CDC Health Advisory: Accelerated Subtyping of Influenza A in Hospitalized Patients
Posted by radioactiveru@reddit | PrepperIntel | View on Reddit | 79 comments
CDC today issued this health advisory:
“CDC is recommending a shortened timeline for subtyping all influenza A specimens among hospitalized patients and increasing efforts at clinical laboratories to identify non-seasonal influenza. Clinicians and laboratorians are reminded to test for influenza in patients with suspected influenza and, going forward, to now expedite the subtyping of influenza A-positive specimens from hospitalized patients, particularly those in an intensive care unit (ICU). This approach can help prevent delays in identifying human infections with avian influenza A(H5N1) viruses, supporting optimal patient care and timely infection control and case investigation.”
I see this as one of the more proactive responses of the CDC to the continually increasing spread and is a personal prompt for continued preparations.
Jeep-Eep@reddit
Someone's seen a report or a computer simulation model that made them brown trou.
Jeep-Eep@reddit
Alright, look alive people! Masks on, handwash extra aggro and start buying anything that the supply chain might shit itself on.
Goofygrrrl@reddit
So in layman’s terms, if someone tests positive for Influenza A and they need to be hospitalized, we can now order subtyping. Subtyping means we can tell whether it’s an H1 or H3 (the seasonal variants circulating now) or whether it’s an H5. If it’s an H5 subtype it will undergo additional testing to see if it’s an H5N1. If it’s H5N1, it undergoes genotyping to see if it’s the type that comes from cattle or birds.
Before this, we often weren’t doing necessarily subtyping and if you were, then you couldn’t send it as a Stat send out order (overnight it to the appropriate lab). You would have to wait to “batch” test it which could be days. Also, before this we had to prove the patient needed the test. The patient needed history of contact with animals before you could get permission to test.
This likely came about because the positive child in San Francisco down not have a clear source of infection.
jkoihmn@reddit
.
johnyfleet@reddit
Thank you
PerpetuaLeaves@reddit
We’ve been subtyping all positive influenza As in my state since last spring. They didn’t take them from my rural area seasonally until last spring. They were only doing epidemiology from the more populated area until that time.
radioactiveru@reddit (OP)
Yes, I suspect the San Francisco case likely prompted this in tandem with the increasing influenza A rates emerging (seasonally) as well as some cases of unknown origin. I’m encouraged that subtyping will pick up but still concerned for more rural settings.
Goofygrrrl@reddit
I work in rural systems so this just gives me a little ammo to start ordering subtyping. I’m concerned with the H10 circulating in China. There’s a lot of possibilities for assortment right now.
HappyAnimalCracker@reddit
Thank you for pushing for this!
pickypawz@reddit
Truthfully they may not know what-all is circulating in China, particularly as they aren’t allowed to test for Covid, and likely don’t have the tests to do so, regardless.
elziion@reddit
Thank you for the additional info! Very informative for me!
GoldieRosieKitty@reddit
This is a very very very interesting directive
Pantsy-@reddit
CDC seems a little behind the times on this one. They should’ve been sub-typing strains for a year now. WTF are we doing? Did we learn nothing from Covid?
PerpetuaLeaves@reddit
My state started this a year ago. So yeah, I think people don’t realize that the CDC collects data from state labs, who in turn collect from hospital and reference labs. Some states are on it already and I’m guessing some are not.
PuzzleheadedHeron345@reddit
Should this be a sign to start worrying that human to human spread is already happening undetected? I've been trying hard to not panic until there's good reason to, and seeing this makes me a little nervous.
No_Detail9259@reddit
I have suggested that before and it was not well received.
Every case of pink eye should be tested.
radioactiveru@reddit (OP)
Agree, particularly in combination with even mild flu symptoms. Clinicians receiving this CDC alert will hopefully have this same thought and pursue testing/subtyping when present.
PerpetuaLeaves@reddit
Laboratories are the sentinels in this situation. I’ve lived in three western states working in microbiology labs. There are set laws regarding organism reporting and which organisms we must send to the state lab. In my current state I am rural and the seasonal sub-typing was always done from the large population center. Last spring the state sent us a letter requiring that we send ALL positive flu A specimens to them for subtyping. So, some states have already instituted more rigorous surveillance.
emseefely@reddit
Rip to anyone with school aged kids
anotheroutlaw@reddit
I’ve never had pink eye a day in my life. Had it in both eyes last Spring. My eyes were crusted completely shut every morning. No other symptoms though, but very out of the ordinary for me.
Wytch78@reddit
Yup!!
I’m a teacher and flu is ravaging our school right now. 50% out in my daughter’s class. Kids are spiking high fevers, parents freak out and take them to urgent care: positive flu test. Kids are complaining of eye pain and burning. Two moms told me this, separate of one another.
Incndnz@reddit
Would you mind giving your general location? If that’s allowed?
Wytch78@reddit
Flarduh
Commandmanda@reddit
"Regular flu" can sometimes cause eye pain, light sensitivity, a feeling of grittiness while blinking, and eye redness.
Certain clades of Covid can also cause extreme redness, nicknamed "blood eyes", and is often bilateral (affecting both eyes at once).
The bird flu virus causes redness of the eye, watery eyes and discharge (pus-like and/or crust). In this, it is similar to "pink eye".
MaebyFunke42@reddit
My family got covid for Christmas, and the eye pain and light sensitivity were intense, and my mom had both eyes turn very red. The extreme gooey, crusty eye stuff that comes with conjunctivitis was absent.
Commandmanda@reddit
There yah go. Poor thing. Did she recover well, I hope,?
MaebyFunke42@reddit
Yes! Thankfully, this was her first (known) infection. She'd been diligent about yearly boosters and got Plaxoid quickly after testing positive. She's 70 with COPD, and although the current stain isn't as deadly, it's still very dangerous for the 65+ crowd and she was a hell of a lot sicker than me or my teen, so it was worrisome. I'd say she's just now feeling like she's completely over it.
ChickenandtheEggy@reddit
Yikes I didn’t realize eye pain was a symptom of this bird flu. My whole family was sick (the sickest we’ve ever been) over Christmas and the kids tested positive for the flu. My oldest complained about her eyes and they were red for a while.
Commandmanda@reddit
Not eye pain. Conjunctivitis. There is a difference. Sometimes having the flu can cause the body to fail to fight off other viruses and bacteria, which cause Pink Eye, or actual Conjunctivitis. Flu can also cause children to rub their eyes more often due to light sensitivity, fatigue, and a feeling of grittiness. This in turn makes it more likely that they will self-infect themselves.
helluvastorm@reddit
If it is already spreading we’re in a good place because hospitalizations and deaths haven’t spiked to unusual levels. It could be the subtype that is effecting the dairy workers is the one spreading if it even is because that subtype appears mild. The one the child in Canada and the patient in Louisiana had is not mild and it would be picked up quickly if it were spreading.
radioactiveru@reddit (OP)
In all honesty we won’t know. Our family is planning and preparing for many possible outcomes, and our strategy is to consider what happened directly to us and our region with Covid and then multiply that outcome twofold (as in it will be twice as severe).
I found some analysis of the Covid response by the US government agencies and looked to their timeline and reporting for our ‘triggers’ and what to expect as they will likely follow the same course. Things are up in the air with a new administration incoming though, so watchful waiting continues.
We are masking indoors everywhere now. We get looks and snide remarks but who cares.
We topped up our deep pantry recently and have our goals met now in case of shortages or closures. Finances are next on the horizon. We are now able to look outside our own home and consider our extended family and community and offer support where we can.
HumbledPilgrim@reddit
softsnowfall@reddit
All this… Consider stocking up also on… OTC etc meds… Pet food ( Pet food was a circus last time)… Paper towels etc if you use those things… Deep pantry (of things you eat) like you said …Things for entertainment like books, puzzles, and games… n95 masks, gloves, a pair of stoggles, lysol, and Clorox wipes (or whatever you want to disinfect as surface transmission is a vector for bird flu)…
Practice not touching your face… Wash hands… Take shoes off at the door… All that sort of not fun stuff…
If the CFR is high, that will make things much worse. Then, we have to add in RFK Jr & Oz… Then, we have to consider how half the country is anti-mask and anti-science…. Then, we have to factor in how people might have a weakened immune system from a recent case of covid or have covid at the same time which could increase the CFR…
I know there’s never a good time for a pandemic, but right now seems especially bad…
radioactiveru@reddit (OP)
Great list!
Pet food was a big one for us. We worked up to a year stock and now as we use up a bag we buy another and replenish (first in, first out) for all pets.
Some other things in short supply in Covid: dish and hand soaps, sanitizer, masks, laundry detergent, paper products, cleaning products, stress snacks, HVAC air filters.
We switched to a plant based diet (rough transition) but included our usual staples in bulk: beans, rice, oats, wheat, honey, healthy oils, seeds, nuts (shorter shelf life), whole grains like khorasan/buckwheat/farro. We made a list of all the meals we can and do eat and built our pantry from there focusing on canned and dry goods.
We have a large garden and also support a local farm with a CSA so we can have access to local food systems. From this we can and dehydrate foods to put up year round. It’s a real treat to eat a home canned sweet tea peach in the dead of winter.
We built up our deep pantry from shopping weekly sales, a local discount store, and our garden and local farms. We try to make these activities family hobbies and learning opportunities and it’s been a valuable and rewarding way to prep sensibly. We have had tons of failures but kept trying again and again to find a low stress way to prep in our budget over time so we avoid any sense of panic.
softsnowfall@reddit
Awesome response! We do the same as you with pet food. Same with most things. We just maintain a supply that we rotate & replace.
The biggest lesson for me was to specifically prep what we eat & use, whether it’s a specific kind of bean or detergent or etc…
We do still eat meat but not nearly as much. For a lot of our meals, the protein is tofu or beans. We grew a lot of tomatoes last year. We have seeds for other things and would eventually
love to a have a tiny homemade greenhouse. We have considered doing a CSA. You guys love yours?
radioactiveru@reddit (OP)
The CSA has been fantastic. They offer big 40lb+ canning boxes and it’s nice to have a source of fresh veg we don’t have to grow. Highly recommend local farms and foodways and it’s a great way to build community.
MazW@reddit
I am definitely masking up for the time being.
A_Toxic_User@reddit
No
Biden recently disbursed hundreds of millions of dollars to the CDC to counter Bird flu, seems like they’re putting that money to use.
Maintain a general state of preparedness (as is always a good idea) and you’ll be fine
OPaddict69@reddit
“Push and shove everyone, push and shove!!”
plotthick@reddit
Probably more of a "if/when it pops up we need to corral any H2H HPAI locally, so we need more testing. Let's all for it now that the end of the Holiday Disease Sharing Season is in sight."
Striper_Cape@reddit
I said it in a different sub. If this flu outbreak is actually the bird Flu, then we got lucky. It ain't shit.
2020willyb2020@reddit
ICU could be packed if respirators are needed- this timeline sucks
eric685@reddit
So many of my friends in the US are so incredibly sick right now. Many claim their symptoms are worse than COVID. They had very high fevers and flu-like symptoms. One friend in this situation tested negative for influenza and COVID.
Anyone else seeing this trend? Any ideas what could be the cause?
radioactiveru@reddit (OP)
Same here in the West. The holidays always compound the illnesses and there are a number of viruses folks are seeing including increased pneumonia pockets. It’s worthwhile to check county wastewater if it’s accessible to you. We’re seeing large Influenza A spikes here and anecdotal norovirus reporting. Isolation isn’t really accepted or supported by most workplaces and daycare is impossible for a lot of folks so it all just keeps spreading.
HappyAnimalCracker@reddit
Yeah the “work sick” culture helps no one.
HappyAnimalCracker@reddit
RSV and pneumonia are also circulating
Less_Subtle_Approach@reddit
Each covid infection causes cumulative organ damage and your immune system is an organ. People really seem to struggle with the concept of chronic illness in general, and covid specifically damages the brain in ways we don’t fully understand yet. Collectively, folks on their 6th infection are worse off and will have more trouble understanding why.
eric685@reddit
So you’re suggesting the immune systems are weakened from infections from viruses like covid and the symptoms of more common strains are hitting harder?
Less_Subtle_Approach@reddit
Yup, lots of studies out there corroborating long-term damage to the immune system from covid specifically. We don't have a clear view into the mechanism at the moment but anecdotally it seems particularly brutal on folks with young kids getting rapid back to back infections. Health outcomes seem to be deteriorating substantially for friends in that boat at the moment.
Wytch78@reddit
Yup! I’m a teacher and see 400 kids a week. I’ve had Covid 4x. I’ve had unrelated pneumonia three times afterwards too. I really need to leave education before it kills me.
Lainnnn@reddit
Got covid in September, then immediately after had walking pneumonia and then a week or two after that had some other illness. All of this from September to December
Wytch78@reddit
It’ll do that to you!! My neighbor who is just about a hermit (he’s an eco fascist homesteader, let’s be real) finally got covid in the Fall. Every time I’ve seen him since then he’s like “I can’t believe I’m sick again!” Like. Yeah dude I been telling you about this shit.
Inaponthursdays@reddit
I am as well. I’ve been beyond sick multiple times- back to back since the school year start and each time ended up on abx. This last time I woke up first day of winter break super sick with the craziest symptoms ever- red eyes (like the whites of my eyes), purple rashes, fever for days, a huge decrease in lung function- had abx, steroids- tested negative for the big three- stillll sick and actually on leave. Had a bunch of tests and from early results- my complement system is wiped out- meaning I have no juice to fight any infections at the moment. Have a few more tests and imaging to do, and at the moment been given a leave to give my body a chance to recover rather than being thrown back into hundreds of sick kids under extreme workloads and burnout. Hopefully better news ahead- but sickness unlike anything I’ve ever had
Wytch78@reddit
Omg this was scary to read! I’m so sorry you’re going through this. I’m afraid I’m one click away from this tho. I had pneumonia (the mycoplasma going around) again in November. I’m currently sick with a “cold” I caught the first week back teaching after the break.
I try to take immune boosting supplements and I eat well, but I feel so tired all the time. Covid does a lot of damage to our T cells. I wonder what they’d find if I ran some labs for that.
It’s kinda normal for first year teachers to get sick a lot. But I’ve been working with kids for 25 years now. I also think mold in the environment is quickly becoming an issue for me.
Thank you for sharing your struggle with me. 🫶🏻
Inaponthursdays@reddit
I’m sorry you’re also sick- and it infuriates me that teachers have an insane amount of pressure and guilt thrown on them on self-care to the point we burn ourselves out (massive affect on immune system alone)- and then are exposed to who knows what that walks into the classrooms everyday. I truly hope you recover soon and I appreciate the love from your comment.
Pneumonia is the worst- I caught it almost 10 years ago now in my second year of teaching along with a coworker who passed away from it. I definitely recommend keeping in touch with your doctor if you’re not improving as well! Yes Covid has been shown to alter immunity as well- and now there are some scary things out there worse than that it seems. I’m at a point in my career that I’m terrified to go back to work until I’m healthy but I’m under a lot of pressure to come back and provide output for the school- genuinely thinking of leaving my career because I now know how risky setting foot inside of schools older than my mom that are overcrowded and underfunded is to my health.
It’s a lot of extra stress on top of the illness. I imagine many teachers are likely in the same scenario given the amount of illness floating around and ignored for the sake of “keeping the wheels turning”.
Inaponthursdays@reddit
I should also mention that I’ve learned that many of the schools built in the 80s and before were often built with asbestos. While undisturbed it’s unlikely to cause massive health problems as far as we know— many schools still have it
Wytch78@reddit
I’m in a “newer” building (built in the late 90s) so I actually feel better sometimes at work than I do at home. House built in 1982 and more dust and clutter than I am physically able to deal with.
No_Detail9259@reddit
So you have been serious sick 7 times plus 4 flu shots and 5 covid shots, roughly?
Your body must be worn out.
Wytch78@reddit
Ain’t had the first shot actually. 🤷♀️
chaos-gardening@reddit
Bro :(
Girafferage@reddit
Sort of like measles wipes out your immune "memory". It essentially means you have to get sick with everything all over again at the worst level. good times. real fun stuff.
chaos-gardening@reddit
Yep, we have been kicking around what is basically aerosolized HIV that coagulates our blood for 5 years and it has a cost.
Jagcan@reddit
Its been known about for years
Wytch78@reddit
Covid takes a big shit on your T cells basically.
MazW@reddit
I got sick a few days after Christmas and I am a lot better now, but still coughing. Husband too. Not COVID (although i understand those tests are not 100% accurate). Massachusetts.
I got the COVID booster and the flu shot in October.
My son got a slightly runny nose. My daughter and sister did not get sick at all. That sort of random infection pattern made it seem like COVID, but again, tested negative.
TheWhiteRabbitY2K@reddit
I've had multiple RSV adults getting their butt kicked this past few months. 3 relatively health men in their 40s getting admitted with Hypoxia or other comorbidity issues like DKA.
aggressiveleeks@reddit
Mycoplasma pneumonia (walking pneumonia), RSV and Norovirus are very bad this year. RSV is usually just kids but last year and this year a lot of adults are getting it too. The bird flu 'should' test positive for influenza A, but there are lots of influenza A viruses so might not be bird flu.
eric685@reddit
Isnt novovirus spread via food and improperly handling it? Would it cause a fever?
Lovely5596@reddit
I think it’s caused by touching a surface, food, or bodily fluids that have the virus on it. My toddler got it and gave it to me- it did cause a fever, for me.
aggressiveleeks@reddit
Norovirus is usually gastro symptoms like vomiting/diarrhea/nausea but can definitely cause fever. A few people I know got it recently and described it as a horrible combo of flu plus food poisoning symptoms. It's super contagious and you can get it from food or touching surfaces or shaking hands and then touching something you eat.
adeptusminor@reddit
I'm in Tennessee, and yes, many people here are sick. No one masks, or even tests, so who knows what they have? I know one neighbor claimed norovirus, but she didn't seek treatment, so undiagnosed by a professional. But lots of folks are sick.
starktargaryen75@reddit
Won’t matter in 3 days.
BardanoBois@reddit
Let's go reasortment boys let's gooooooooo
oltop@reddit
Soo we still at threat level yellow or..
radioactiveru@reddit (OP)
I’m personally encouraged by this alert but we’re considering a threat level orange (not yet red but a little higher than yellow). The unknown origin of some illnesses and a recent U.S. death raised the alert for us, and the CDC says the threat is low BUT they’re watching with increased interest. The recent massive funding for research, testing, and vaccine development reveals the multi-agency concern around this and was a trigger point for us to top up.
oltop@reddit
Cheers friend, this is great post
reality72@reddit
We need all insurance companies to start covering the at-home rapid tests that test for COVID + Flu.
Commandmanda@reddit
Glad the CDC has made it easier to test hospitalized patients. We need this to get a handle on what's going on. Better late than never.
radioactiveru@reddit (OP)
The link also discusses testing protocol, the case history and current state of H5N1 in the States, treatment protocol, and has a list of links with more information.