Surveillance on California dairy farms reveals multiple sources of H5N1 transmission

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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Cow Coughs, Milk Splashes, and Wastewater: H5N1 Lurks Everywhere on Dairy Farms

This study investigated H5N1 transmission on dairy farms and found the virus present in air samples from milking parlors, exhaled breath, and farm wastewater. The study also examined H5N1 positivity in individual cow udders, finding a heterogeneous distribution of infection and noting that H5N1 infection doesn't always correlate with clinical mastitis. While the longitudinal study focused on one farm with a limited number of cows over a short period, the findings suggest multiple modes of H5N1 transmission on dairy farms.

Possible Conflicts of Interest

The authors disclosed that SSL and LCM receive funds from Flu Lab and NIH, and ASL receives funds from Flu Lab, NIH, and CDC, and some consulting fees and research support from Roche outside of the submitted work. No other conflicts were identified.

Identified Weaknesses

Limited sampling size and duration

The study acknowledges the limitations of their longitudinal study including that the study was conducted on only one farm for a short period of time.

Uncontrolled milking order and shared equipment

The order of milking for the 14 cows in the longitudinal study was not controlled, and shared equipment was used, which makes it challenging to ascertain transmission routes.

Underestimation of infectivity in wastewater

This may underestimate the true extent of infectivity. While the study identified some cows shedding infectious virus, it is possible that more were doing so at levels below the detection threshold of the assays used.

Correlation between Mastitis and H5N1

Although the study examined mastitis and H5N1, it's important to note that mastitis may have different underlying causes in real-world scenarios, which can impact transmission patterns. More research is needed to fully understand the interplay of mastitis and H5N1.

Limited confirmation of airborne transmission

While the study suggests airborne transmission via aerosols and droplets, further research with larger sample sizes and diverse farm settings is necessary to validate these findings and assess the true extent of this mode of transmission.

Rating Explanation

This study provides valuable insights into potential H5N1 transmission routes on dairy farms, using multiple sampling methods across various sites. Detecting the virus in air, wastewater, and milk highlights the widespread contamination and potential for transmission. The study's limitations, such as the small sample size and short duration of the longitudinal study, prevent a full 5-star rating. However, the findings are significant and warrant further investigation to refine mitigation strategies. The declared funding sources and consulting fees could represent a conflict of interest, although this does not diminish the value of the findings themselves, so does not affect the rating of the paper.

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