recent comments... about “workers” with conjunctivitis suggested multiple cases reports of one #H5N1 presumptive positive Nevada Churchill Co human #H5N1 D1.1 variant w/ PB2 D701N other comment NV State Ag Commiss suggests there are more NOT a surprise

Large cat seqs uploaded to BLAST search at Genbank (linked to Northwest Natural recalled pet food) #H5N1 B3.13 w/ NP Y52Q

@RajlabN @Nucleocapsoid @KinCONN @CDCgov @USDA But D1.1 has a North American N1 which would not be expected to be closely related to European N1 (and the same is true for all Genotypes which compare North American segments to European)

Note that number of major D1 and D2 #H5N1 genotypes continue to evolve although all have North American PB2

when it gets into people... cause a much more serious disease than... (B3.13).... #H5N1 D1.1 variant w/ PB2 D701N has already been reported in 4 Churchill Co NV Cows Highly likely in first human presumptive pos Can synergize w/ PB2 E627K ( D1.1 BC 13F)

worker’s symptoms include red, inflamed eyes, or conjunctivitis Since six of the seven #H5N1 dairy herds in NV are in Churchill Co and all appear to have D1.1 variant w/ D701N (mammalian adaption) it is likely this Dairy worker is also in Churchill Co (1st H5N1 Herd in Nye Co)

Above should say PB2 D701N

In May #H5N1 in migratory birds moved to Canada Human season flu season largely over Each household had lab confirmed B3.13 Timing of symptoms consistant with H5N1 transmissions Adolescent would have been 1st H5N1 in US cat2cat and human2cat would have raised awareness