Bird Flu in US: What We Know, What We Don’t
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Monthly Archives: May 2024
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Dog and deer take stroll through Iowa town before police intervene: ‘All good walks must come to an end’
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Published May 3, 2024, 11:24 p.m. ET
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In a scene out of a Disney movie, a dog and a deer were seen wandering the streets of an Iowa town together.
The adorable dynamic duo was spotted on Wednesday taking a stroll seemingly without a care through the streets of Tipton, a small town of roughly 3,000 people about 40 miles northwest of Davenport.
“Sometimes a dog just wants to take his deer for a walk,” the Tipton Police Department quipped on its Facebook page.
The post included a photo of the two pals walking along the sidewalk side-by-side. The dog, which appears to be a large golden retriever, looks back in one photo at the police officer creeping up behind them.
The deer even looked like it might be window shopping in one picture, a user commented.
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Another image shows the deer walking across a lawn towards the dog, who had stopped for a rest on the grass.
But the unlikely pair’s day out on the town ended soon afterwards. About an hour later, Tipton police posted an update with the animals loaded up in police cruisers after they were rounded up.
“All good walks must come to an end. The pair was too close to traffic,” police said.
“The dog is clearly remorseful but the deer was muttering something about breaking free and doing it all again tomorrow,” the department joked.
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Four reasons to be concerned (but not freak out) about the bird flu
U.S. government officials said Wednesday they are closely monitoring the bird flu virus in food, livestock and people. Experts say more should be done, but people shouldn’t worry … yet.
USA TODAY
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Even as several federal agencies scheduled a Wednesday news conference to explain steps being taken to monitor and contain bird flu in the U.S., public health officials this week said even more vigilance is needed.
Now is the time to get ahead of bird flu, a handful of experts said, so we don’t end up with another nightmare scenario.
“Every moment we’re not preparing for it, is a failure on our part,” said Dr. Nahid Bhadelia, an infectious disease specialist and founding director of Boston University’s Center on Emerging Infectious Diseases. “It is always later than we think it is in an outbreak.”
Bird flu is the nonscientific name for avian influenza, a type of flu virus that commonly infects waterfowl, turkeys and other birds. If it stays in birds, the main danger is to poultry. Flocks of chickens have had to be killed and eggs destroyed.
The larger concern is that it might evolve to become easily transmitted person-to-person. Bird flu is considered more dangerous than the annual flu because it’s a strain humans have never encountered and it’s likely to be highly contagious.
This probably hasn’t happened yet, experts say.
“There’s no current evidence of sustained human-to-human transmission,” said Dr. Raj Panjabi, a part-time faculty member at Harvard Medical School and the former White House senior director for global health security and biodefense on the United States National Security Council.
“It’s the moment to get ready to step up investments in public health, especially around prevention, protection and preparedness,” Panjabi said.
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Federal officials Wednesday said the latest round of testing proves the commercial milk supply is safe, as are products like cottage cheese and sour cream that are made from milk. They continue to test people who work on farms and only one person is known to have caught the virus in recent months. Vaccines and antivirals should be available if bird flu becomes transmissible from person to person.
But public health officials say they suspect more people have caught the virus from animals than we’re aware of, and the chance of a bird flu pandemic cannot be ruled out.
Bhadelia said the absence of more human infections so far may reflect a lack of testing rather than a lack of actual infections.
“If I were a betting person, I would say there have probably been more human infections than what we’ve detected already in this country,” she said. “I would bet part of my retirement on that.”
In interviews this week, she and other leading epidemiologists, infectious disease, public policy and dairy industry experts, outlined four major concerns about bird flu, and one area where they feel mostly reassured:
It’s called ‘bird flu’ but it’s now in cows and other animals
What makes the outbreak so concerning is that the bird flu virus already has jumped from birds to other animals, including cows.
This form of avian influenza, a strain called H5N1, has been around since at least 1997, but it mutated a few years ago to become adaptable to more kinds of bird species as well as to mammals. Since then, it’s been found in a range of animals, including a bottlenose dolphin off the coast of Florida in March 2022 and 29 house cats in Poland in June 2023.
But finding it on American cattle farms in early February was still a surprise, said Gerry Parker, associate dean for Global One Health at the College of Veterinary Medicine & Biomedical Sciences at Texas A&M University. Cows are not considered especially vulnerable to flu.
A virus that can thrive in a range of mammals might thrive in humans.
“The probability is going up that we might get a genetic reassortment that could turn this into a human virus,” Parker said. “We don’t know that, but as this continues to circulate into more mammalian species, the likelihood just increases. It may never happen but if it did, it could easily become a potential pandemic threat.”
Do we really know where it’s spread?
Bird flu initially struck a single dairy farm in the Texas panhandle and spread to other dairy farms from there, Dr. Rosemary Sifford, chief veterinary officer with the Department of Agriculture, told reporters Wednesday.
But it’s still not clear exactly where the flu virus has spread or what it’s capable of, said several experts, including Jennifer Nuzzo, a professor of epidemiology and director of the Pandemic Center at the Brown University School of Public Health.
“Our surveillance is inadequate to know where this virus is and where it isn’t, which is critical for protecting farmworkers and people involved in the dairy industry ‒ but also important for staying ahead of this virus to prevent a future pandemic,” Nuzzo said.
About 100 people working on dairy and cattle farms have been tested for active infections. Nuzzo and others said testing should be more widespread and should also include tests to see whether some had already recovered from infections.
“If there are a lot more people infected who aren’t sick enough to go to the hospital, that would be important to know,” Nuzzo said. “We have to have a much stronger conversation about how to improve our surveillance.”
It’s also unclear exactly how this virus is being transmitted among animals, which is crucial information for slowing or stopping the spread and protecting people working on farms.
Although flu is typically a respiratory virus passed through the air and by touching contaminated surfaces, it has behaved differently among cows; at least some of the transmission appears to be through unpasteurized milk. Farm cats have contracted the virus, potentially by drinking this milk.
“We think milk is the primary vector for movement (of the virus),” Sifford told reporters.
Milking equipment is cleaned but not sterilized between cows, Parker said, so the virus may be transmitted when one cow with the virus in her milk leaves some of it on the machine to be picked up by the next cow’s udder.
The cows also passed it back to birds. Eight poultry flocks located near infected dairy herds contracted the virus after the cows did, though how they got it remains unclear.
No one knows how sick a person might get if they catch H5N1.
Birds often die; most cows, so far, have recovered from their infections, said Jamie Jonker, chief science officer of the National Milk Producers Federation.
The one farmworker in Texas who caught bird flu only suffered from an eye infection and apparently recovered fully. Bhadelia speculated he might have caught it by touching his eye after touching contaminated milking equipment, which is why the infection was focused on his eye.
Since 1997, about half the people hospitalized globally with bird flu have died. But Bhadelia said many more might have caught the virus from direct interactions with infected birds and never showed symptoms or were so mildly ill that they never required treatment ‒ so the actual death rate is unknown. Plus, if the virus did adapt to become transmissible in people, it might become milder, though we can’t count on that, she said.
In any kind of emerging crisis, there’s never enough data, Parker said. “I call it the fog of war,” he said.
Workers may not be adequately protected
Although the average American is not at risk right from bird flu, farmworkers, especially those working around poultry and cattle, probably are.
“We’ve been so fixated on, ‘Is this going to become a pandemic?’ and not enough on ‘There’s a threat on our farms today,'” Nuzzo said. “We should not wait for a severe illness in order to protect farmworkers.”
The Centers for Disease Control and Prevention recently recommended dairy workers and people who come onto dairy farms use eye protection, wash their hands frequently and wear things like disposable coveralls if they travel from farm to farm, so as not to carry the virus with them, Jonker noted.
In addition to the basic worries about worker health, the more workers become infected, the greater the risk one of them won’t be able to clear the virus quickly. Viruses evolve as they pass from person to person but also within a single person, especially if they don’t shake it off quickly, Bhadelia said.
“The more people it infects, and the longer it adapts to the human body,” she said, the more likely the virus will become contagious ‒ and dangerous ‒ to other people.
Yes, there are vaccines and antivirals, but…
Unfortunately, even people who’ve gotten annual flu shots or caught the flu recently won’t have any protection against the H5N1 strain, said Lawrence Gostin, a leader in global health at Georgetown University, where he is faculty director of the O’Neill Institute for National and Global Health Law.
The federal government has flu vaccine and antiviral stockpiles that theoretically could be useful if H5N1 becomes easily transmissible among people.
But public health experts say the reality is much more complicated.
There won’t be enough for everyone and the vaccine that’s been stockpiled hasn’t been tested to prove it can effectively prevent infection or severe disease.
“I don’t know that anyone has a vaccine that’s been tested thoroughly that anyone would be really confident about its effectiveness,” said Dr. Jeremy Luban, a professor at the UMass Chan Medical School and member of the executive committee of the Massachusetts Consortium on Pathogen Readiness. “Part of the problem is we don’t actually know what that virus is until it appears.”
Two companies are testing a candidate vaccine in early trials, David Boucher, a top official within the Administration for Strategic Preparedness and Response, said at the news conference.
If the virus moves from animals into people, it will continue to mutate, so existing vaccines might not be effective and it’s challenging to develop and test a vaccine against a virus that does not yet exist, Luban said.
Such testing would take time and the flu virus, which mutates much faster than the virus that causes COVID-19, would continue to transform.
Antivirals, like Tamiflu, are likely to be effective against bird flu, federal officials say.
But they need to be taken within the first day or two after infection starts, at a time when most people aren’t even sure whether they are sick and well before they have time to make a doctor’s appointment and get and fulfill a prescription for an antiviral.
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No one wants to think about pandemics. But bird flu doesn’t care.
A pandemic response that amounts to hoping and praying isn’t nearly enough.
By Kelsey Piper May 3, 2024, 8:00am EDT
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Kelsey Piper is a senior writer at Future Perfect, Vox’s effective altruism-inspired section on the world’s biggest challenges. She explores wide-ranging topics like climate change, artificial intelligence, vaccine development, and factory farms, and also writes the Future Perfect newsletter.
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The so-called “bird flu” H5N1 virus only rarely infects humans. Over the course of several decades during which it has circulated and resulted in the deaths of tens of millions of birds, about 880 cases in humans have been reported, generally in humans who work very closely with livestock.
But when it does make the leap to human hosts, H5N1 is often lethal — out of 26 cases reported since 2022, seven people died. That’s why it’s troubling that H5N1 has been recently discovered to have quietly spread across the country’s dairy farms, with testing finding genetic material of the virus present in 1 in 5 milk samples across the country. (Pasteurization kills the virus, so milk remains safe to drink.)
That prevalence suggests that H5N1 is now spreading in mammals — and since cows on dairy farms are in frequent contact with farm workers, it seems likely the virus will have many chances to evolve to spread more easily among humans. If it does that, we may have another pandemic on our hands.
None of that is great news, but the thing that has struck me most about the bird flu outbreak is that among the general public, it’s been greeted with a weariness that borders on indifference. The dominant attitude I’ve encountered when I ask people their concerns about bird flu amounts to “Well, I hope that doesn’t happen; I don’t have it in me to go through a pandemic again.”
The Covid-19 pandemic was awful for people — not just for the millions who died and the many more who it hospitalized and lastingly affected, but also for the billions whose daily life it damaged, from lockdowns and school closures to dramatic new restrictions on movement and travel. You might expect that precisely because Covid-19 was so awful, the general public would be raring to make sure it can never happen again, by insisting our leaders do whatever it takes to be prepared for the next pandemic.
But that doesn’t seem to have happened. Instead, with trust in our public health institutions badly damaged and many people suffering from pandemic fatigue, we now lack the attention span for the kind of serious policy response that could feasibly prevent the next pandemic.
Repeated efforts to get a serious pandemic prevention program through Congress have fizzled. Despite the desperation of Americans to not go through this again — or possibly because of the desperation of Americans to not go through this again — we’ve basically decided to handle pandemic preparedness by hoping really sincerely it doesn’t happen again.
But it will. If not with this virus, another one.
Crossing our fingers isn’t a policy response
H5N1 has never, as far as we know, had sustained human-to-human transmission. It may never mutate to be capable of that — many viruses don’t.
The CDC says “the current public health risk is low,” and while that gives me flashbacks to Covid, it’s accurate at this moment; unless you spend a lot of time with cows or poultry, or drink raw milk, you’re unlikely to be exposed unless the virus evolves new capabilities. H5N1 has been dancing along the line of human spillover for more than 25 years without making the full leap. Hoping really hard that it goes away might work out fine.
But if we are truly desperate to prevent the next pandemic — if we feel very viscerally that we can’t do this again, that our normalcy and our unmasked gatherings are among the most precious things we have these days — then that’s reason to prioritize preparedness more highly, not less so.
We need an actual, serious policy response aimed at looking closely at the possible origins of pandemics, at how to reduce human-wildlife interfaces. We should be closely monitoring research with pandemic potential, and work to improve our infrastructure for spotting pandemics early, developing vaccines and countermeasures.
If we want to stop pandemics, then stop pandemics
It’s very understandable that the general public doesn’t want to have to become an expert in the different varieties of pandemic-potential virus out there. They don’t want to check the CDC website for case numbers, don’t want to see another round of school closures, don’t want to let pandemics consume their life again.
But if there’s limited public pressure to prevent the next pandemic — the issue doesn’t rank among the most important ones for the 2024 elections — policymakers will evidently just not do it. So I think we have to, somehow, process the wreckage wrought by Covid, and turn our sense that we can’t live through this again into a determination to do better so we never have to.
Pandemics aren’t like earthquakes. They happen for predictable reasons, and we know how to stop them. It would be an enormous tragedy if we fail to get that work done because Covid-19 was so painful and so exhausting that we can’t even think clearly about the possibility it might happen again.
A version of this story originally appeared in the Future Perfect newsletter. Sign up here!
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