#oseltamivir — Public Fediverse posts on home.social

''As #oseltamivir is the most widely used therapeutic and prophylactic against IAV, the continued #circulation of viruses harboring NA- #H275Y may necessitate a re-evaluation of #influenza #treatment #strategies in #Canada.''

#oseltamivir #circulation #h275y #influenza #treatment #strategies

Giuseppe Michieli @[email protected] · 2025-02-21 · 20:27 UTC

#Neuraminidase #reassortment and #oseltamivir #resistance in clade 2.3.4.4b A(#H5N1) viruses circulating among #Canadian #poultry, 2024, https://etidiohnew.blogspot.com/2025/02/neuraminidase-reassortment-and.html

Isolates from 8 farms reveal a mutation in the neuraminidase protein (H275Y) that is exceptionally rare among clade 2.3.4.4b viruses (present in 0.045% of publicly available clade 2.3.4.4b isolates). NA-H275Y is a well-known marker of resistance to the neuraminidase inhibitor oseltamivir.

#neuraminidase #reassortment #oseltamivir #resistance #h5n1 #canadian

Giuseppe Michieli @[email protected] · 2025-02-18 · 20:18 UTC

#Neuraminidase #reassortment and #oseltamivir #resistance in clade 2.3.4.4b A(#H5N1) viruses circulating among #Canadian #poultry, 2024, https://etidiohnew.blogspot.com/2025/02/neuraminidase-reassortment-and.html

#neuraminidase #reassortment #oseltamivir #resistance #h5n1 #canadian

Giuseppe Michieli @[email protected] · 2025-02-07 · 16:51 UTC

#USA, #Flu #Antiviral Drugs #Resistance: Two A #H1N1pdm09 viruses had NA-H275Y amino acid substitution conferring highly reduced #inhibition by #oseltamivir and #peramivir. One A #H1N1pdm09 virus had NA-I223V and NA-S247N amino acid substitutions and showed reduced inhibition by #oseltamivir. FluView: https://www.cdc.gov/fluview/surveillance/2025-week-05.html

#usa #flu #antiviral #resistance #h1n1pdm09 #inhibition

DoomsdaysCW @[email protected] · 2025-01-07 · 04:19 UTC

The Emerging Threat of #H5N1 to Human Health

Authors: Michael G. Ison, M.D., and Jeanne Marrazzo, M.D., M.P.H.A
Published December 31, 2024

"Highly pathogenic avian influenza (#HPAI) A(#H5N1) emerged in 1997.1 Since then, it has spread globally by migratory birds, resulting in infections in animals on every continent. HPAI A(H5N1) clade 2.3.4.4b emerged in 2021 and resulted in fatal infections in poultry as well as terrestrial and marine mammals. In early 2024, influenza A infection was first recognized in dairy cows with mastitis in Texas. Infection in dairy cows is now widespread in the United States, affecting more than 875 herds in 16 states. Most cow infections are genotype B3.13, whereas most outbreaks in wild birds and poultry are genotype D1.1.

"Against this background, more humans have come into contact with HPAI A(H5N1). Investigators now report in the Journal a series of human cases from the United States and Canada. The former series involves 46 case patients with generally mild, self-limited infection with A(H5N1): 20 with exposure to poultry, 25 with exposure to dairy cows, and 1 with undefined exposure. Among case patients with occupational exposure, the use of personal protective equipment (PPE) was not universal. Most case patients presented with conjunctivitis, almost half with fever, and a minority with mild respiratory symptoms, and all recovered. The only hospitalization occurred in the case patient with undefined exposure, although hospitalization was not for respiratory illness. Of cases with sequenceable virus, most were B3.13; four cases in patients with poultry exposure were D1.1.

"In Canada, a 13-year-old girl with mild asthma and obesity presented with conjunctivitis and fever and had progression to respiratory failure. She received intubation and venovenous extracorporeal membrane oxygenation. After treatment that included oseltamivir, amantadine, and baloxavir, she recovered. Notably, genotype D1.1 was detected; sequencing of one isolate from the lower airways that was collected 8 days after the onset of symptoms showed three mutations potentially associated with enhanced virulence and human adaptation: E627K in the polymerase basic 2 gene and E186D and Q222H in the H5 hemagglutinin gene. It is unclear whether these mutations were present in the infecting virus or emerged during the course of the patient’s illness.

"These reports show several critical features of the threat of HPAI to human health, and how we might respond. First, collaboration among investigators in human and veterinary medicine, public health leadership, health care providers, and occupational authorities (especially agricultural), exemplified by the case series in United States, is paramount. Cases of H5N1 respiratory illness have been detected because of a standard surveillance approach aimed at detecting novel (nonseasonal) influenza. This approach involves cultivating trust not only among numerous entities but with people seeking care for symptoms of concern, including #conjunctivitis.

"Second, the #mutations evident in the Canadian case highlight the urgent need for vigilant surveillance of emerging mutations and assessment of the threat of human-to-human transmission. The One Health paradigm is foundational to this outbreak, yet to date, genomic sequencing data that have been collected from animals frequently lack critical metadata. Without information pertaining to where and when isolates were collected, the data cannot be linked phylogenetically to other reported sequences, which limits insight into how the virus is spreading. Such data would also provide opportunity for early detection of mutations that might portend avidity for human respiratory epithelium, which may require as little as one mutation.

"Third, we must continue to pursue development and testing of medical countermeasures. Fortunately, current vaccine candidates neutralize the circulating strains in vitro, and these strains so far are susceptible to antiviral agents. Studies have shown the safety and immunogenicity of A(H5N1) vaccines and the need for a two-dose prime–boost approach and use with adjuvants. Work is ongoing to complete candidate vaccines for clinical use, if needed. Furthermore, studies are ongoing to develop messenger RNA–based A(H5N1) vaccines and other novel vaccines that can provide protection against a broad range of influenza viruses, including A(H5N1). Circulating isolates are susceptible to all approved neuraminidase inhibitors, adamantanes, and baloxavir marboxil. The Canadian case showed higher viral loads in the lower airway and very prolonged shedding, despite therapy, which highlights the potential need for longer therapy. Recently, the Centers for Disease Control and Prevention (CDC) issued emergency-use instructions for oseltamivir that recommend longer durations of oseltamivir therapy for persons hospitalized with novel influenza viruses and twice-daily dose administration for prophylaxis. Baloxavir marboxil is not recommended for monotherapy in hospitalized patients because of concern for resistance emergence. Resistance to #oseltamivir has occurred frequently among patients hospitalized for A(H5N1) infection. Combination of two agents may reduce this risk.

"Fourth, precautions to prevent infection are critical, including the use and optimization of PPE in occupational settings and education about the risk of contact with sick birds and animals. PPE use can be challenging in settings where dust, milk, and feathers may easily contaminate surfaces. Many environments are not air-conditioned and during the summer may be exceptionally warm, and the use of large fans may facilitate airborne particles.
Although these reports help to define some aspects of the clinical course of infection in the current H5N1 outbreak, many questions remain. The type of clinical presentation and severity may depend on the host, the route and inoculum of exposure, and the virus clade. For example, severe cases to date have been associated only with the wild-bird clade, D1.1. Historically, H5N1 infection in Southeast Asia and Egypt has been associated with a case fatality rate of approximately 50%. Whether host immunity (e.g., changes in population-level immunity to the neuraminidase component [N1] of seasonal influenza virus), route of exposure, or other changes in the virus itself might be partly responsible for the lower case fatality rate in North America is unknown.
The CDC still designates the risk of HPAI A(H5N1) to most Americans as low. We do have candidate vaccines and antivirals available to try to mitigate severe influenza in the case of wider spread. That said, a balance between enhanced vigilance and “business as usual” is needed. The past weeks have seen more cases detected in more states as well as more persons with respiratory illness acquired through exposure to poultry or from an unknown source. Without a clearer understanding of the extent of exposure, infection, viral evolution, and transmission, we will be unable to properly protect our communities from a pathogen that has proven to be a formidable challenge to human and animal health."

https://www.nejm.org/doi/full/10.1056/NEJMe2416323
#BirdFlu #Flu #Pandemic #PPE #AvianInfluenza

#h5n1 #hpai #conjunctivitis #mutations #oseltamivir #birdflu

Giuseppe Michieli @[email protected] · 2024-11-28 · 20:37 UTC

#Benefit of early #oseltamivir #therapy for #adults hospitalized with #influenza A: an observational study

Source: Clinical Infectious Diseases, AbstractBackgroundclinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza. MethodsA multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza…

https://etidioh.wordpress.com/2024/11/28/benefit-of-early-oseltamivir-therapy-for-adults-hospitalized-with-influenza-a-an-observational-study/

#benefit #oseltamivir #therapy #adults #influenza

ETIDIoH @[email protected] · 2024-11-28 · 20:37 UTC

#Benefit of early #oseltamivir #therapy for #adults hospitalized with #influenza A: an observational study

Source: Clinical Infectious Diseases, https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciae584/7912192

Abstract
Background
clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza.

Methods
A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during October 1, 2022–July 21, 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), adjusting for baseline (admission day) severity, age, sex, site, and vaccination status. Multivariable logistic regression models were used to evaluate the odds of intensive care unit (ICU) admission, acute kidney replacement therapy or vasopressor use, and in-hospital death.

Results
A total of 840 influenza-positive patients were analyzed, including 415 (49%) who started oseltamivir treatment on the day of admission, and 425 (51%) who did not. Compared with late or not treated patients, those treated early had lower peak pulmonary disease severity (proportional aOR: 0.60, 95% CI: 0.49–0.72), and lower odds of intensive care unit admission (aOR: 0.24, 95% CI: 0.13–0.47), acute kidney replacement therapy or vasopressor use (aOR: 0.40, 95% CI: 0.22–0.67), and in-hospital death (aOR: 0.36, 95% CI: 0.18–0.72).

Conclusion
Among adults hospitalized with influenza, treatment with oseltamivir on day of hospital admission was associated reduced risk of disease progression, including pulmonary and extrapulmonary organ failure and death.

____

#abstract #antivirals #health #healthcare #news #oseltamivir #research #SEASONALINFLUENZA #vaccine #wellness

#abstract #antivirals #health #healthcare #news #oseltamivir

ETIDIoH @[email protected] · 2024-11-22 · 16:55 UTC

13th #Meeting of #WHO Expert Working #Group on #Surveillance of #Antiviral Susceptibility of #Influenza Viruses for WHO #GISRS

Source: World Health Organization, Weekly Epidemiological Record: https://www.who.int/publications/journals/weekly-epidemiological-record

{Excerpt, edited}

Executive summary

The WHO Expert Working Group on Surveillance of Influenza Antiviral Susceptibility (AVWG) supports the WHO Global Influenza Surveillance and Response System (GISRS) by providing practical guidance for monitoring the antiviral susceptibility of seasonal and emerging influenza viruses The 13th WHO AVWG meeting was held in hybrid format (faceto-face and virtually) on 13–14 June 2024 in Lyon, France.

Update on susceptibility of seasonal influenza viruses to approved antiviral agents

Between May 2023 and May 2024, WHO collaborating centres (CCs) and participating national influenza centres (NICs) reported that seasonal influenza activity in various regions had resumed to levels before the coronavirus disease 2019 (COVID-19) pandemic. Co-circulation of A(H1N1)pdm09, A(H3N2) and influenza B/Victoria lineage viruses was detected in most regions. Overall, influenza A and B viruses with reduced inhibition (RI) or highly reduced inhibition (HRI) to neuraminidase (NA) inhibitors (NAIs) were detected at low frequency. The most frequently identified substitution associated with RI or HRI by NAIs was NA-H275Y in A(H1N1)pdm09 viruses, which was detected at <2%. Double amino acid substitutions (NA-I223V+ NA-S247N) in A(H1N1)pdm09 viruses (referred to as dual mutant viruses) that resulted in RI by oseltamivir were first detected in May 2023 and spread rapidly to several regions of the world.{1,2} Influenza A and B viruses with amino acid substitutions in the polymerase acidic (PA) protein associated with reduced susceptibility to endonuclease inhibitor (baloxavir) were detected at low frequency. The PA-I38X (including I38T, I38N, I38M and I38V) amino acid substitution being the most frequently reported, but the overall detection frequency has remained low (<2%).

Update on susceptibility of zoonotic and animal influenza viruses to approved antiviral agents

From May 2023 to May 2024, clade 2.3.4.4b A(H5N1) highly pathogenic avian influenza (HPAI) viruses continued to be detected in various regions of the world. Since early 2024, there has been an outbreak of clade 2.3.4.4b A(H5N1) genotype B3.13 viruses in dairy cattle in several states in the United States of America, resulting in sporadic zoonotic infections in humans. In addition, human infection with clade 2.3.2.1c A(H5N1) HPAI has been reported in Cambodia and Viet Nam. WHO CCs, participating NICs and WHO H5 reference laboratories reported antiviral susceptibility testing of A(H5N1) HPAI, low pathogenic avian influenza (LPAI) of various subtypes and swine influenza viruses. Of the clade 2.3.4.4b A(H5N1) HPAI viruses, the NA-T438I substitution, which confers RI by zanamivir and peramivir, was detected at <2% frequency. NA-H275Y, NA-N295S and NA-N295S+NA-T438N associated with RI or HRI by NAIs were also detected among A(H5N1) viruses. NA-T438I has been detected in A(H5N1) viruses isolated from dairy cattle. PA-I38T, PA-A37T and PA-I38M, associated with reduced susceptibility to baloxavir, were detected in A(H5N1) viruses. Most A(H5N1) HPAI viruses remain susceptible to M2 ion channel blockers. Among LPAI, NA-H274Y with HRI by oseltamivir was detected in one A(H8N4) isolate. PA-E199G with reduced susceptibility to baloxavir was detected in one A(H9N2) virus. Overall, animal or zoonotic influenza viruses with reduced susceptibility to NAIs or baloxavir were detected at very low frequencies.

Update of protocols and guidance for GISRS laboratories

Genotypic and/or phenotypic assays can be used to monitor the susceptibility of influenza viruses to NAIs and baloxavir. The WHO AVWG routinely reviews and updates information on NA{3,4} and PA{5} amino acid substitutions associated with reduced susceptibility to NAIs and baloxavir, respectively. Reference virus panels that can be used for NAI and baloxavir susceptibility testing are available for GISRS laboratories at the International Reagent Resource.{6} The WHO AVWG will develop an algorithm for NICs to decide on testing strategies (genotypic versus phenotypic) and methods according to their capacity. Guidance on phenotypic assays for NAI susceptibility testing is provided in a WHO guidance document to NICs, which was updated in 2018.{7} A new phenotypic assay has been developed for testing susceptibility to baloxavir.{8} The protocol will be posted on the WHO website. The WHO-AVWG will also update the WHO guidance document to NICs to include the new phenotypic assay for baloxavir susceptibility testing. In addition, the WHO AVWG will work with the Global Initiative on Sharing All Influenza Data{9} to facilitate identification of NA and PA substitutions in submitted sequences.

Review of external quality assessment programme (EQAP) panels

EQAP was initiated in 2007, and the antiviral panel was introduced in 2013 (panel 12) as an optional component of EQAP to evaluate the ability of NICs to identify influenza viruses with reduced susceptibility to NAIs. Genotypic testing for baloxavir susceptibility was introduced in 2020 (panel 19) for educational purpose (i.e. not scored). Results for the 2023 Global EQAP panel were reported at the 13th WHO AVWG meeting. A total of 178 laboratories participated in the 2023 EQAP; 46 (25.8%) participated in NAI susceptibility testing and 16 (9.0%) in baloxavir susceptibility testing. The results from the Global EQAP antiviral panel are used by members of the WHO AVWG to assess the training requirements of NICs.

Way forward

Two reports, on global antiviral surveillance in 2020-2023 and in 2023–2024, are being prepared for publication. The next WHO AVWG meeting is scheduled for June 2025.

___

{1} Leung RC et al. Global emergence of neuraminidase inhibitor-resistant influenza A(H1N1)pdm09 viruses with I223V and S247N mutations: implications for antiviral resistance monitoring. Lancet Microbe. 2024;5(7):627–8. doi:10.1016/S26665247(24)00037-5.

{2} Patel MC et al. Multicountry spread of influenza A(H1N1)pdm09 viruses with reduced oseltamivir inhibition, May 2023-February 2024. Emerg Infect Dis. 2024;30(7):1410–5. doi:10.3201/eid3007.240480.

{3} Summary of neuraminidase (NA) amino acid substitutions associated with reduced inhibition by neuraminidase inhibitors (NAIs). Geneva: World Health Organization; 2023 (https://www.who.int/publications/m/item/summary-of-neuraminidase-(na)-amino-acid-substitutions-associated-with-reduced-inhibition-by-neuraminidase-inhibitors-(nais).

{4} Summary of neuraminidase (NA) amino acid substitutions associated with reduced inhibition by neuraminidase inhibitors (NAIs) among avian influenza viruses of Group 1 and Group 2 NAs. Geneva: World Health Organization; 2024 (https://www. who.int/publications/m/item/summary-of-neuraminidase-(na)-amino-acid-substitutions-associated-with-reduced-inhibition-by-neuraminidase-inhibitors-(nais)among-avian-influenza-viruses-of-group-1-and-group-2-nas).

{5} Summary of polymerase acidic (PA) protein amino acid substitutions analysed for their effects on baloxavir susceptibility. Geneva: World Health Organization; 2024 (https://www.who.int/publications/m/item/summary-of-polymerase-acidic-(pa)-protein-amino-acid-substitutions-analysed-for-their-effects-on-baloxavirsusceptibility).

{6} See https://www.internationalreagentresource.org.

{7} Practical guidance for national influenza centres establishing or implementing neuraminidase inhibitor susceptibility surveillance. Geneva: World Health Organization; 2024 (https://www.who.int/publications/i/item/practical-guidance-for-national-inf luenza-centres-establishing-or-implementing-neuraminidase-inhibitor-susceptibility-surveillance).

{8} Baloxavir susceptibility assessment using influenza replication inhibition neuraminidase-based assay (IRINA). Atlanta (GA): Centers for Disease Control and Prevention; 2023 (https://cdn.who.int/media/docs/default-source/influenza/avwg/ cdc-phenotypic-lp-492rev01d—baloxavir-susceptibility-assessment-using-irina. pdf?sfvrsn=f24254ac_3).

{9} See https://gisaid.org.

_____

#aH3n2 #aH5n1 #aH9n2 #amantadine #antivirals #AVIANINFLUENZA #baloxavir #birdFlu #drugsResistance #h1n1pdm09 #h5n1 #health #influenza #oseltamivir #science #SEASONALINFLUENZA #updates #WHO #zanamivir

#ah3n2 #ah5n1 #ah9n2 #amantadine #antivirals #avianinfluenza

Giuseppe Michieli @[email protected] · 2024-11-14 · 16:27 UTC

Adverse #events associated with #oseltamivir and #baloxavir marboxil in against #influenza virus #therapy: A #pharmacovigilance study using the FAERS database

Source: PLoS One, AbstractBackgroundInfluenza virus is a widespread pathogen that poses significant health risks to humans. Oseltamivir and Baloxavir Marboxil are commonly utilized medications for both treating and preventing influenza infections. Despite their widespread use, there remains a need to thoroughly…

https://etidioh.wordpress.com/2024/11/14/adverse-events-associated-with-oseltamivir-and-baloxavir-marboxil-in-against-influenza-virus-therapy-a-pharmacovigilance-study-using-the-faers-database/

#events #oseltamivir #baloxavir #influenza #therapy #pharmacovigilance

ETIDIoH @[email protected] · 2024-11-14 · 16:27 UTC

Adverse #events associated with #oseltamivir and #baloxavir marboxil in against #influenza virus #therapy: A #pharmacovigilance study using the FAERS database

Source: PLoS One, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0308998

Abstract
Background
Influenza virus is a widespread pathogen that poses significant health risks to humans. Oseltamivir and Baloxavir Marboxil are commonly utilized medications for both treating and preventing influenza infections. Despite their widespread use, there remains a need to thoroughly investigate their safety profiles and potential adverse reactions.

Objective
This study aims to comprehensively analyze the adverse events associated with oseltamivir and baloxavir marboxil in real-world clinical settings, with the goal of assessing their safety and potential risks in the management of influenza virus infections.

Methods
We conducted a retrospective analysis utilizing data from the Food and Drug Administration Adverse Event Reporting System (FAERS) database, spanning from the first quarter of 2004 to the third quarter of 2023. The analysis encompassed examination of drug utilization patterns, types of adverse events reported, patient demographics, and other pertinent factors.

Results
From the first quarter of 2004 to the third quarter of 2023, FAERS collected over 17,035,521 adverse event reports (AE reports). Among these reports, there were 38,384 reports associated with oseltamivir, and 3,364 reports associated with baloxavir marboxil. Oseltamivir and Baloxavir Marboxil were primarily used for the treatment of influenza virus infections, accounting for 62.43% and 67.49% of their total usage, respectively. The main adverse reactions reported for oseltamivir were vomiting (case reports = 1402) followed by confusional state (case reports = 353), while for baloxavir marboxil, adverse reactions mainly centered around off-label use (case reports = 378) and intentional product use issues (case reports = 278). In terms of systemic adverse reactions, oseltamivir primarily affected psychiatric disorders (n = 45), whereas baloxavir marboxil mainly impacted the gastrointestinal system (n = 7). Additionally, regarding adverse reactions in pregnant women, the occurrence of normal newborns was a significant signal for oseltamivir, suggesting a certain level of safety during maternal use. Conversely, reports of adverse reactions such as respiratory arrest were documented for baloxavir marboxil, while no such reports were associated with oseltamivir.

Conclusion
This study provides a comprehensive analysis of the adverse reactions observed with the clinical use of oseltamivir and baloxavir marboxil, revealing the safety and risks associated with these two drugs in the treatment and prevention of influenza virus infections. Firstly, although both drugs are used for influenza treatment, they exhibit different types of adverse reactions. Oseltamivir predominantly affects the psychiatric system, while baloxavir marboxil primarily impacts the gastrointestinal system. Additionally, oseltamivir demonstrates a certain level of safety for use in pregnant women, while reports of adverse reactions such as respiratory arrest are associated with baloxavir marboxil. Despite the clinical significance of this study, limitations exist due to the voluntary nature of data reporting, which may lead to reporting biases and incomplete information. Future research could employ more rigorous prospective study designs, integrating clinical trials and epidemiological studies, to more accurately assess the safety risks of oseltamivir and baloxavir marboxil.

____

#abstract #antivirals #baloxavir #birdFlu #drugsSafety #health #healthcare #news #oseltamivir #pregnancy #research #seasonalInfluenza

#abstract #antivirals #baloxavir #birdflu #drugssafety #health

ETIDIoH @[email protected] · 2024-11-08 · 20:27 UTC

Source: US Centers for Disease Control and Prevention, https://www.cdc.gov/bird-flu/prevention/hpai-interim-recommendations.html

{Excerpt}

Summary

The purpose of this guidance is to outline CDC's recommendations for preventing exposures to highly pathogenic avian influenza (HPAI) A(H5N1) viruses, infection prevention and control measures including the use of personal protective equipment, testing, antiviral treatment, patient investigations, monitoring of exposed persons (including persons exposed to sick or dead wild and domesticated animals and livestock with suspected or confirmed infection with highly pathogenic avian influenza (HPAI) A(H5N1) virus), and antiviral chemoprophylaxis of exposed persons. These recommendations are based on available information and will be updated as needed when new information becomes available.

(…)

____

https://etidioh.wordpress.com/2024/11/08/highly-pathogenic-avian-influenza-ah5n1-virus-interim-recommendations-for-prevention-monitoring-and-public-health-investigations/

#aH5n1 #antivirals #avianInfluenza #human #oseltamivir #postExposureProphylaxis #PPE #updates #USCDC #USA

#ah5n1 #antivirals #avianinfluenza #human #oseltamivir #postexposureprophylaxis

ETIDIoH @[email protected] · 2024-11-08 · 09:46 UTC

Source: US Centers for Disease Control and Prevention, edited, https://www.cdc.gov/media/releases/2024/t1107-mmwr-telebriefing.html

Please Note: This transcript is not edited and may contain errors.

Operator – 00:00

Welcome and thank you for standing by. At this time, all participants are in a listen only mode until the question and answer session of today's conference. At that time, you may press star one on your phone to ask a question. I would like to inform all parties that today's conference is being recorded. If you have any objections, you may disconnect at this time, I would now like to turn the conference over to Benjamin Haynes, thank you, maybe again.

Moderator – 00:23

Thank you Courtney, and thank you all for joining us today as we release a new MMWR and updated CDC guidance on the H5N1 bird flu outbreaks. We're joined today by Dr. Demetre C. Daskalakis, Director of the National Center for Immunization and Respiratory Diseases and CDC Principal Deputy Director, Dr. Nirav Shah, I'd like to remind everybody that this briefing is embargoed until 1pm Eastern, when our MMWR goes live on the CDC website. I'll now turn the call over to Dr Daskalakis.

Dr. Demetre C. Daskalakis – 00:58

Thank you and good morning everyone. I will first provide an update on H5 cases in the United States. Then we'll share some findings that are being published in an MMWR later today.

So first, the situation overview.

To date, there have been 46 human cases of H5 in the US, in 2024 25 cases were due to the ongoing outbreak in dairy cows. 20, which of which are 21, of which are in California. 20 cases are due to poultry depopulation, including the 11 recent cases from Washington State. Additionally, there is one case in Missouri with no known animal or animal product exposure.

CDC continues to assess the risk to the general population is low.

Efforts to protect people with exposure to animals or animal products affected by H5 continues to be a key focus of our public health activities. I'd like to now share the results of an important study focused on workers that will be published in the Morbidity and Mortality Weekly Report later today, or MMWR.

So this is the Michigan Colorado dairy worker survey, CDC, coordinated with state health departments in Michigan and Colorado to conduct an anonymized serosurvey among dairy workers exposed to dairy cows infected with H5N1 influenza A. So as a reminder, a serosurvey is a collection and testing of blood from a defined population.

In this case, dairy farm workers to estimate the prevalence of antibodies against an infectious pathogen, in this case, H5N1, as an indicator of possible exposure prevalence or immunity.

The purpose of the serosurvey was to expand our understanding of the extent of infections among exposed dairy farm worker workers, how these infections related to symptoms experienced by participants, and what activities or actions were associated with infection.

Blood samples were collected from June to August 2024 from 115 people who worked on dairy farms in Michigan and Colorado with cows that were confirmed positive for H5 virus.

35 of the people included in this serosurvey had results previously reported earlier this summer, and as a reminder, there were dairy farm workers from Michigan and all tested negative for H5N1 antibodies.

80 additional people were recruited in Michigan and Colorado to increase the sample size of the serosurvey and provide more robust results.

Samples were collected 15 to 90 days after H5N1 virus was identified in cows on the farm. Along with getting their blood drawn, individuals were interviewed to learn more about what they did on the farm, what protective measures they took, and whether they had been sick since cows on their farms had been diagnosed with H5N1 or quarantine.

All samples were tested for antibodies against the H5N1 virus isolated from the first human case this year in Texas. And we also tested samples against a seasonal H1N1, virus as a positive control.

So on to the results, eight of the 115 samples, that's 7% were seropositive against HPAI, or highly pathogenic avian influenza. The 2.3.4.4b A clade that we see circulating among dairy cows using two different antibody tests to be considered antibody or seropositive, both tests had to be positive using accepted criteria.

Another lab protocol was also performed to remove seasonal influenza antibodies and to rule out that the positive H5N1 tests were due to cross reactivity related to these commonly circulated viruses.

On to the specific results, 8 of the 115 people tested positive for H5N1 antibodies using this protocol of the seropositive individuals, four remembered having symptoms, mostly conjunctivitis. The other four did not among these four people, illnesses began prior to or shortly after identification of infected herds, more details of who was who had positive results. All eight were Spanish speakers. All eight reported milking cows or cleaning the milking parlor, supporting these as higher risk activities, none wore respiratory protection, and less than half were eye protection, highlighting the need for better tools to support worker protection. Only one person reported they worked with infected cows, despite the fact that they were working with cows on farms with known infection.

One important limitation to the survey data is that the interviews were conducted on an average 49 days after the first exposure to infected cows with some workers interviewed up to 90 days after their first exposure. That makes recall of minor symptoms potentially difficult.

Nevertheless, these data help us better understand the potential for infection with mild or no symptoms, as well as highlighting interventions that may help workers reduce their risk of exposure and infection with H5N1.

I’ll now hand the mic over to Dr. Shah, who will go into more details about actions that CDC is taking to further mitigate risk to people who work with animals and animal products potentially affected by H5N1 Dr Shah.

Dr. Nirav Shah – 06:05

Thank you, Dr Daskalakis, and good morning everyone. This is Nirav Shah from CDC, and I'm going to be discussing the steps that CDC is taking in light of the serology results that Dr Daskalakis just outlined. The purpose of these actions is to keep workers safe, to limit the transmission of H5N1 to humans and reduce the possibility of the virus changing right now.

There are two principal ways that people in the United States are being infected with H5N1 via exposure to infected poultry during culling events, and via exposure to infected dairy cows during the milking process. What we are announcing today is an intensification of recommendations to focus on the highest exposure tasks in poultry and dairy operations, ultimately to reduce the risk of infection.

We're doing so in three areas.

Number one, expanding our recommendation for who should be tested for H5N1.

Number two, a new recommendation for use of Tamiflu for exposed, asymptomatic workers.

And then number three, focusing our PPE guidance for workers based on their risk of exposure coupled with additional training activities.

So let's start with testing the serology data that Dr Daskalakis outlined show that there may be individuals who were infected with H5 but who do not recall having symptoms. That means that we in public health need to cast a wider net in terms of who is offered a test so that we can identify, treat and isolate those individuals. Now, previously, as part of an outbreak investigation, we focused on workers who were exposed and who had symptoms.

Going forward, CDC is expanding our testing recommendation to include workers who were exposed and who do not have symptoms, particularly those workers who were exposed without having worn proper PPE. Again, we're expanding our recommendation to include workers who were exposed and who do not have symptoms, particularly those who were not wearing appropriate PPE.

The purpose of this expansion, informed by the new serology data, is to actively identify exposed workers with H5, even if their symptoms are so mild as to be unnoticeable, so that those two that those workers too, can be offered treatment and isolation. This active case finding reduces the likelihood that a mild infection could turn into a severe infection, or that the infection spreads to anyone else.

Simply put, the less room we give this virus to run, the fewer chances it has to cause harm or to change. And the best way to limit the virus's room to run is to test, identify, treat and isolate as many cases as possible in humans and as quickly as possible.

Second, let's turn to our new recommendation for medication for exposed asymptomatic workers. A key part of our strategy is to offer treatment with Tamiflu to workers who were exposed and who show symptoms that are consistent with H5N1 infection, but in light of the data that Dr Daskalakis outlined, which showed again, the existence of individuals with mild or even no symptoms that they can remember, CDC now recommends offering Tamiflu to asymptomatic workers who had a high risk exposure to H5N1 animals without having worn adequate PPE.

Again, we are expanding the scope of who CDC recommends Tamiflu for to include now workers who are asymptomatic, who had a high risk exposure to an H5N1 infected animal without having worn adequate PPE.

So what's at high risk exposure? Well, that could include an unprotected splash in the face with raw cow milk or on the poultry setting, something that might have happened during a depopulation or culling event where the individual was not wearing appropriate PPE.

Just as with our expanded testing recommendation, more widespread use of Tamiflu achieves several goals. Chief among them is to protect workers. It reduces the likelihood of an asymptomatic case being symptomatic because they're receiving Tamiflu, and thus, it lowers the risk and the chances of onward transmission to close contacts, and then the third thing is our focus on PPE guidance to farms and workers based on their risk level.

CDC continues to focus on primary prevention strategies like PPE for workers with potential occupational exposures to animals or to animal products that are infected by H5 in light of the serology data. CDC is updating our PPE recommendations for workers based on their risk of workplace exposure going forward.

CDC PPE recommendations will prioritize what PPE a farm worker should wear based on our data indicating which farm tasks present the highest risk for H5N1, exposure and infection, for example, culling operations or working in the milking parlor with sick or infected animals, simply put, the higher risk activities will call for more PPE use.

CDC has developed additional resources to support training workers on PPE use and to explain its role in preventing H5N1 from animals infecting humans.

CDC will continue to evaluate this situation and will update our guidance as needed. To close, what we've discussed today is an example of CDC using data to drive action. We will continue working with trusted partners to reach farm workers and their employers to communicate these prevention strategies as widely as possible. And then finally, before we open it up to questions, we will, we anticipate publishing a spotlight today that contains these updated recommendations. With that, we'll turn it over back to our team for questions.

Moderator 12:34

Thank you. Dr. Shah. We are now ready to open up for questions.

Operator – 12:39

Thank you. We will now begin the question and answer session. If you would like to ask a question, please press star one. If you need to withdraw your question, press star two. Again to ask a question, please press star one. Our first question comes from Brenda Goodman from CNN.

Brenda Goodman – CNN – 12:58

Thank you so much for taking my question and congratulations on these studies, because I know you had some significant headwinds to get them done. I have a question about the eight workers, are they counted as cases now? Or will they be counted as cases in the human case count? And then I was curious. You gave an update at the beginning. Dr Daskalakis about how many human cases of H5 were associated with poultry depopulations this year. Why do you think we're so many seeing so many more human infections with poultry depopulation because we've had age five in poultry before, and I think we only had one case prior this year.

Dr. Demetre C. Daskalakis – 13:38

Great. Thank you for those questions. So on the first question, these retrospective serologies are not going to be reported as cases, so they are really looking retrospectively, helping us learn, but they're not going to be called cases. On the second question, I think there are a lot of reasons why we could potentially be seeing more human disease related to or human infections related to the culling operations. 

One is there's more H5, so that's probably one of the most important. Like both in wild birds as well as in poultry, we're seeing a significant increase, and the more the sort of H5 community viral load is high in animals, the more likely it is that humans will be exposed. 

I think the second is also that we, I think, have raised a lot of attention to carefully screening individuals with H5 exposure for even mild symptoms. So there could be that as well. 

In terms of other characteristics of the virus, we are not seeing any changes with the virus that would indicate ease of transmission. But given sort of our current environment, the sort of increasing experience with age five and one really creating strategies to better protect workers based on this data is, I think, the right thing to do at this time.

Operator – 15:00

Our next question comes from Megan Molteni from STAT

Megan Molteni from STAT – 15:06

Thanks for taking my question. I was wondering if you could clarify something that you said about only one of the persons who tested positive for antibodies reporting having worked with known infected cows, and it sounded like you were saying that that meant there was a need for more additional education. But could it also be that these animals that they're working with are asymptomatic, and so, you know, they're going through the milking parlors and they're not getting separated out into quarantine? Can you talk a bit about what we know about asymptomatic disease in the animal.

Dr. Demetre C. Daskalakis – 15:41

Great. Thank you. So. So I think that you put the nail on the head that this is really about about education and also self-assessment of risk, which I think is an important piece of both why one would wear post, why one would wear appropriate PPE as well as pursue post exposure prophylaxis. So these were farms with known infected cows, and so it was really about the fact that they didn't have the awareness that they had any sick cows that they were working with, even though they were in environments where sick cows were known. So it really speaks to the importance of more on farm training around H5 as well as ways to protect from H5

Megan Molteni from STAT – 16:22

Okay, thank you. Can you also just, very quickly, are there any more serology studies planned in other states, like thinking about California, given the number of herds we see there now.

Dr. Demetre C. Daskalakis – 16:33

Thank you for that question. So we are currently working, and I think we've, we've put this up on one of our prior spotlights on a serology study, a serosurvey, that is that was conducted it physically in Ohio, because there was a large convention of bovine practitioners, and so we about 150 of them provided blood samples as well as survey data. And we will update on those once they become available.

Operator – 17:04

Our next question comes from Josh Nathan-Kazis from Barrons.

Josh Nathan-Kazis from Barrons – 17:08

Sorry. Thank you so much. Two quick questions. One, I wonder if you could have some context. I mean, how unexpected is it that there would be asymptomatic HVAC cases? That's something that's been seen before elsewhere. How much of a surprise of the finding and separately I saw in the MMWR says that 40% of the workers reported feeling ill while H5 was on their farm, although only a fraction of those actually had serological evidence of infection. I wonder, if you just talk about what might be going on there and why so many of the workers said they felt sick, even if their blood tests didn't say they were sick.

Dr. Demetre C. Daskalakis – 17:46

Thank you. So on the first question, I think that the only way to sort of take out surprises by doing the studies, which is why it's important that we have that information. 

But I think given the mildness of the symptoms that many people are presenting with, it's not a surprise that some people wouldn't recall symptoms up to 90 days after their exposure. 

So again, though not surprising, it actually is approximately in line with other serosurveys that have been conducted that focused on, on, again, this specific clade of H5N1, so a study that happened in workers, 2223 showed about 4.6% were seropositive, and about 14% as you recall from a pre print that UT Galveston Galveston put out in early 2024 also showed asymptomatic individuals with infection. 

So again, not surprising, but in line with some of the other data. 

Now, question two, not every respiratory symptom is related to H5N1. And so we've actually seen in other environments that there is several other viruses that could explain respiratory symptoms. 

So in this circumstance, though there was not serology done for other respiratory symptoms, that likelihood is that the illnesses that they that they experienced, were not caused by H5N1 based on our testing criteria. Over,

Dr. Nirav Shah – 19:13

Hey Josh, this is Nirav. One other point you noted, or you framed some of these results as asymptomatic, the structure of the survey itself doesn't demonstrate whether these individuals were asymptomatic or whether they just couldn't remember having had symptoms. 

And so the most we can say is that they can't remember having had symptoms. Some of them may have had mild symptoms that, again, were unmemorable. Some of them may have been indeed asymptomatic. The data that we have does not allow us to determine which of those it was, and so for that reason, we're not characterizing these as asymptomatic. All we can say is that they don't recall having had symptoms.

Operator – 19:55

Our next question comes from Erica Edwards.

Erica Edwards – 20:00

Hey, thanks so much. I appreciate the opportunity. And a couple questions. One is about the severity of H5N1 illness in people. I mean, obviously previous estimates from other areas of the world have quoted mortality rate of at least 50% I'm curious what you're learning about from studying the H5N1 infections here in the US that I think would be quite mild. What's different here? And then, if I also could ask, could you talk about any work that's being done to develop rapid tests, H5N1? Thank you.

Dr. Demetre C. Daskalakis – 20:32

Thanks for that question. So on, the severity, again, what we've been seeing in the United States is extremely mild symptoms. 

So again, ranging from moderate to mild conjunctivitis, and some people also experiencing mild respiratory symptoms, and also some with constitutional symptoms, like there have been some folks with beavers. 

So, you know, I think that there are a couple of hypotheses, which is all that we can really provide as to why there's a difference in severity. 

One, you know though, though H, all, H, 5n, ones are not built the same. So these are actually potentially different genotypes. So we know that there's sort of different clades and genotypes circulating. 

So what we have in the US at this point has only caused mild illness. 

Also, there could be issues related to the populations that are exposed to the virus, as well as to the magnitude of the exposure. So again, all hypotheses. So we don't have a very clear answer, but from the perspective of what we're seeing in the US, everything has been mild.

Dr. Nirav Shah – 21:40

And then this is Nirav on your latter question around rapid tests. So CDC has been working very closely with our colleagues at NIH particularly their rad X program, to evaluate some of the rapid diagnostic tests that are already available on the market, to determine whether those tests are capable of detecting H5 These are tests that can already detect influenza A, influenza B, sometimes even COVID in general. 

But the question is, can they detect H5 the current circulating version of H5 as part of their overall diagnostic approach? And CDC has been collaborating with our NIH colleagues to try to understand the utility of those tests. We don't have a timeline on when those data will be available, but I know that work is underway right now. 

Separately, we've been working with diagnostics companies to determine what types of additional rapid tests might be useful in the marketplace to try to move or shorten the duration between becoming symptomatic or exposed and then being able to have access to testing. Clearly rapid test still an important niche there, so we're very much in favor of them. We've just got to make sure that they are capable of serving that purpose.

Dr. Demetre C. Daskalakis – 22:48

Just one other thing to add is CDC will also be working with with a couple of states, to do a testing pilot where we're actually assessing a near point of care, or point of care test against lab based testing for H5, so that will also help elucidate some point of care strategies or or self-testing that may help in the future.

Operator – 23:15

Our next question comes from Washington Post.

Washington Post – 23:21

Hi. Thanks for taking this call. Two questions. One, you mentioned one of the justifications for these precautionary measures being preventing onward spread, but we've also been hearing there's no evidence of human to human transmission. So does this new data create any concerns that some of these dairy workers may have been spreading the virus among each other, and then the second one is now that we have an incoming administration that's promised mass deportations. Are you worried about about a cooperation with these, investing with these investigate public health investigations in the future? Would you get the same kind of cooperation that you did with with workers, if there's a potential, if there's mass deportations looming, great

Dr. Nirav Shah – 24:07

This is Nirav as to the former question, I'm glad you raised that for avoidance of doubt and for clarity, there is nothing that we've seen in the new serology data that gives rise to a concern about person to person transmission. So to your point that you made about, why are we going this extra step with additional testing and Tamiflu to further in that regard? And the answer is to drive that risk down as low as possible. This is fundamentally a respiratory virus, and although we have not seen changes to the virus that would suggest the capacity for it to spread from person to person. 

We want to keep that risk as low as where it is right now, one of the best ways to do that is to identify individuals who have been exposed through greater testing and provide them with Tamiflu to drive down the levels of virus in their body, which, again. Helps us keep that low risk as low as possible. As to your latter question, we're not commenting on anything related to transition or an incoming administration. We're focused today on the serology data and the CDC actions therein. Thanks,

Moderator – 25:15

Cortney. We have time for two more questions, please.

Operator – 25:19

Our next question comes from Youri Benadjalud from ABC News.

Youri Benadjalud from ABC News – 25:22

Thanks for taking my question. This data seems to support that there are a lot of cases that are potentially being undercounted, and there's only 46 confirmed by the CDC so far. How many cases in across forums, in the US, do you think that could actually be out there? And then I'll have a follow up, please.

Dr. Nirav Shah – 25:43

Thanks Yuri. Our data suggests that there in any outbreak situation, we know that there are individuals who may have been exposed, may have been infected, who are not part of the count. This is what serology data helps us get a better retrospective understanding of we still need more data to better characterize that so we can't speculate today on how many unidentified cases that there might be. We've always known that that's a possibility. What these data really help us understand is that some of those workers may have had such mild symptoms, such that they may not recall having been ill, and thus we need to identify those individuals and make sure they've got medication, as I said, in connection with the prior question, to drive their risk of getting ill as far as possible down, as well as to reduce the likelihood of spread. But better characterizing right now, how much of the iceberg is above the water versus below the water. It's not something we have enough data on quite yet.

Operator – 26:43

Our last question was from Kai Kuperschmid from Himes Magazine.

Kai Kuperschmid from Himes Magazine – 26:51

Thanks for taking my question. So I wanted to ask a little bit about the timeline. Here you said the the samples were taken, I think June to August. It's November now, and just in general, I mean, it's taken a long time to get this kind of data. I know a lot of people have been waiting for it. Can you describe a little bit why it took this long, and what the hurdles are to do this, also to do it in other places, possibly. Thanks guys.

Dr. Demetre C. Daskalakis – 27:14

So I think a lot of the timeline is really around just sort of the standard procedures for serology for H5. So the first is again, we had to sort of gather the specimens. They had to come to CDC. And then the subsequent pieces are that these 115 specimens had to be run in our BSL, three labs that, as increasing data emerged, the cross reactivity with seasonal flu became something that we needed to be addressing in the testing. We then had to develop additional protocols to do the adsorption for seasonal flu, then run the absorption and then rerun the tests again. So this was released, really at a good time and a good timeline, given the complexity of non-routine laboratory testing that was needed to be able to characterize these individuals. Thanks for your question.

Moderator – 28:10

I’d like to thank you all for joining us today. If we did not get to your question, or if you have follow up questions, please feel free to call the main CDC press office at 404-639-3286 or you can email [email protected] Thank you for joining us, and this will conclude our call.

That concludes today’s conference. Thank you for participating. You may disconnect at this time.

____

https://etidioh.wordpress.com/2024/11/08/transcript-for-mmwr-telebriefing-evidence-of-recent-h5-birdflu-infections-among-dairy-workers-and-cdc-guidance-updates/

#aH5n1 #antivirals #avianInfluenza #AVIANINFLUENZA #birdFlu #h5n1 #health #human #news #oseltamivir #PPE #serology #updates #USCDC #USA

#ah5n1 #antivirals #avianinfluenza #birdflu #h5n1 #health

Giuseppe Michieli @[email protected] · 2024-08-31 · 16:49 UTC

Whole-Genome #Analysis of #Influenza #H1N1pdm09 Viruses Isolated from ILI #Outpatients in #Myanmar & CA #Oseltamivir-Resistant Strains Present from 2015 to 2019 https://pubmed.ncbi.nlm.nih.gov/39205274/?utm_source=Feedly&utm_medium=rss&utm_campaign=None&utm_content=10ykRO9og5pGdo51l9DEPEpOJ3DVFIn__QK2QPM3dci1C1dEYq&fc=None&ff=20240831103754&v=2.18.0.post9+e462414

3 viruses possessed the #H275Y substitution in #neuraminidase protein, appearing to be community-acquired without prior administration of neuraminidase inhibitors. These viruses exhibited highly reduced susceptibility to #oseltamivir and #peramivir.

#analysis #influenza #h1n1pdm09 #outpatients #myanmar #oseltamivir

Giuseppe Michieli @[email protected] · 2024-08-23 · 09:04 UTC

#Antivirals for #PEP of #influenza: a systematic #review and network meta-analysis https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01357-6/fulltext?rss=yes

PEP with #zanamivir, #oseltamivir, #laninamivir, or #baloxavir probably decreases #risk of symptomatic seasonal flu in individuals at high risk for severe disease after exposure to seasonal flu viruses. PEP with zanamivir, oseltamivir, laninamivir, or baloxavir might reduce risk of symptomatic #zoonotic flu after exposure to novel viruses associated with severe disease in infected humans.

#antivirals #pep #influenza #review #zanamivir #oseltamivir

Giuseppe Michieli @[email protected] · 2024-08-23 · 09:03 UTC

[Articles] #Antivirals for #treatment of severe #influenza: a systematic #review and network meta-analysis of randomised controlled trials https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01307-2/fulltext?rss=yes

In hospitalised patients with severe flu, #oseltamivir & #peramivir might reduce duration of hospitalisation compared with standard care or placebo, although certainty of evidence is low. Effects of all antivirals on mortality & other important patient outcomes are very uncertain due to scarce data from #RCTs.

#antivirals #treatment #influenza #review #oseltamivir #peramivir

Giuseppe Michieli @[email protected] · 2024-08-15 · 08:16 UTC

Whole- #Genome #Analysis of #Influenza #H1N1pdm09 Viruses Isolated from #ILI #Outpatients in #Myanmar & Community-Acquired #Oseltamivir - #Resistant Strains Present from 2015 to 2019 https://www.mdpi.com/1999-4915/16/8/1300

1 virus intra-subtype reassortment, collected in the '15 season. 3 viruses possessed #H275Y substitution in NA protein, appearing to be CA without prior administration of neuraminidase #inhibitors. These viruses exhibited highly reduced susceptibility to #oseltamivir & #peramivir.

#genome #analysis #influenza #h1n1pdm09 #ili #outpatients

Giuseppe Michieli @[email protected] · 2024-08-09 · 08:17 UTC

#Synergistic activity of an #RNA #polymerase PA-PB1 interaction #inhibitor with #oseltamivir vs #human & avian #influenza viruses in #cell culture & in ovo, Antiviral Res.: https://www.sciencedirect.com/science/article/abs/pii/S016635422400189X?via%3Dihub

The PA-PB1 interaction inhibitor '54' acts synergistically with oseltamivir vs influenza A & B. '54' & oseltamivir combined at low doses inhibit viral progeny production & proteins expression in cell culture. 54 inhibits avian influenza replication both in cell culture & in embryonated chicken eggs.

#synergistic #rna #polymerase #inhibitor #oseltamivir #human

Giuseppe Michieli @[email protected] · 2024-07-27 · 07:15 UTC

''Symptom #onset began within 2-3 days & peaked within 5 days after the start of depopulation. Among 9 workers who tested positive for avian influenza A(H5), all reported mild symptoms (predominantly #conjunctivitis) & were tested within 3 days of symptom onset. All cases have been provided #oseltamivir & are recovering. ''

#onset #conjunctivitis #oseltamivir

Giuseppe Michieli @[email protected] · 2024-07-27 · 07:11 UTC

#Emergency #Use #Instructions (#EUI) for #Oseltamivir, #US #CDC: https://www.cdc.gov/bird-flu/hcp/emergency-use-oseltamivir/index.html

What to know: On July 19, 2024, CDC issued Emergency Use Instructions (EUI) for an #antiviral called oseltamivir, generic for brand name drug #Tamiflu, for #treatment or post-exposure #prophylaxis (#PEP) of #pandemic #influenza A viruses and novel influenza A viruses with pandemic potential.

#emergency #use #instructions #eui #oseltamivir #us

Giuseppe Michieli @[email protected] · 2024-07-25 · 19:53 UTC

#US #CDC Confirms 3 #Human #Cases of #H5 #BirdFlu Among #Colorado #Poultry #Workers, https://www.cdc.gov/media/releases/2024/s0725-three-human-cases-of-h5-bird-flu.html

The 3 confirmed cases occurred in people who were working directly with infected poultry at a commercial egg layer operation that had reported an outbreak of H5 bird flu among poultry. All 3 people have mild #illness and have been offered the antiviral drug, #oseltamivir, for treatment.

#us #cdc #human #cases #h5 #birdflu

Giuseppe Michieli @[email protected] · 2024-07-11 · 08:21 UTC

#Genotypic & #phenotypic susceptibility of emerging avian #influenza A viruses to
#NAIs & cap-dependent endonuclease #inhibitors, Antiviral Res.: https://www.sciencedirect.com/science/article/pii/S0166354224001682?via%3Dihub