
"Using an agnostic, hybrid-capture sequencing approach, we report the detection of H5N1 in wastewater in nine Texas cities, with a total catchment area population in the millions, over a two-month period from March 4th to April 25th, 2024. Sequencing reads uniquely aligning to H5N1 covered all eight genome segments, with best alignments to clade 2.3.4.4b. Notably, 19 of 23 monitored sites had at least one detection event, and the H5N1 serotype became dominant over seasonal influenza over time. A variant analysis suggests avian or bovine origin but other potential sources, especially humans, could not be excluded. "
https://www.medrxiv.org/content/10.1101/2024.05.10.24307179v1
Developing...
https://data.wastewaterscan.org/tracker/?charts=CiIQACABSABSBjcyYTdiMFoGSE1QVl80eL8DigEGMTBjMzE3&selectedChartId=10c317
The question of whether asymptomatic transmission is occurring in Texas is perplexing.
Maybe (???). There IS wastewater dumping going on from farms, but it is unclear if this would account for all the virus being seen in wastewater. The virus appears not to have picked up the necessary mutations for a really productive human infection as is sort of seen with the Texas farm worker whose major symptom appeared to be conjunctivitis. I think (?) there might be a Kansas case where at least one of the cows has picked up another viral adaption not seen in Texas.
https://twitter.com/RajlabN/status/1786825096335630476
Glad you're following this TACT, because my brain doesn't have the bandwidth for all this.