News: Bird flu questions linger with 2nd case

Thursday, May 23, 2024

Bird flu questions linger with 2nd case

May 23, 2024

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Driving The Day

Cowboys herd cattle from one pasture to another.

Cattle are thought to be the cause of the second known case of bird flu in humans this year. | John Raoux/AP

SECOND WORKER WITH BIRD FLU PROMPTS QUESTIONS — Federal officials said Wednesday that the second human case of avian flu tied to the current outbreak in cattle wasn’t unexpected, given worker exposure to infected herds, as they continue to urge states to monitor for the virus.

What we know: The CDC said Wednesday that a farmworker in Michigan has the virus. The case follows another infection of a dairy worker in Texas. Public health officials continue to advise that risk to the public is low.

But the second confirmed case shows the virus “remains in circulation and still presents a serious occupational hazard to people who have exposure to raw milk,” said Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at the Brown University School of Public Health.

Here's what we still don’t know about the U.S. outbreak:

When was the farmworker tested?

While the CDC confirmed the sample on Tuesday night as positive, state officials, citing privacy concerns, won’t share when the second farmworker was first tested for avian flu.

Will drugs and vaccines be effective against the latest detected virus?

Government officials say two vaccine candidates in development will be well matched against the virus, but genomic sequencing data expected soon will provide more certainty as to whether the virus is susceptible to them or to antivirals the U.S. has stockpiled.

Dawn O'Connell, HHS assistant secretary for preparedness and response, told reporters Wednesday that the government has begun to prepare about 4.8 million vaccine doses.

What’s happening in other states and farms where avian flu hasn’t been detected?

Federal officials praised Michigan’s surveillance system for monitoring exposed workers and identifying the latest human case. However, Nuzzo said not all states are monitoring for avian flu, leaving a gap in information on farms and states where it’s unknown whether there’s an outbreak.

“This happened because the farm already identified the outbreak,” she said. “What about farms that aren’t testing?”

The USDA said on Wednesday that it would provide more financial and testing support to the dairy industry, including expanded funding for dairy herds not positive for the flu’s circulating H5N1 strain. The assistance includes coverage for veterinary costs associated with virus testing.

Is the virus spreading through the respiratory system?

Avian flu is known as a respiratory virus in birds, but the farmworker in Michigan tested negative for influenza with a nasal swab — but positive with an eye swab. This suggests the virus was contracted via direct contact in the eye, Nuzzo said.

“There’s no evidence of it being a respiratory infection,” she said.

CDC Principal Deputy Director Nirav Shah also called the nasal swab results reassuring.

“It reduces the likelihood [but does not eliminate] … of a respiratory route of transmission,” he said.

WELCOME TO THURSDAY PULSE. We’re almost to the long weekend. Anyone have a good beach read? I just finished “Nothing to See Here” by Kevin Wilson. Send your book recommendations, tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.

A message from PhRMA:

The size of the 340B drug pricing program has ballooned in recent years, but patients aren’t seeing the benefit. Instead, hospital systems, chain pharmacies and PBMs are exploiting the program to generate massive profits. Let’s fix 340B so it better helps patients.

NURSING HOMES

A nurse hydrates residents in a retirement home

Nursing homes are pushing back against legislation that would set a minimum number of health care workers in the facilities. | Romain Perrocheau/AFP via Getty Images

NURSING HOMES PLAN FIGHT — The long-term care lobby has promised an “aggressive” strategy to block the Biden administration from mandating nursing home staffing levels.

Katie Smith Sloan, president and CEO of LeadingAge, which represents nonprofit long-term care facilities, said Wednesday the group is “pursuing an aggressive, multifaceted strategy employing all the tools available to us — legislative, legal and regulatory — to both address the fundamental issue of building the long-term care workforce and halt the regulation’s implementation.”

A LeadingAge spokesperson declined to provide more details. Some House Republicans have unveiled legislation to block the rule’s implementation.

The rule, finalized last month by CMS, requires nursing homes to have a minimum staffing level, with a phased-in approach over the next few years.

But the nursing home lobby has complained that the rule will be costly and unworkable.

An HHS spokesperson told Pulse that the “current status quo of understaffed nursing homes unacceptably endangers residents and drives workers into other professions.”

“We’re encouraged by the fact that nonprofit nursing homes are about three times as likely to already provide staffing at or above our individual staffing requirements and encourage stakeholders to review the staggered implementation approach and exemptions for facilities facing hardships,” the spokesperson said.

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In Congress

FIRST IN PULSE: NEW HEALTH CAUCUS — Bipartisan members are launching the Congressional Preventive Health and Wellness Caucus today.

The group, led by Reps. Vern Buchanan (R-Fla.), chair of the House Ways and Means Health Subcommittee, and Gwen Moore (D-Wis.), aims to tackle the obesity epidemic, focusing on prevention, research, food as medicine, exercise and health disparities. The caucus will also address the impact of obesity on military readiness.

Additionally, the group intends to calculate the costs of obesity to the nation, hold fact-finding hearings on the topic and introduce legislation that would support treating, preventing and researching obesity.

The bigger picture: Obesity has surged in recent years, with more than 2 in 5 American adults qualifying as obese. The launch reflects an increasingly urgent desire to address the issue.

Expect weight loss drugs to be a potential subject of interest. Popular, pricey weight-loss drugs have often been touted as a way to address obesity, but Medicare is barred from covering them. Close to a quarter of the Senate has signed onto legislation from Sen. Tom Carper (D-Del.) that would lift that prohibition, as has a similar share of the House for its version from Ways and Means member Rep. Brad Wenstrup (R-Ohio). Moore also co-sponsors the bill.

The drugs’ long-term effects are also not yet known.

MEET THE ‘FOIA LADY’ — Republicans and Democrats on a House panel excoriated a former aide to Dr. Anthony Fauci in a hearing Wednesday over his use of personal email to avoid potential federal transparency disclosures of his communication about the Covid-19 pandemic’s origin, POLITICO’s Carmen Paun reports.

Republicans on the House Select Subcommittee on the Coronavirus Pandemic released more than a hundred pages of personal email exchanges belonging to Dr. David Morens, a former senior adviser to Fauci when the latter was leading the National Institute of Allergy and Infectious Diseases.

In one exchange, Morens writes that the woman in charge of Freedom of Information Act requests taught him “how to make emails disappear after I am foia’d but before the search starts.”

Another email seems to indicate he was sending professional emails to Fauci’s personal email address. Fauci could not be immediately reached for comment.

Morens sent many disclosed emails to Peter Daszak, the president of environmental research nonprofit EcoHealth Alliance, which has been caught at the center of an unproven theory that the pandemic started following a leak from a Chinese lab Daszak was collaborating with.

Morens avoided incriminating himself in answers to lawmakers, claiming he didn’t remember many of the emails made public but admitting that they look “pretty incriminating.”

Why it matters: Lawmakers’ scrutiny of Morens extends the criticism of oversight of potentially risky research to the NIH, suggesting that lack of compliance with federal rules extends to the research institution and is not just limited to a grantee.

A message from PhRMA:

Global Health

SYPHILIS RISE IN THE AMERICAS — The Americas face the highest rates of new syphilis cases worldwide, according to a new World Health Organization report.

Why it matters: Syphilis was all but eliminated in the U.S. in 2000 but has since spiked — including an explosion in congenital cases — which has alarmed public health officials. Untreated syphilis can cause serious brain and cardiovascular diseases and can be transmitted to a fetus.

According to the WHO report, cases escalated by more than 1 million worldwide in 2022, reaching 8 million. The Americas account for 42 percent of all new cases.

The percentage of pregnant women in the Americas with syphilis also increased by 28 percent in the past two years, translating to an increase in babies born with syphilis — an estimated 68,000 in the region in 2022.

The report attributes the rise in infections to disparate access to health care and treatment, stigma around sexually transmitted diseases and a lack of awareness.

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Names in the News

David McAlpine has joined public affairs firm Burson as a senior vice president of earned media. He comes from genomics company Illumina and previously worked at General Motors.

Stacey Frisk is now executive director of the Rare Disease Company Coalition. She previously worked at rare disease company Sarepta Therapeutics as director of global regulatory affairs.

WHAT WE'RE READING

POLITICO’s Helen Collis reports on a draft UN declaration that calls for ending the nonmedical use in animals of antibiotics essential for fighting infections in humans.

NBC News reports that daily marijuana use has outpaced daily alcohol use in the U.S.

The New York Times reports that the first patient to receive a Neuralink brain implant is upbeat — despite setbacks in the technology.

A message from PhRMA:

A recent report from the Berkeley Research Group shows the 340B program is the second largest federal drug program for another year in a row. Despite its massive size, 340B has zero reporting requirements and zero patient protections to ensure the program is working as it should. Let’s fix 340B so it better helps patients.