-transmission of cow H5 to poultry farms has been observed but also unclear how; thought to be by shared workers

They outline that human infections are likely being missed; and we may be the vectors propagating further spread between mammals and between species.

2/ Broader testing protocols can pick up 'outliers' like the case we picked up through Stanford in a child in Alameda County. These cases are very important because they can shed light on blindspots in the response.

3) Important to remember this is genotype D1.1 (different than what is infecting dairy cows). This is the same as what caused severe disease in the patient in British Columbia.

t.co/twjE1EyJ1I

2) These mutations were not identified in the birds that likely infected the patient suggesting they occured while the patient was infected.