Category: Flu Virus

By Amy Maxmen Updated July 19, 2024 Originally Published July 15, 2024

Six people who work at a poultry farm in northeastern Colorado have tested positive for the bird flu, the Centers for Disease Control and Preventionreported July 19. This brings the known number of U.S. cases this year to 10.

The workers were likely infected by chickens, which they had been tasked with killing in response to a bird flu outbreak at the farm.The endeavor occurred amid a heat wave, as outside temperatures soared to 104 degrees Fahrenheit.

The barns in which culling occurs were no doubt even hotter, said CDC principal deputy director Nirav Shah at a July 16 press briefing. Wearing N95 respirators, goggles, and other protective gear was a challenge. Industrial fans whipped feathers around the facility that could have carried the virus, Shah added.

In this environment, the farmworkers collected hundreds of chickens by hand and placed them into carts where they could be killed by carbon dioxide gas within two minutes.

If a farm worker gets severely ill or dies from an H5N1 infection, it will be a stain on US public health that we didnt do more with the tools we have, Jennifer Nuzzo, director of the Pandemic Center at Brown University, posted on X. You dont send farm workers in to cull H5N1 infected birds without goggles and masks. Period. If its too hot to wear those protections, its too hot to cull. We need vaccines to be made available to farm workers. We have to stop gambling with peoples lives.

More than 99 million chickens and turkeys have been infected with a highly pathogenic strain of the bird flu that emerged at U.S. poultry farms in early 2022. Since then, the federal government has compensated poultry farmers more than $1 billion for destroying infected flocks and eggs to keep outbreaks from spreading.

As summer temperatures rise across the country, Shah said, the agency is contending with how to offer farmworkers safety from the virus, as well as safety from extreme heat.

The H5N1 bird flu virus has spread among poultry farms around the world for nearly 30 years. An estimated 900 people have been infected by birds, and roughly half have died from the disease.

The virus made an unprecedented shift this year to dairy cattle in the U.S. This poses a higher threat because it means the virus has adapted to replicate within cows cells, which are more like human cells. The four other people diagnosed with bird flu this year in the U.S. worked on dairy farms with outbreaks.

Scientists have warned that the virus could mutate to spread from person to person, like the seasonal flu, and spark a pandemic. Theres no sign of that, yet.

So far, all 10 cases reported this year have been mild, consisting of eye irritation, a runny nose, and other respiratory symptoms. However, numbers remain too low to say anything certain about the disease because, in general, flu symptoms can vary among people with only a minority needing hospitalization.

The number of people who have gotten the virus from poultry or cattle may be higher than 10. The Centers for Disease Control and Prevention has tested only about 60 people over the past four months, and powerful diagnostic laboratories that typically detect diseases remain barred from testing for bird flu. Testing of farmworkers and animals is needed to detect the H5N1 bird flu virus, study it, and stop it before it becomes a fixture on farms.

Researchers have urged a more aggressive response from the CDC and other federal agencies to prevent future infections. Many people exposed regularly to livestock and poultry on farms still lack protective gear and education about the disease. And they dont yet have permission to get a bird flu vaccine.

Nearly a dozen virology and outbreak experts recently interviewed by KFF Health News disagree with the CDCs decision against vaccination, which may help prevent bird flu infection and hospitalization.

We should be doing everything we can to eliminate the chances of dairy and poultry workers contracting this virus, said Angela Rasmussen, a virologist at the University of Saskatchewan in Canada. If this virus is given enough opportunities to jump from cows or poultry into people, it will eventually get better at infecting them.

To understand whether cases are going undetected, researchers in Michigan have sent the CDC blood samples from workers on dairy farms. If they detect bird flu antibodies, its likely that people are more easily infected by cattle than previously believed.

Its possible that folks may have had symptoms that they didnt feel comfortable reporting, or that their symptoms were so mild that they didnt think they were worth mentioning, said Natasha Bagdasarian, chief medical executive for the state of Michigan.

In hopes of thwarting a potential pandemic, the United States, United Kingdom, Netherlands, and about a dozen other countries are stockpiling millions of doses of a bird flu vaccine made by the vaccine company CSL Seqirus.

Seqirus most recent formulation was greenlighted last year by the European equivalent of the FDA, and an earlier version has the FDAs approval. In June, Finland decided to offer vaccines to people who work on fur farms as a precaution because its mink and fox farms were hit by bird flu last year.

The CDC has controversially decided not to offer at-risk groups bird flu vaccines. Demetre Daskalakis, director of the CDCs National Center for Immunization and Respiratory Diseases, told KFF Health News that the agency is not recommending a vaccine campaign at this point for several reasons, even though millions of doses are available. One is that cases still appear to be limited, and the virus isnt spreading rapidly between people as they sneeze and breathe.

The agency continues to rate the publics risk as low. In a statement posted in response to the new Colorado cases, the CDC said its bird flu recommendations remain the same: An assessment of these cases will help inform whether this situation warrants a change to the human health risk assessment.

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Colorado Poultry Workers Battle Bird Flu in Heat Wave as US Struggles to Contain Outbreak - Kaiser Health News

In mid-July,the US state of Colorado reportedsix cases ofavian flu orH5N1 in samples taken from poultry workers. This brought the national total to 10 cases confirmed by the US Centers for Disease Control and Prevention (CDC) since April 2024.

The United States government has upped zoonotic/animal testing, and is now discovering more cases of infection with the virus in cows and other mammals. So far, it has reported H5N1 in more than 160 herds of cows.

The growing number of cases comes amid growing concern about the spread of the virus, with a recent studypublishedin the journal Nature suggestingthat the H5N1 found in cows may be more adaptable to humans.

In response to this situation, the US governmentrecently awarded a $176m project to Moderna to support clinical trials for an mRNA vaccine against the virus. Other countries are also becoming alert about these developments, with Finland launching a vaccination drive aimed at safeguarding the most at-risk communities from the disease.

The increasingly frequent reports of new cases have caused some experts to suggest that another pandemic situation may be on the horizon. While that is by far not a certainty, we should still be prepared for it. Yet the worlds readiness to respond tosuchhealth threats still appears fragmented and inequitable.It should be worrying to us all that we still do not haveadequate tools for early detection and containment.

What we know so far is that H5N1 is a fast-moving, rapidly evolving virus that can cause severe illness and death. However, the lack of diagnostic testing and genetic sequencing for humans and animals obscures our understanding of how the virus is mutating and if there are any potential mutations that may increase the likelihood of human-to-human transmission. The lack of focus on surveillance and investment in diagnostics is irresponsible.

It is crucial to avoid repeating mistakes from the COVID-19 pandemic, especially when dealing with H5N1, where the risks could be even greater due to its high mortality rate. Over the past 20 years, fatal outcomes have been reported in about 50 percent of known cases.

It is likely that infections have been under-reported and under-diagnosed due to limited testing capacity and so the mortality rate may be lower. Furthermore, this rate would not necessarily be replicated if the virus established itself in the human population. Still, there is a risk that a H5N1 pandemic may be significantly different from the COVID-19 one and deadlier.

The bad news is that at present, there are currently no commercially available diagnostic tests to detect H5N1 specifically. Nucleic acid-based (molecular) tests are the current gold standard for the detection of influenza viruses, but they generally require lab infrastructure to support their use. And even when such infrastructure is available, it may not function fast enough. For example, whena sickAustraliangirl was tested for bird fluin March,it tookseveral weeks to get the positive result back.

As seen duringtheCOVID-19pandemic, rapid tests that can provide a result in around 10-15 minutes are a critical tool for outbreak containment even if they are less sensitive than molecular tests.Investing in research and development that leads to quick,affordable tests for H5N1 influenzacan laythe foundationforpreparedness.

Tests should be made available worldwide including in low- and middle-income countries and prioritised in populations where there is a likelihood of human exposure to the virus, like farms or veterinary clinics.

Scaling up the monitoring of bird and animal populations, training personnel effectively, streamlining reporting mechanisms and utilising cutting-edge technologies like artificial intelligence for speedy analysisshouldallbepriorities for governments. There also need to be incentives to encourage at-risk populations, currently those working with animals that are potentially sick, to test.

Effective ongoing collaboration on developing and sharing treatments and vaccines is equally essential. Partnerships, like the Access to COVID-19 Tools Accelerator which includes health leaders from the World Health Organization; the Foundation for Innovative New Diagnostics (FIND); Gavi, the Vaccine Alliance; and the Coalition for Epidemic Preparedness Innovations (CEPI) should be used to encourage governments and pharmaceutical groups to ensure the production of at-scale health countermeasures and that they are available to all countries.

This is not charity, it is investing in global public health to ensure we are all protected. No country can stop a pandemic by itself.

More than a million lives may have been lost during COVID-19 because of inequity. We need to make sure this does not happen again. There needs to be a focus on helping low- and middle-income countries gain access to all the countermeasures needed to tackle the next pandemic.

Action is needed now, while human-to-human transmissionhas still not beendetected, so that if and when it is, arapid coordinated global response to H5N1can be deployed.

The new cases in Colorado do not suggest the world is about to end, but are a signal worth heeding. While the US and other Western countries are able to take measures, poorer countries that do not have the resources or access to technology cannot.

This unequal situation notonlythreatensnationalhealth security but also hindersthe worldsability to preventan H5N1 pandemic if it is to emerge. Global leaders must acknowledge the interconnectedness of health systems and commit to distributing resources fairly.

If H5N1 starts spreading from human to human and we are not prepared for it, we will pay an unimaginable heavy price in terms of human lives and livelihoods.

The views expressed in this article are the authors own and do not necessarily reflect Al Jazeeras editorial stance.

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Has the next pandemic already started? - Al Jazeera English

Topline

Heres the latest news about a global outbreak of H5N1 bird flu that started in 2020, and recently spread among cattle in U.S. states and marine mammals across the world, which has health officials closely monitoring it and experts concerned the virus could mutate and eventually spread to humans, where it has proven rare but deadly.

A sign warns of a outbreak of bird flu.

July 15Officials confirmed a fourth bird flu case in a poultry farm worker on the same Colorado farm from last week, and a fifth suspected case is pending confirmation from the Centers for Disease Control and Prevention. This brings the national number to nine since the first human cases was detected in the state in 2022, with eight of the cases reported this year.

July 12Colorado authorities announced three workers in a commercial egg operation have presumptive positive cases of bird flu, bringing the states count of known human infections up to as high as fiveand the national number to seventhough authorities said none of the workers have been hospitalized, and showed common respiratory infection symptoms and pink eye. Its the first time multiple cases have been recorded at the same location.

July 3Colorado health officials confirmed the states second human case of bird flu in a dairy farm worker who has since recovered and only had mild symptoms, reporting pink eye.

June 25Finland said it plans to begin vaccinating vulnerable populations like farm workers against bird flu as early as next week using 10,000 vaccine serieseach with two dosesacquired as part of a European Union deal with vaccine maker CSL Seqirus to provide up to 40 million vaccines to 15 countries.

June 11The World Health Organization announced a four-year-old child in India was infected with H9N2 bird flua different flu strain from H5N1but recovered after suffering from seizures, respiratory distress, fever and abdominal cramps; H9N2 has infected around 100 people globally since 1998, and this is the second human case in India.

June 6Dozens of cows infected with bird flu have either died or been slaughtered in Colorado, Ohio, Michigan, South Carolina and Texas, which is unusual sinceunlike poultrycows cost more to slaughter and around 90% usually make a full recovery, Reuters reported.

June 5A new study examining the 2023 bird flu outbreak in South America that killed around 17,400 elephant seal pups and 24,000 sea lions found the disease spread between the animals in several countries, the first known case of transnational virus mammal-to-mammal bird flu transmission.

May 30Another human case of bird flu has been detected in a dairy farm worker in Michiganthough the cases arent connectedand this is the first person in the U.S. to report respiratory symptoms connected to bird flu, though their symptoms are resolving, according to the CDC.

May 23A new study with mice suggests that drinking infected milk can spread the diseaseand that a certain type of pasteurization may not always be effective in killing the virus.

May 22Michigan reported bird flu in a farmworkerthe second U.S. human case tied to transmission from dairy cowsthough the worker had a mild infection and has since recovered.

May 21Australia reported its first human case of bird flu after a child became infected in March after traveling to India, though the child has since recovered after suffering from a severe infection, according to the Victorian Department of Health.

May 16The USDA conducted a study, and discovered that after high levels of the virus was injected into beef, no trace was left after the meat was cooked medium to well done, though the virus was found in meat cooked to lower temperatures.

May 14The CDC released influenza A waste water data for the weeks ending in April 27 and May 4, and found several states like Alaska, California, Florida, Illinois and Kansas had unusually high levels, though the agency isnt sure if the virus came from humans or animals, and isnt able to differentiate between influenza A subtypes, meaning the H5N1 virus or other subtypes may have been detected.

May 10The Food and Drug Administration announced it will commit an additional $8 million to ensure the commercial milk supply is safe, while the Department of Agriculture said it will pay up to $28,000 per farm to help mitigate the spread of the disease, totaling around $98 million in funds.

May 9Some 70 people in Colorado are being monitored for bird flu due to potential exposure, and will be tested for the virus if they show any symptoms, the Colorado Department of Public Health told Forbesit was not immediately clear how or when the people were potentially exposed.

May 1The Department of Agriculture said it tested 30 grocery store ground beef products for bird flu and they all came back negative, reaffirming the meat supply is safe.

May 1The Food and Drug Administration confirmed dairy products are still safe to consume, announcing it tested grocery store samples of products like infant formula, toddler milk, sour cream and cottage cheese, and no live traces of the bird flu virus were found, although some dead remnants were found in some of the foodthough none in the baby products.

April 30Wenqing Zhang, head of WHO's Global Influenza Programme, said during a news briefing "there is a risk for cows in other countries to be getting infected," with the bird flu virus, since its commonly spread through the movement of migratory birds.

April 29The Department of Agriculture told Forbes it will begin testing ground beef samples from grocery stores in states with cow outbreaks, and test ground beef cooked at different temperatures and infected with the virus to determine if it's safe to eat.

April 24The USDA said cow-to-cow transmission may be occurring due to the cows coming into contact with raw milkand warned against humans and other animals, including pets, consuming unpasteurized milk to prevent potential infection.

April 18Jeremy Farrar, chief scientist for the World Health Organization, said during a press conference the threat of bird flu spreading between humans was a great concern, since its evolved and has increasingly been infecting mammals (on land and sea), which means it could possibly spread to humans.

April 1The CDC reported the second U.S. human case of bird flu in a Texas dairy farmer who became infected after contracting the virus from infected dairy cows, but said the person was already recovering.

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Bird flu doesnt transmit easily from person-to-person, according to the World Health Organization. Bird flu rarely affects humans, and most previous cases came from close contact with infected poultry, according to the CDC. Because human-to-human spread of bird flu poses pandemic potential, each human case is investigated to rule out this type of infection. Though none have been confirmed, there are a few global casesnone in the U.S.where human-to-human transmission of bird flu was thought to be probable, including in China, Thailand, Indonesia and Pakistan.

It is very deadly. Between January 2003 and March 28, 2024 there have been 888 human cases of bird flu infection in humans, according to a report by the World Health Organization. Of those 888 cases, 463 (52%) died. To date, only two people in the U.S. have contracted H5N1 bird flu, and they both were infected after coming into contact with sick animals. The most recent case was a dairy worker in Texas who became ill in March after interacting with sick dairy cows, though he only experienced pink eye. The first incident happened in 2022 when a person in Colorado contracted the disease from infected poultry, and fully recovered.

Raw, unpasteurized milk is unsafe to drink, but pasteurized milk is fine, according to the FDA. Bird flu has been detected in both unpasteurized and pasteurized milk, but the FDA recommends manufacturers against making and selling unpasteurized milk since theres a possibility consuming it may cause bird flu infection. However, the virus remnants in pasteurized milk have been deactivated by the heat during the pasteurization process, so this type of milk is still believed safe to consume.

The CDC warns against eating raw meat or eggs from animals confirmed or suspected of having bird flu because of the possibility of transmission. However, no human has ever been infected with bird flu from eating properly prepared and cooked meat, according to the agency. The possibility of infected meat entering the food supply is extremely low due to rigorous inspection, so properly handled and cooked meat is safe to eat, according to the USDA. To know when meat is properly cooked, whole beef cuts must be cooked to an internal temperature of 145 degrees Fahrenheit, ground meat must be 160 degrees and poultry must be cooked to 165 degrees. Rare and medium rare steaks fall below this temperature. Properly cooked eggs with an internal temperature of 165 degrees Fahrenheit kills bacteria and viruses including bird flu, according to the CDC. It doesnt matter if they may or may not have [avian] influenza runny eggs and rare pieces of meat are never recommended, Francisco Diez-Gonzalez, director and professor for the Center for Food Safety at the University of Georgia, told Forbes. To play it safe, consumers should only eat fully cooked eggs and make sure the yolks are firm with no runny parts, Daisy May, veterinary surgeon with U.K.-based company Medivet, said.

Symptoms of bird flu include a fever, cough, headache, chills, shortness of breath or difficulty breathing, runny nose, congestion, sore throat, nausea or vomiting, diarrhea, pink eye, muscle aches and headache. However, the CDC advises it cant be diagnosed based on symptoms alone, and laboratory testing is needed. This typically includes swabbing the nose or throat (the upper respiratory tract), or the lower respiratory tract for critically ill patients.

This years egg prices have increased as production decreased due to bird flu outbreaks among poultry, according to the USDA. A dozen large, grade A eggs in the U.S. costed around $2.99 in March, up almost a dollar from the fall. However, this price is down from a record $4.82 in January 2023, which was also spiked by bird flu outbreaks. Earlier this month, Cal-Maine Foodsthe countrys largest egg producertemporarily halted egg production after over one million egg-laying hens and chickens were killed after being infected with bird flu.

Once chickens have been infected with bird flu, farmers quickly kill them to help control the spread of the virus, since bird flu is highly contagious and fatal in poultry. The USDA pays farmers for all birds and eggs that have to be killed because of bird flu, as an incentive to responsibly try and curb the spread of the disease. The USDA has spent over $1 billion in bird flu compensation for farmers since 2022, according to the nonprofit Food & Environment Reporting Network.

The FDA has approved a few bird flu vaccines for humans. The U.S. has a stockpile of vaccines for H5N1 bird flu, but it wouldnt be enough to vaccinate all Americans if an outbreak were to happen among humans. If a human outbreak does occur, the government plans to mass produce vaccines, which can take at least six months to make enough for the entire population. CSL Seqirus, the maker of one of the approved vaccines, expects to have 150 million vaccines ready within six months of an announcement of a human bird flu pandemic. Although there are approved vaccines for other variants designed for birds, there are none for the H5N1 variant circulating. However, the USDA began trials on H5N1 animal-specific vaccines in 2023.

As of May 30, more than 92 million poultry (primarily chickens) in 48 states have been euthanized because of bird flu since 2022, and 57 dairy cow herds across nine states have tested positive, according to data from the CDC (unlike chickens, cows appear to recover from the virus). The USDA believes wild migratory birds are the original source of the cow outbreaks that recently has experts concerned it may mutate and spread more easily in humans, though the CDC said its risk to the public remains low. Farrar called the cattle infections in the U.S. a huge concern, urging public health officials to continue closely monitoring the situation because it may evolve into transmitting in different ways. The increased number of mammal bird flu infections since 2022 could indicate that the virus is looking for new hosts, and of course, moving closer to people, Andrea Garcia, vice president of science, medicine and public health for the American Medical Association, said. The first report of a walrus dying from bird flu was detected in April on one of Norways Arctic Islands, and the first U.S. dolphin infected with bird flu died back in 2022, according to a report published April 18. More than 10 human bird flu cases were reported to the World Health Organization in 2023, and all but one survived. Bird flu has devastated bird populations, and 67 countries reported the deaths of 131 million poultry in 2022 alone. Although bird flu typically infects wild birds and poultry, its spread to other animals during the outbreak, and at least 10 countries have reported outbreaks in mammals since 2022. Around 17,400 elephant seal pups died from bird flu in Argentina in 2023, and at least 24,000 sea lions died in South America the same year. Besides cattle, bird flu has been detected in over 200 other mammalslike seals, raccoons and bearsin the U.S. since 2022. Although rare, even domestic pets like dogs and cats are susceptible to the virus, and the FDA warns against giving unpasteurized milk to cats to avoid possible transmission.

On June 5, WHO confirmed the first human death of a strain of bird flu thats never before been seen in humans and is separate from H5N1. A 59-year-old man in Mexico contracted H5N2, and died on April 24 after being hospitalized and developing a fever, diarrhea, nausea, shortness of breath and general discomfort. Cases of H5N2 have been reported in poultry in Mexico, but the man had no history with poultry or animals, WHO said. Its unclear how he became infected. He was bedridden for weeks prior to the infection, and suffered from several other health conditions.

Another Bird Flu Variant Reaches Humans: What To Know About H5N2After First-Ever Confirmed Death

WHO Warns Threat Of Bird Flu Spreading To Humans Is Great Concern (Forbes)

One In Five Milk Samples From Across US Had Traces Of Bird Flu Virus, FDA Says (Forbes)

Can Pets Get Bird Flu? Heres What To Know (Forbes)

Avian H5N1 (Bird) Flu: Why Experts Are WorriedAnd What You Should Know (Forbes)

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Bird Flu (H5N1) Explained: U.S. Human Infections Rise To 9 - Forbes

Facing increasing doubts that the U.S. can control the outbreak of avian influenza among dairy cattle, federal officials reiterated on Tuesday that they believe the country can still eliminate the H5N1 virus from dairy cows, even as it continues to spread to new herds.

All the signs that we have are, with good biosecurity, with good farmer participation, we will be able to eliminate this, Eric Deeble, the acting senior adviser for the H5N1 response at the U.S. Department of Agriculture, said on a call with reporters.

The reason for that confidence, Deeble said, is that investigations have shown its the transport of cows, as well as the shared use of equipment and vehicles, that is spreading the virus. That means that cutting the virus off at those points can contain it, he said, noting that officials have not seen new introductions of the virus to dairy cows from birds since the outbreak started, likely late last year.

We understand that this moves with the cattle and with the people that are closely associated with them, so enhanced biosecurity should get us to a point where we can arrest the spread, Deeble said. He added that the possible future deployment of an H5 vaccine in cattle which is an idea that remains under discussion could further facilitate the elimination of this disease from the national herd.

Outside experts are increasingly skeptical of that view given the ground the virus continues to gain. Theyve argued that the problems that have impeded the outbreak response from the beginning from a surveillance system that isnt keeping up with the spread of the virus to a lack of cooperation from dairy farms havent changed dramatically. And they argue that the longer the virus persists in cattle, the more likely it is that it could mutate in such a way that would make it more transmissible among people.

The USDA has started providing more resources to farms with infected cows, which could improve the willingness of dairy farms to test their animals. But experts still believe that the poor tracking of the virus officially, more than 155 herds in 13 states have reported infections, though its widely presumed that both numbers are undercounts means officials dont know the scale of the outbreak or all the herds that are affected. Surveys have also shown that farmers have continued to move cows even after they have shown signs of disease.

There are no clear signs that the outbreak is or is about to come under control, a report from the Norwegian Institute of Public Health last month stated, adding that the probability of persistent chains of infection is considered high.

Deebles remarks came as health and agricultural officials provided an update on a cluster of human H5N1 cases in Colorado.

The five cases (four are confirmed, one is still considered presumptive) were among people who were involved in culling birds at a poultry farm with an H5N1 outbreak in Colorados Weld County. But the available evidence suggests that the virus possibly reached the 1.8-million bird poultry farm from an infected dairy herd.

On the press call, officials noted that there have been infected dairy herds in Weld County. They also said that a genetic sequence from one of the human cases indicated that the virus was related to the version thats spreading among cows. Notably, the genetic sequence of a key component of the virus the hemagglutinin subunit was an exact match to the hemagglutinin sequences from two earlier human cases tied to the dairy outbreak, officials said.

That does raise the possibility that this virus was transmitted from a dairy herd in Colorado to the poultry farm, Nirav Shah, the principal deputy director at the Centers for Disease Control and Prevention, told reporters. That is a hypothesis. It is a hypothesis that needs and requires a full investigation. But that is a hypothesis at this point.

The five Colorado cases were all mild, Shah said. The people had different symptoms, with some experiencing the more traditional flu signs of fever and cough, and others having conjunctivitis, a symptom thats been seen with some of the dairy workers whove been infected during the outbreak.

The human cases also underscored some of the challenges authorities face in seeking to prevent spread from animals to people. Health officials have been urging dairy workers to wear personal protective equipment in milking parlors, for example, given the sky-high levels of virus in cows udders and their milk. But milking parlors can be hot and stuffy, meaning its not comfortable or feasible to wear masks and goggles.

Workers involved in culling poultry with H5N1 outbreaks depopulation in the parlance of agricultural officials are meant to wear full PPE, from boots to suits to masks and goggles. But officials noted that when the culling was taking place, it was over 100 degrees in Colorado. Moreover, the industrial fans that were meant to cool down the barns where the culling was taking place were so strong that workers had a hard time keeping their masks and goggles sealed to their faces. Plus, the fans were whipping up birds feathers, which can carry the virus.

The culling method used on this farm which requires workers to pick up chickens and place them in a cart where they are euthanized with carbon dioxide also meant there was lots of contact with the birds, officials said.

We understand that PPE use was not optimal, particularly the masks and the eye protection, Shah said. He added, however, that these factors do highlight a pathway to prevention, with better engineering and PPE use possibly able to avoid future cases.

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USDA maintains bird flu can be eliminated from dairy cows, even as doubts mount among experts - STAT

You may have heard about the current outbreak of bird flu thats been identified in the United States. Currently, the risk of bird flu infection throughout the country is low. The risk of bird flu infection in Philadelphia is also low.

The reason that bird flu (also known avian influenza, H5N1 and HPAI) is in the news is that its making our milk-producing cows sick and people who work with affected poultry and cows have also become sick. Thats unusual and its why people are paying attention to this disease. Usually, bird flu spreads in wild birds and poultry, such as chickens and turkeys. Sometimes it can make mammals, including people, sick.

The current outbreak in wild birds, poultry and mammals began in February 2022.Wild aquatic birds, such as ducks and geese, are the most common carriers of bird flu. Many may be infected but dont look sick. They can transfer the virus to other animals. Bird flu is very deadly to domestic chickens and several species of mammals, such as seals, foxes and skunks.

In March 2024, we saw the first reported cases of bird flu in dairy cows in Texas, followed by the second human infection in the United States (the first human infection occurred in 2022). A total of nine people have now tested positive, all after exposure to dairy cows and poultry. While bird flu has been deadly to humans in previous outbreaks around the world, these farm workers only had mild to moderate symptoms.

As of July 19, 163 dairy herds across 13 states have tested positive for this bird flu.Bird flu is not a big risk to most Philadelphians. But there are things you can do to keep it that way.

Everyone who has developed bird flu has had direct contact with poultry or dairy cows. While the risk of becoming infected remains very low, here are some steps you can take to protect yourself:

Commercial milk sold in grocery and other food stores is safe to drink. Thats because commercial milk has been pasteurized. Pasteurization is a process that heats milk to kill bacteria and viruses.

Unpasteurized milk, commonly referred to as raw milk, can carry dangerous bacteria and viruses that can make you very sick and even cause life-threatening illness. The health department, doctors and experts across the country strongly advise against drinking raw milk because it can be so dangerous. Studies have shown that in a 20-year period, more than 2,500 people have gotten sick from drinking raw milk, and three people died.

Some people online will tell you that raw milk is better for you or can protect you from bacteria or viruses. That is wrong and dangerous.

Just to be safe, here are some tips to help protect you from bird flu and other bacteria or viruses that might be lurking in your food:

Songbirds and other typical feeder birds dont usually carry bird flu viruses. Its generally safe to keep your birdfeeder out for them. However, you may want to temporarily remove it if you also raise chickens or turkeys because they might expose your backyard birds to the virus.

In general, its best to stay away from wild birds, such as geese and ducks, as they are common carriers of bird flu. Wild birds can have bird flu without appearing sick.

Domestic chickens are particularly susceptible to bird flu. Over half of the affected flocks since the start of the outbreak have been backyard flocks. If you care for chickens, heres how to keep them and you safe:

Bird flu isnt a big risk in Philadelphia, but its always better to be protected and ready if things change.

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Risk of bird flu (H5N1) infection in Philadelphia remains low - City of Philadelphia (.gov)

Two large US investments in human vaccines for avian influenza A(H5N1) are aimed at boosting US readiness in the case of a pandemic.

Last week, the US Department of Health and Human Services (HHS), through the Biomedical Advanced Research and Development Authority, announced it will pay Moderna $176 million to develop an mRNA-based pandemic influenza vaccine.

The announcement came weeks after the government ordered 4.8 million doses of a pre-pandemic cell-based vaccine, well matched to the currently circulating H5N1 strain, according to the manufacturer, CSL Seqirus. The doses are expected to be available next week for the US National Pre-Pandemic Influenza Vaccine Stockpile.

The cell-based vaccine would need to be approved by the US Food and Drug Administration (FDA) before any potential distribution.

A spokesperson for the Administration for Strategic Preparedness and Response (ASPR) told Medscape Medical News, "ASPR has hundreds of thousands of doses that could be deployed within weeks pending regulatory approval by the FDA and is filling approximately 4.8 million additional doses to augment this reserve."

Moderna has started its phase 1/2 trial to test the safety of its investigational pandemic influenza vaccine (mRNA-1018) in healthy adults. The study includes antigens against the H5 and H7 avian flu viruses. Results are expected later this year, Moderna said in a press release. According to the company, the $176 million in funding will support the late-stage development of the vaccine.

Dawn O'Connell, assistant secretary for preparedness and response at HHS, said Moderna's phase 3 trials could begin in 2025. She said the funding agreement allows the government to shift quickly to supporting the development of other versions of the mRNA vaccines when new viral strains emerge.

The Centers for Disease Control and Prevention (CDC) maintains that the avian flu risk to humans remains low. "No segment of the population has been recommended for vaccination," the ASPR spokesperson noted.

But in the CDC's most recent update, the agency said, "This is a rapidly changing situation" and posted interim recommendations for prevention, monitoring, and public health investigations of avian flu virus infections in people.

A fourth case of cow-to-human transmission was reported on July 3, this time in Colorado. Three previous human cases were reported in farmworkers in Texas and Michigan. There have been 145 confirmed cases in livestock herds in 12 states.

The two kinds of vaccine work in different ways. The cell-based version grows the influenza virus in a cell culture, and the virus is then inactivated, purified, and used as the vaccine antigen.

Rather than using a part of an actual virus, Moderna's vaccines use mRNA that codes for viral antigens. The body's own cellular machinery then creates those antigens, which induce the immune system to generate antibodies that will recognize them on the virus. Once cells finish making a protein, they quickly break down the mRNA.

With the two vaccines soon to be available is needed, HHS Secretary Xavier Becerra said the country is well prepared for a potential pandemic. "We have successfully taken lessons learned during the COVID-19 pandemic and used them to better prepare for future public health crises. As part of that, we continue to develop new vaccines and other tools to help address influenza and bolster our pandemic response capabilities," he said in a statement. "Importantly, we are doing this work in partnership with some of the nation's leading scientists and clinicians."

No relevant financial relationships were disclosed.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune, Science News, Northwestern magazine, and Nurse.com and was an editor at the Chicago Sun-Times, Cincinnati Enquirer, and St. Cloud Times. Follow her on X: @MLfrellick.

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US Boosts Investment in Avian Flu Vaccine Candidates - Medscape

U.S. health officials have announced two more bird flu cases among farmworkers

By

MIKE STOBBE AP Medical Writer

July 19, 2024, 4:34 PM ET

2 min read

NEW YORK -- U.S. health officials on Friday announced two more bird flu cases among farmworkers, but they also said a new study in Michigan suggested the virus is not causing silent infections in people.

Last month, the Michigan Department of Health and Human Services launched a study of workers who were around cows sickened by the bird flu. The researchers drew blood from 35 people.

One goal was to determine if there were people who never had any symptoms but did have evidence of past infections. None of the blood testing showed antibodies that would indicate such infections, the Centers for Disease Control and Prevention reported on Friday.

Meanwhile, two more infections tied to a Colorado poultry farm were reported, bringing the total to six. It's the largest outbreak of human bird flu infections in U.S. history, and accounts for most of the 11 cases reported to date. Ten of those cases occurred this year, all among farmworkers and all with mild symptoms.

A bird flu virus has been spreading since 2020 among mammals including dogs, cats, skunks, bears and even seals and porpoises in scores of countries. Earlier this year the virus, known as H5N1, was detected in U.S. livestock, and is now circulating in cattle in several states.

Health officials continue to characterize the threat to the general public as low, and the virus has not spread between people. But officials are keeping careful watch, because earlier versions of the same virus have been deadly.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institutes Science and Educational Media Group. The AP is solely responsible for all content.

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Two more bird flu cases reported in Colorado, but elsewhere a study finds no asymptomatic infections - ABC News

Mike Stobbe/AP

U.S. health officials on Friday announced two more bird flu cases among farmworkers at a Colorado poultry farm, bringing the total to six.

It's the largest outbreak of human bird flu infections in U.S. history and accounts for most of the 11 cases reported to date nationwide. Ten of those cases occurred this year among farmworkers. All experienced mild symptoms.

The highly pathogenic avian influenza is commonly known as H5 bird flu. The Centers for Disease Control and Prevention said it is keeping an eye on the situation and working with states, including Colorado, to monitor people who've been around animal exposures. Symptoms include conjunctivitis (also known as pink eye) or other common flu systems.

U.S. health officials also said a new study in Michigan suggested the virus is not causing silent infections in people.

Last month, the Michigan Department of Health and Human Services launched a study of workers who were around cows sickened by the bird flu. The researchers drew blood from 35 people.

One goal was to determine if there were people who never had any symptoms but did have evidence of past infections. None of the blood testing showed antibodies that would indicate such infections, the Centers for Disease Control and Preventionreportedon Friday.

A bird flu virus has been spreading since 2020 amongmammals including dogs, cats, skunks, bears and evensealsand porpoises in scores of countries. Earlier this year the virus, known as H5N1, was detected in U.S. livestock, and is now circulating in cattle in several states.

Health officials continue to characterize the threat to the general public as low, and the virus has not spread between people. But officials are keeping careful watch, because earlier versions of the same virus have been deadly.

CPR Health Reporter John Daley contributed to this report.

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Two more bird flu cases reported among farmworkers in Colorado as new study finds no asymptomatic infections - Colorado Public Radio

Bird flu

As heatwaves hit the US, farm workers struggle to wear PPE. The country now faces its biggest human outbreak

Fri 19 Jul 2024 06.00 EDT

Extreme heat may be a crucial factor behind the biggest bird flu outbreak in humans in the US as officials continue to track the virus spread.

A heatwave in Colorado likely caused personal protective equipment not to work correctly for workers culling poultry infected with H5N1, a highly pathogenic bird flu. Four people have tested positive for H5N1 and a fifth is also expected to have their case confirmed as bird flu, officials said this week.

Its the first time a cluster of human cases of bird flu has been reported in the US.

On dairy farms, it has also been difficult for workers to wear PPE, in part because of the heat spreading across much of the US. Colorado confirmed a case of bird flu in a dairy worker earlier this month.

Climate change, which has been linked to intense heat across the country, can amplify outbreaks of deadly diseases like these, experts say. Climate change has also been linked to the emergence and wider spread of pathogens like these, including new migratory patterns for H5N1-infected wild birds.

When you change a global system like climate so profoundly, small shifts can have seismic impacts, sometimes in unexpected ways, said Alexandra Phelan, an associate professor at Johns Hopkins Bloomberg School of Public Health.

In Colorado, the workers were culling a flock of egg-laying chickens that had tested positive for H5N1.

They went bird by bird catching them, putting them in a cart and killing a few dozen birds at a time with carbon dioxide gas.

Its a very, very manual difficult, laborious process, Julie Gauthier, from the Animal and Plant Health Inspection Service at the US Department of Agriculture (USDA), said at a press briefing on Tuesday.

And it can be dangerous to work in such close and prolonged quarters with animals infected with bird flu, which has a mortality rate of about 50% among people.

It was 104F (40C) outside, but in the chicken houses, it was even hotter.

Between the sweat and the enormous industrial fans to stave off even higher temperatures, workers couldnt keep their goggles and masks sealed on their faces, Nirav Shah, principal deputy director of the US Centers for Disease Control and Prevention (CDC), told reporters. The fans also spread feathers and debris, which can carry the virus aloft, Shah said.

Of the 160 people working on the farm, 60 went on to develop symptoms, and five tested positive or are presumed to be positive. The remaining 55 workers tested negative for H5N1 at the Colorado state health lab, and some of them were diagnosed with other respiratory illnesses. Only symptomatic workers were tested.

As the epidemiological investigation proceeds, it is important to note that additional cases may be detected, Shah said.

Workers will continue culling the chickens, which make up a flock of 1.8m birds, over the next 10 to 14 days, Eric Deeble, acting senior advisor for H5N1 response at USDA, said at the briefing.

USDA considers it very important for depopulation to continue to stop virus amplification and shedding, prevent further spread and to reduce the viral load in the environment, Deeble said. If depopulation were to be paused, workers would still be required to care for and feed animals, prolonging their exposure risk.

Those involved with culling on the farm including poultry producers, employees, contractors and USDA employees are required to wear Tyvek suits, N95 respirators, goggles, boots and gloves while working with infected chickens.

Upon detecting possible cases in people, Colorado immediately alerted the CDC, which dispatched a team of 10 experts including an industrial hygienist to work on procedures to reduce exposure risks for the workers as they continue to handle infected chickens, Shah said.

The CDC and the state of Colorado have been joined at the hip, Shah said in contrast to other outbreaks at farms around the country, where the CDC typically has had limited access to affected animals and people.

The poultry operation is in the same county as dairy herds that have tested positive for bird flu.

Genomic sequencing shows that these cases are closely related to the outbreak in dairy cows; it seems to have jumped from cows to chickens to people, though its not clear how at this point. A USDA report from Michigan last month found the virus may be transported by people between farms.

Climate change can negatively affect human health, making people more vulnerable to extreme weather and spillover events like these, and it remakes animal interactions and migration patterns that can lead to more spillover.

In fact, it may be responsible for the H5N1 outbreak in the Americas.

In late 2021, wild birds carrying the virus managed to fly from northern Europe to Iceland and then to Newfoundland.

One reason it happened is because of unusually strong winds, said Jean-Pierre Vaillancourt, a professor of veterinary medicine at University of Montreal. Its very unusual for the birds to be able to travel that far, but when this happened, we had really unusual climate conditions, he said.

Its not just the extreme heat. Its the fact that you have unusual climate events, said Vaillancourt. It may disrupt usual migratory patterns and other human and animal behaviors, opening new avenues of risk.

These are the first cases in US poultry workers since 2022, when an inmate tested positive after culling infected chickens in Colorado.

The five workers in 2024 reported conjunctivitis (or pink eye) and teary eyes, as well as more typical flu symptoms, like fever, chills, coughing and a sore throat, said Shah. None of them required hospitalization, and they are all recovering, he said.

The CDC has not changed its risk assessment for the general public or its policies for addressing the farm outbreaks, including recommendations on vaccines.

CDC is not recommending H5 specific vaccine for livestock workers, given the mild symptoms that have been noted thus far, in the absence of any changes to the viruss genetic makeup, Shah said.

Vaccines for cows are also being studied.

We do believe that we can eliminate this within the dairy herds, Deeble said.

Enhanced biosecurity would get us to a point where we can arrest the spread, and hopefully in the future, we may get a vaccine which can further facilitate the elimination of this disease from the national herds, he said.

Officials need to keep climate considerations top of mind in responding to and potentially eliminating viruses like these, Phelan said. Across all areas, governments need to actively and urgently incorporate climate considerations into all health and safety measures more than simply at the surface level.

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Extreme heat may be crucial factor in human spread of bird flu - The Guardian

Since an unusual bird flu outbreak was first detected in dairy cows in March, experts have warned that the virus could be infecting more farm workers than have been officially detected. Testing has been severely limited, constraining what health officials know about the ways that the virus is spreading from sick cows and contaminated equipment and how often it is spilling over into humans.

In recent weeks, state and federal officials have been working to unravel part of that mystery: whether silent, undetected infections are occurring in farm workers. Officials in Michigan recently began testing the blood of 35 dairy workers for antibodies to the virus, which would provide evidence of past infection.

On Friday, the Centers for Disease Control and Prevention shared preliminary results, which showed that none of the workers were carrying antibodies to the virus, known as H5N1. All worked on dairy farms in Michigan that had suffered outbreaks, and many worked directly with sick cows, the agency said.

Dr. Natasha Bagdasarian, Michigans chief medical executive, noted that the study was small and that the results were not definitive. The farm workers tested were also volunteers, which means that they may not be representative of dairy workers more broadly.

Still, she said, the results suggested that asymptomatic transmission is likely not widespread, and that this disease is not something that is spreading with minimal contact.

In its online update, the C.D.C. noted that the results supported its approach to testing, which has focused on symptomatic people who had been in contact with sick animals.

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Is Bird Flu Spreading Widely to Farm Workers? A Small Study Offers Some Reassurance - The New York Times