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Threat posed by H5N1 bird flu deepens, as public health authorities delay action

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Since the highly pathogenic avian influenza (H5N1 bird flu) was first detected among dairy cows in late March, a total of 132 herds across 12 states have now officially been impacted. In the last 30 days, an additional 65 infected herds have been confirmed across eight states. Despite repeated assurances given by the federal government that every resource is being utilized to eliminate the threat, scientists are increasingly concerned that far too little is actually being done to protect humanity from another pandemic.

Number of dairy cow herds infected with H5N1 weekly in the US (Source: USDA) [Photo: USDA/WSWS]

To date, the Centers for Disease Control and Prevention (CDC) has only tested 51 people potentially exposed to H5N1, a figure which has remained essentially static since the outbreak was detected. This only confirms in the negative that little has been done to conduct surveillance, testing, and serological studies of communities where people and livestock live in close proximity, which are necessary for epidemiologists to comprehend the scope of the ongoing threat.

More recently, a Michigan initiative is underway with the support of the US Food and Drug Administration (FDA) to begin testing a wider range of dairy products and a human serology study to assess the impact on workers after exposure to sick cows. The CDC stated that the objective of these efforts is to determine the efficacy of antivirals on the circulating clade of the bird flu, understanding infection in people, estimating the incubation period and potential mechanisms to mitigate the possibility of an H5N1 pandemic.

In a recent social media post on Twitter/X, molecular biologist and social science journalist Kai Kupferschmidt commented on research being conducted in a high security lab in Germany where cows were infected with the H5N1 strain circulating in US dairy cows and strains from H5N1-infected wild birds. He wrote, “In both cases they infected the udders directly through the teats and in both cases the animals got sick. They showed clear signs of disease such as a sharp drop in milk production, changes in milk consistency and fever.”

A dairy cow. [Photo: Keith Weller/USDA]

Kupferschmidt noted that the preliminary results imply that wherever H5N1 is circulating, the virus can spill over into cows. The researchers also indicated that transmission among cows may be a result of human activity, in which contaminated equipment is causing transmission through direct contact. However, he said that more research is needed on the potential for cow-to-cow transmission, and he is awaiting the results of the research to be published soon.

In a special report published in STAT News, based on interviews with numerous experts and federal representatives, the authors concluded,

The country still does not have a sufficient testing infrastructure in place, nor a full understanding of how the virus is moving within herds and to new herds, experts say. Government officials also have not secured the cooperation from farmers and dairy workers that would be required to rein in the outbreak.

In another interview, former CDC director in the Trump administration Dr. Robert Redfield said, “I really do think it’s very likely that we will, at some time, it’s not a question of if, it’s more of a question of when we will have a bird flu pandemic.” He added that a bird flu pandemic would have considerably greater mortality than COVID-19, placing the figure at “somewhere between 25 and 50 percent mortality,” while the death rate for COVID-19 has been estimated at 0.6 percent.

As CDC director under Trump, Redfield botched the initial rollout of mass testing and contact tracing and was instrumental in the dismantling of public health infrastructure. He discouraged COVID-19 testing, advocated the deadly reopening of schools in the fall of 2020, lied about the airborne nature of the virus and denigrated masking. One must ask, when the next pandemic ignites, will Redfield call for an elimination strategy or endorse a “forever bird flu” policy?

Redfield’s decades of experience in public health and discussions with experts on flu viruses and the evolution of H5N1 over nearly three decades underscore the significance of his warnings. That this particular virus has insinuated itself into livestock and animals, such as cats and mice, known to habitate homes and farms, indicates the potential ability for the virus to mutate further and potentially evolve to easily infect people via respiratory pathways.

The case of SARS-CoV-2, the virus that causes COVID-19, and its emergence from the wild animal market in Wuhan, underscores these concerns. According to the EcoHealth Alliance’s 2022 study published in Nature, the authors found an abundance of SARS-and SARS-CoV-2-related bat coronaviruses across a broad geographic region in Southern China, home to 300 million people. Their estimates indicated approximately 66,000 people were exposed to these viruses annually.

Given that 16 million people were engaged in the wild animal trade industry in China at that time, estimated at $73 billion by the Chinese Academy of Engineering, brings to the fore the connection between economics, human activity, the need for sources of alternative proteins given the prohibitive cost of basic foods and the threat of pandemics.

That SARS-CoV-2 has the ability to infect a wide array of animals besides humans suggests that the virus had already been well established in intermediary hosts before it had erupted in a self-sustaining outbreak in December 2019. Such is the case with H5N1 clade 2.3.4.4b, which emerged in 2020 when the virus reassorted between wild birds and poultry and has led to the mass killing of hundreds of millions of birds, as well as dozens of animal species.

As the STAT News report highlights, private dairy farms and agricultural businesses see the need for a thorough public health investigation into the outbreak of H5N1 as an intrusion into their profit-making. That is why the statement by the USDA—“The actions we have taken to limit movements, improve biosecurity and encourage testing are expected to establish the foundation for eliminating this virus from the dairy herd”—must be taken with a massive grain of salt. While the USDA advocates for a sound scientific approach, it is ultimately invested in the corporate structure.

It is precisely because the US cattle industry is struggling to break even that the call to investigate H5N1 on their farms and among their workers and livestock is met with trepidation. According to the Federal Reserve Bank of Kansas City, cattle inventories are at historic lows. A March 29, 2024 report notes:

Cattle producers may face challenges maintaining or restocking herds, as higher interest expenses on cattle and input purchases in 2022-23 have constrained profit margins. Although feed costs have decreased slightly, higher costs for financing and other operating expenses could continue to put pressure on cattle production and profitability.

The STAT News piece indicates the cool response from farmers to public health measures that might cut into their profits, noting:

But the government’s own data indicate the efforts have holes large enough for the virus to run through. In one USDA survey, 60 percent of farms acknowledged moving cows within a state even after the animals had started showing symptoms of infection. Federal officials have acknowledged they’re not getting much cooperation from dairy producers and workers.

Despite the clear and growing dangers of a bird flu pandemic, there is now a repeated refrain that the threat posed thus far remains low. However, one should recall a report from 2010 by influenza virologist Professor Yoshihiro Kawaoka and colleagues from the School of Veterinary Medicine at the University of Wisconsin-Madison, studying potential reassortments between co-circulating H5N1 and human H3N2 influenza viruses, which noted:

Our data demonstrate that the gene segments of these two viruses are largely compatible, resulting in 184 reassortant viruses with different replicative abilities. Pathogenicity experiments performed with 75 H5 reassortant viruses showed that 22 viruses were more pathogenic for mice than the parental SK06 virus. Strikingly, three viruses exhibited substantial lethality for mice.

As H5N1 continues to spread deeper into US dairy farms, one can ask how might the flu season evolve if these two flu viruses co-circulate, thereby allowing H5N1 to gain respiratory transmission potential with its pathogenicity intact? Are such possibilities being considered, and what preparations should US and World Health Organization (WHO) authorities undertake to prevent such a catastrophic development?

To suggest, as many political mouthpieces have, that the US and the world will somehow be prepared to vaccinate their way out of a pandemic scenario is utterly depraved and dangerous. As Rick Bright, former director of the Biomedical Advanced R&D Authority, recently told Fortune, “A head-in-the-sand approach to influenza readiness will not serve the public well when there is a need to respond to an influenza pandemic. The time to commence serious action is now, not when the country is staring down the barrel of a full pandemic.”

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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