The Dr. Niman Show 11162024

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You
Hello and welcome to the Dr. Niman show today is Saturday, November 16, 2 02 4H5 and one has been exploding in the United States with various human cases and also in many ways that never has before here with us is the aforementioned Dr. Henry Niman, he will give the talk 

Dr. Niman
Hi Ryan, thanks for the introduction and it's the recently events Make it necessary to start giving regular updates because I think this situation is is literally and figuratively evolving extremely quickly just to get a little background. I've been following each five and one probably since it. Cut a reappeared in in 2 00 4 HR and one initially Captured the interest to quite a few scientists in 199 7 when it was involved with an outbreak in Hong Kong I think there were 18 cases and six of the 18 died and There was a high fatality rate and A lot of signage just got interested in an H5 and one back then are they they ended up tracing it to wet markets in Hong Kong. They called all the all the birds there and that the human case is kind of bomb. Die down, the virus continued to infect, poultry fires, largely and in China, but then At the beginning of 2 00 4 children started showing up at emergency rooms in northern Vietnam and they are they they had flu like symptoms. They tested him for influenza a and they were positive and then they tried the sub type to find out if they had each one, add one or H3 and two. Two versions of seasonal flu and they were negative for both that make long story short they eventually tested them for H 5 and found out that indeed they had H5 and one That is five and one spread throughout stealthy Asia and the symbol. The sequences were similar and it was designated as I'm not surprisingly played one. But then things started to heat up more in the following year in 2 00 5 And one of the major incidents happened in the spring of 2 005 that Shanghai Lake in China Central China is the largest lake in China and there were all of these wild birds that were dead on the water And the Main species were actually Barrhead geese, but there were many different species that that were represented in the dead category and Initially, China denied it was H59 one but eventually Samples were collected, and indeed was a try that one and it led to actually two back-to-back publications, one in nature and one in science, and they described the sequences And what really stood out with the sequences is that they had this one particular change in the polymerase one of the three primary teams PB two and it was designated E62 7 K because the position 627 changed to a K and that was well known that was a change that The K is actually present in at the time all seasonal flew both each three and two add each one and one that That's the human version of flu and that was concerning because it was known that that mutation was temperature sensitive and the PB two is actually peace. Answer for polymerase is one of three liras the virus codes for the copies genetic information. And if there's a E at that position as position 62 7 The inside the ability to copy is is optimal at 41 ° C which is the body temperature of a bird but if the E K then at the enzymes optimal at 33° C which is much closer to the human body temp of 37° C And human outside in the cold in the winter there, their nose and throat would actually be a little bit cooler than their body temperature and it would be a lot closer to 33 ° C of the virus is very good at replicating in mammals, especially in mammals in the In the winter so That was one of the reasons there were so much interest in this played in the wild birds and they ended up dividing up H5 and one that wasn't played one in the three different sub plates clay too two point one was the five and one in Indonesia and it actually never got out of Indonesia actually 2.2 was the version of Shanghai Lake And played 2. 3 was the version of H5 and one that was circulated circulating its Fuji and pro at the time The I was interested actually in the wild bird version because you could actually track it in China initially which was not always that forthcoming because it actually did affect waterfall Whereas the earlier version of H5 $ one we're pretty lethal to chickens, but they really were tolerated relatively well by water, foul and part because they had been affected by low path HI they had some immunity the H5 in general And they were able to kind of handle the high H5 and one where the chickens were not there they were spread very quickly and it was very lethal, but you could see what the HI than one plate 2.2 was doing because it kind of went from the High Lake in central China, and move north Northwest in and through Northwestern China, and then it went into Kazakhstan and then it went into Siberia Russia, and this path really was the wild birds migrating to the north to To spend the summer in the in the cooler climate, and this was the place where the various bird flyway is overlapped and so the virus that was in China was able to get out of China by flying to Kazakhstan and Russia and then for the summer and then in the fall, they would infect birds and another fly waves that intersection intersect in Russia And turned off it ended up flying to Europe at the Middle East and northern Africa, and It was concerning because they had a 67 K but then it was also concerning because they had some receptor by the domain changes which made it more able to infect humans as you predicted one of those changes in position to 2 7 using H3 numbering and that was S 227 and and there was predicted because that had been seen in In China and I had looked to see what it would take to take the play 2.2 sequence and try and acquire that through recombination and it turned out the donor sequences that will allow it to acquire S27 and was was present in another Zero type H9 and two which was circulating in the Middle East and the prediction was these birds flew out of China and ended up in the Middle East. They were interact with the sky too, and they would end up creating scepter by domain change. And I wrote about that in November of 2 00 5 and then the birds arrived in the Middle East in Europe The fall of 200 5 and and the first human case I got inspected right at the end of 2 005 and turkey. There were four children that there were positive and they were hospitalized in early 200 6 and. I think possibly all four of them died, but I was waiting for the sequencing. It's really delayed and they were only four sequence sister came out of. Turkey and two out of the forehead the S22 7 and And those that particular virus, it was in cause a lot of problems and the problems were so bad that the WHO reports stop giving the Collection date, or the election date is on that date or the gender of those infected because if you had that information, it would be pretty clear to see that there were clusters that were arising in Turkey in fact, almost all of the infections and turkey were clustered. I think the clusters I think they ended up preferred me something like 20 some cases and they're always paired up. But eventually, this human case is faded that they were just a turkey. They were an answer by John they were in Egypt. They were actually even. Booty and then they made it all the way over to Nigeria that they were limited numbers of cases and most of the cases happened in early 200 6. I kind of persisted in Egypt that kept going for several years with H5 and one human cases, but eventually the. The virus flew back to To Siberia again and add the 2.2 prescient for several years and then it subsequently got replaced by the food version the clay 2. 3 and the current outbreak is actually a derivative of the 2.3 that's why it's called 2 .3 .4 . 4 B And that's based upon the 8 5 and It's got a poly basic clever site so it's got a bunch of basic amino acids right where the the H egg gets cleaned and it could be cleaned by a lot of different enzymes that are present a lot of different cells so the virus is able to get out of the respiratory track and attack many different Cell types or organs that's part of the reason so lethal with the chickens that they just die of organ failure because they have the virus throughout their their body so antifreeze fast forward out of Asia and Europe The first major H5 – one outbreak in the United States happened at 20 14 and and that did actually involve the same site that the 2.3 44. 4 and it came down the Pacific fly away, which goes down the West Coast of Alaska Canada in the United States and it started right about now Australia in 20 14. It started at the beginning of December and her first showed up the British Columbia and. And their poultry fires, and then it showed up in Washington state and the virus they came from Asia really had already picked up some North American sequences segment said that flu is a segmented genome so it's kind of like it's got eight different chromosomes. It's got eight separate segments for his genome and they can mix and mat. One host has more than one virus so they can end up taking the some of the segments from one of the virus and some from the other and come up with a new version and they're actually given Type names and it turned out that the original Sequences that showed up in North America in 20 14 really had a North American N and it really had three different serotype so there was H5 and one H5 then 2H5 then eight and like I say the N1 the N2 with the N8 all we're North American so they replaced the Eurasian version that the start out in in Asia And eventually, the H5 that two became dominant, and that started creating major problems in the spring when the virus headed back north and it killed a lot of turkeys in Minnesota, which is the number one turkey producer in the United States and I killed a lot of layer chickens in Iowa in Iowa is the wire chickens lay eggs And Iowa is the number one egg producer in the United States so in 2 0 15 there were there were major shortages of both Turkeys and eggs in the United States because the virus ended up killing over 50 million birds and in that case the virus went back to Canada and they kind of faded away and Created problems again, and 2 000 20 Hold on Like it was 20 18 and That that outbreak create a similar problem that there were Another 50 million birds that ended up dying and I'm sorry that there was a 2022 it's what happened it was in 2022 and that one spread All the way south it ended up coming down the Atlantic fly away from Europe and started Newfoundland. Then it went down to. In the United States that went down to North Carolina, and that was the eastern flyway, and then gradually spread to all four flyways in the United States was across the US and and then it went further south And it went into Central America and then it went into South America and it was pretty clear that five that one was in in the Americas for good and indeed it it moved around. He's here but it's been it's been circulating since. 2022 and the Situation kind of changed in the United States, which has been my focus in the United States to Canada really and the situation takes At the beginning of this year in 202 4 and it started out kind of is a mystery disease and it's kinda surprising that it would be a mystery of 2024 since the virus had been creating all kind of problems since 2022, but Dairy cattle in the Texas can't handle Started Losing their milk production that their milk production went down the milk they produced was was very thick and very yellowish and towels themselves were kind of sluggish and It took until March that they actually tested the cows for H5 and one and they indeed were positive and initially it was in the Texas panhandle by the time they identified H5 and one it had spread to north east New Mexico in Southwest Kansas so they were their areas that were close to the panhandle and Kind of had a unique genotype there was designated B3. 13 and it turned out that initially when it was positive not much was done Because in contrast to the wild birds, the cows had this reduction and milk production, but only about 2% of the cows died and they recovered so their milk production went back up although I think that it didn't quite get to the level it was before the infections And the farmers were necessary all that cooperative the cooperation was greater for poultry fires because once they had a side and one, it was the number of dead birds would increase on a daily basis and They basically called all the birds that they didn't call the birds in a limited number of days. All the birds would've been affected and died, except that they have a lot more virus that was gonna contaminate everything then if they killed off the whole fox. Earlier and So the problem with the infections in the cattle is that there's a lot of trading of the of the cows, and there were initially no restrictions and so a lot of cows that were infected with they tried that one were shipped to other states And that really spread the virus around in the US. They were just being moved around by my truck and the truck was carry out and in many cases the cows were asymptomatic when they were shipped and that they were at their new destinations and they were in fact those those. Herds They were frequently be local spread sometimes they weren't. I mean in Ohio I think only the initial far was positive in North Carolina at the same thing, but then other space like Michigan started at one county and then spread four or five other counties, and then it started to spill over into the poultry until then the poultry ended up getting the same virus the dairy attack that's B3. 13. And that ended up changing the situation for a few minutes were concerned that in 20 14. The number of human cases was zero in 202 2. The number of human cases was only one which is the color in Colorado, but then things began to change in 202 4 and of all of the human cases initially were the the Genotype that was found in the dairy farms and They generally started initially as one or two perform and then they had a significant outbreak in Wells County in Colorado. They had one layer farm that this was spill over to the chickens and the layer for farm had. It was fairly big had about 2 million birds and six of the colors ended up getting infected and then there was another 2 million bird farm not too far away also and well countering where three of them were affected so now it wasn't just Individual human cases there were actually colored clusters a few well where were multiple colors were positive and Then things kind of moved into a new version with an outbreak and In Washington state in Franklin County Washington state again it was a layer farm which had about 800, 000 birds and They initially had six of the colors that were positive and then they got three more and it turned out to the three more ended up traveling to Oregon after the color was done and they had a parent probably didn't given a prophylactic Tamiflu Just because they had been exposed to both the poultry as well as the six colors previously and they ended up developing symptoms probably in in Oregon and they ended up getting tester in Oregon and they were not only were they positive for five that one, but they all had A change in the and wanted a minute and it was the acid position 24 7 changed to an end and that made them somewhat resistant to the the also Tammy bear of brand names Tamiflu and so they were Tamiflu resistant But they did end up recovering, but all three of them ended up having the same mutation and they kinda indicated that they were fairly susceptible to this resistance and these didn't have the dairy type. Just be 3 13 they had. This newer one which was D1 that one and turned out the D1 that one was really in the wild bird this time that Canada released 14 sequences from wild birds from British Columbia 13 of them here to D1. One and then they had a teenager that was positive and that teenager. I don't know it's a little bit fuzzy on the timeline. It sounds like the teenager went to the emergency room and. Examined and sent home and then a few days later Said he is not really clear if it's your seat the teenager was went back to the emergency room and it was again sent home and then finally it was They were admitted and then that they actually did the next day. They were confirmed to have 85 and then the sample was sent to the national labs in Winnipeg and they confirmed it was eight by that one and then the reason we're doing these podcast is that last night. They released the sequence of the HI and one from the teenager and I kinda lifted the sequence last night night really started with the with the PB two and saw they did indeed had the E 67 K and it wasn't a clean signal. It was a mixture so it's all part of the signal came from the wild type, which was. The secrets with the E and part of the cave from is switching over to the K and so they represent that by saying that the nucleotide at the in this case, it was the first position coding for Code 62 7 it was a mixture out at the nucleotide level of a key in an a, and that would cause the changes in the protein to go from EK and that was concerning for two reasons that this change had been found previously and the first human that had the Dairy sequence and and that person they were, they weren't that sick that they just had conductor bites, but they that the sample the virus was sent well in Wisconsin that basically Put it into ferrets to see how well the ferrets would do and all the ferrets died and also it was concerning that the E62 7 K on the human that had it wasn't that bad but the human would've would've probably been given Tammy Foux fairly early on and Just had conjunctivitis where is the fairest actually died and so it was worried that this E627K which was an adaptation would cause virus to our replicate to higher levels in a mammal and they would get through a high enough level that it resulted And so the teen who was in British Columbia had the same change it was as a mixture, but it was E627K with you just the E And the teenager actually had deteriorated and was it Was actually in critical condition in the ICU where the teenager still is, but that was one change that was worrying and frankly, I didn't look at the sequence that closely last night but She said, which is the database to the sequences Has a kind of a running Violet genetic tree and they got that one for the H5 and they got one for the M1 and they actually have one for the PB two so three of the 18 segments they would have a treat that they were kind of update and the updated tree so that not only Did have the chain in 627K of the PB two but in the H 5 there were two changes and they were also mixtures and they use the sequence is actually in the The actual H 5 but a Lot of research on the H uses an H3 numbering that part because the sequences that we're studied initially came from seasonal flu H3 and two and the H 5 is slightly different numbers and so you don't get real confused A lot of the conversion is to put them all in the H 3 number at least so you can compare one from the other and add these two changes if you switched it over to H3 numbering When was that position 1 90 and the chain at 1 90 DN E I believe was was well known the exact letters, but it's definitely position 1 90 and That was present in a mix form and then there was another changed. It was that position to 2 6 and that's in the receptor body domain and the two key positions and the H using a street numbering is 226 to 22 8. And this had changed it to 2 6 also and it turned out this one changed from a Q to a H so it had two changes in the H5 sequence and it had one change in the PB two and all of those changes are linked to making the virus more the mail And since the teenager is in critical condition and his their sequence has three key changes There is quite a bit of interested in this particular case and there's quite a bit of concern that other human cases they are affected with the D one that one genotype could end up having these particular changes So I think we'll kind of stop the podcast there that's where things stand as of right now, but I can. I can certainly tell you that this sequence has caused a lot of interest online and a Saturday so yeah I would imagine even more interest will it will be a parent called Monday. When more people realize what the sequence is of this patient in the ICU in British Columbia and They'll be a lot more data than that there will be coming out. It is clear that the human cases are. Are on our up to 52 now are all of them this year and All of them except for these colors and in Washington state, and this teenager in British Columbia all the prior ones this year have all been dairy sequence and very large cluster in Washington state and this One teenager in British Columbia had this d1.one see type and Since most of the wild birds in the Pacific flyway had the same genotype and there's been an explosion of cases in commercial, poultry and backyard, farms and wild birds, and actually the wild birds unlimited the Pacific flyway they they're in all four of the flyways in the United States, but the The backyard farms are the commercial farms or the human cases. I have so far been concentrated in the pacifically fly away, and they sleep in in. The one in British Columbia the cluster Washington state and I think the number in California is now up to 2 6 and I believe that there was a report on Friday that indicated there were something like For five and something positive that had been reported at these would be cases that were positive in the state lab and I've been sent to the national lab and are waiting for confirmation, which would probably happen at the beginning of the week so the number of cases will be going up How many others have the changes they seen in the teenagers is I'm clear but the fact that the teenager had these three very important changes is a very strong argument that they didn't all just happened in the one or two days that they were in the teenager before the sample was collected because they like I say are very T And much more likely that they were already present in the the Wildbird, which is probably the source for this teenager. They were probably already in the wild bird by a low level so the bird had a mixture and it wasn't detected until I went into a mammal. The map selected this and then they got to the level that they are that teenager, where about half of the signal I'll each of these is. Is a keychain that makes the avian H5 that one behave more likely at HI that one and that is that's what the concern is and there should be a lot of information in the next week or two See how rare or cabin the sequence in British Columbia is 

You
OK, thank you for the information. Thank you for the 

Dr. Niman
OK, that's it 

You
information. We will be doing more of these podcasts in the near future please stay tuned. 

 

Edited November 16 by Admin