K-in-CT 😷😷😷@KinCONN
#H5N1 @CDCgov @USDA @CAPublicHealth
⚠️🚨⚠️
There are a few problems with this #H5N1 case in a child in Alameda County, CA.
What strikes me is that CDPH has held onto this rather critical information for many days. That is *not* best practice when trying to avert a pandemic.
CDPH must have some reason, some additional concerns (beyond the obvious), to slow walk this to the extent that they did.
A very important open question: why did they decide to test the child for #H5N1? Why?
They do **not** say that the child's case was picked up on routine surveillance. They would say that if they could.
And if the child's symptoms were indeed "mild," why even test him or her? Many, many, kids are bringing home all sorts of muck on the regular from day care, from school, in the month of November.
The family is in Alameda County, near San Francisco. Not big dairy land due to the cost of real estate.
So why did CDPH even test this child for #H5N1?
CDPH is looking for a wild bird connection.
I would not just be looking for wild birds - sure, maybe the child visited a local park or the seaside.
Maybe CDPH has initial sequencing in hand and knows it's D1.1 (the avian strain)? If it is, I'd be curious to learn if it exhibits any passaging through other humans/mammals before finding the child.
I'd also be looking at who at that day care had been sick in the days *prior* to the child's illness onset. With light symptoms that were light enough to still send a child to school (same for the teachers).
The child's family *all* had similar respiratory symptoms but they were likely not tested until the child returned a positive.
The family members may have transferred the virus to the child - they may have been infected prior to the child, but their cases may have been on the way to resolution by the time the child was tested, and certainly by the time they were tested, if symptoms for all were indeed mild.
They really, really, really, don't want a human #H5N1 cluster that has no animal or bird connection. Even one with "mild" symptoms. They really don't.
CDPH is dismissing the symptoms in the others (and in the child - for whom there is no mention of conjunctivitis) by saying there was a respiratory "co-infection," and we can only hope that it was not a co-infection with a seasonal flu strain. (They don't specify what virus it was that caused the issues).
Everybody's gotten Tamiflu. The antiviral appropriately rendered the child negative upon retest four days after the first positive test.
They state that the child had a "low level" of virus, but I have many, many, questions about how people are being sampled, and when.
The "low level" of virus is signaling that we may not get complete sequence data.
Since it's been a week, why hasn't the sequence data yet become available for this very important human #H5N1 case?
It will be important to learn at least whether this clade is B3.13 (bovine) or D1.1 (avian).
And, I'll ask again, **why** was this child tested for #H5N1?
