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Adverse and Erroneous Publicity Over Single Alleged Case Of HPAI


Egg-NewsAccording to the CDC, an extensive program of surveillance of workers involved in depleting flocks infected with the H5N1strain of HPAI yielded a single human case.   This event has elicited an inordinate amount of media attention.  The American Egg Board has been tracking print, broadcast TV and social media since the onset of the outbreak and as of the beginning of the last week of April was essentially a non-issue.  Political events, inflation, the war in Ukraine, the fluctuating stock market and trivia such as the Johnny Depp trial have dominated the media.  Mention of HPAI has concentrated on turkeys and to a lesser extent on broilers.


The picture may have now changed with the report emanating from the CDC that has been misinterpreted and taken out of proportion.  The facts are that a prisoner in an institution in Colorado was employed to handle chickens from a flock that had been euthanized as a result of contracting HPAI. Whether as a diagnostic procedure or routine surveillance, a nasal swab from the individual yielded nucleic acid indicative of H5 influenza virus, presumably on PCR assay.  This does not mean that the subject was in fact infected with the avian strain virus.  A PCR procedure would provide a positive result denoting the presence of virus in the nasal passages if inhaled on dust.  To establish a diagnosis of avian influenza, it would be necessary to demonstrate the presence of viral nucleic acid over a sequence of days and also demonstrate subsequent seroconversion.  The individual did not display any clinical signs including elevated temperature that could be associated with influenza other than fatigue that is a complaint and not necessarily a symptom.


Egg-NewsUSDA-APHIS has conducted surveillance on workers involved in handling dead birds during the 2022 epornitic and there have been no reports of positive nasal swabs from approximately 25,000 examined. It is difficult to understand how only one individual out of a large population demonstrated the presence of avian influenza nucleic acid in a nasal swab. This may have been a false positive or alternatively failure by the worker to consistently wear a respirator as issued to all farm workers. In reality, the headlines emblazoned across articles and on websites should have read “24,900 exposed workers negative on nasal swab PCR!”


A number of the reports, all short on detail, invoked the single case of HPAI H5N1 diagnosed in a senior in the U.K.  According to relatives, after he was transported to a hospital, 18 ducks were removed from his home and he was known to have fed and cared for free-roaming waterfowl in his garden and village that died of H5N1 HPAI.  In this case, an initial upper respiratory tract swab was obtained on December 24th 2021 that tested positive for influenza A subtype H5.  This result was reproduced on two successive swabs collected during following days confirming viral replication in the upper respiratory tract. During this time the patient was asymptomatic and after isolated observation returned to his home, fortuitously cleaned by neighbors and family members.  In commenting on the case, Dr. Isabel Oliver, Chief Scientific Officer at the U.K. Health Security Agency, stated, “Currently there is no evidence that this strain detected in the U.K. can spread from person to person” She added “We have followed up all of this individual’s contacts and have not identified any onward spread.”  The U.K. Chief Veterinary Officer of the U.K., Dr. Christine Middlemiss, stated, “While Avian Influenza is highly contagious in birds, this is a very rare event and it’s very specific to the circumstances on this premises.”


It is indeed unfortunate that journalists and bloggers are either unable through lack of scientific comprehension or are otherwise disinclined to review and evaluate circumstances, simply publish and amplify events without providing perspective. Regrettably some industry-oriented websites have afforded the CDC release inordinate coverage. Thankfully we still have Johnny Depp.