Last Friday, the Missouri health department announced a recent human case of bird flu.
If it is, though, there’s concern about what the Missouri case could represent.
“But I’m a lot more worried about it than I was.” Bird flu’s threat to most people remains pretty low.
For a flu virus to cause a human pandemic, says Seema Lakdawala, a virologist and flu expert at Emory University, it needs to overcome three hurdles: It must access and replicate efficiently within the respiratory tract to cause disease; it must spread easily from person to person; and it must be novel to our immune systems.
“The last time a flu virus did that, which was 2009, it was around the globe in a matter of days,” says Nuzzo.
Although bird flu has been reported in Missouri only in poultry farms and not on dairy farms, that doesn’t mean it isn’t there, said Nuzzo.
Seasonal flu is coming In a few months, the seasonal flu virus is going to be spreading in the US.
Get a seasonal flu shot Every episode of bird flu infection in a human makes a good case for a seasonal flu shot, says Nuzzo, especially in people who work on poultry or dairy farms.
Every person who’s immunized against seasonal flu is less likely to be a mixing vessel for some new nightmare Frankenflu.
For now, it’s mostly public officials’ and farm owners’ job to worry about bird flu.
The Missouri Department of Health reported a human case of bird flu last Friday. The patient, who was admitted to the hospital on August 22 and subsequently released, is the first of 15 infected individuals in the US to not have reported having contact with animals, which makes the case unsettling. This suggests that the disease may have started to spread among people.
It’s unclear at this time if the virus in question is the same H5N1 influenza subtype that has been affecting dairy cows, poultry, and wild birds around the world since it was discovered in 2020 and caused experts to worry about the possibility of a new pandemic. However, there are worries about what the Missouri case might mean if that’s the case. The director of the Boston University Center on Emerging Infectious Diseases, Nahid Bhadelia, states that there are a few steps left before this could pose a pandemic threat. However, I’m far more concerned about it now than I was. “.
The majority of people are still not particularly at risk from bird flu. Nonetheless, here are the reasons why experts find this case concerning and what you can do to protect yourself.
what worries the experts.
The Missourian required hospitalization due to his severe illness.
All 13 of the human cases of bird flu that had been reported since the virus first infected American dairy cows in January of this year resulted in relatively minor symptoms, such as conjunctivitis, or redness in the eyes, and in one case, a cough without a fever. This was before last Friday.
The most recent case differs in that regard: the patient was admitted to the hospital, indicating a serious illness. Though we are unsure of the patient’s age or other risk factors, the Missouri health department reported that the adult patient “has underlying medical conditions.”.
According to Seema Lakdawala, a virologist and flu expert at Emory University, a flu virus must successfully complete three requirements in order to spread throughout society and cause a pandemic: it must be novel to our immune systems, easily penetrate and replicate within the respiratory tract, and spread easily from person to person. If H5N1 is the virus causing the most recent case, the fact that the patient required hospitalization indicates that the virus is evolving to replicate more effectively in human airways (and getting closer to overcoming the first hurdle).
How the Missouri patient became infected is unknown to us.
All prior H5N1 cases in the United States of America also had one thing in common: they could all be linked to close contact with infected dairy or poultry herds or farmed poultry. It doesn’t seem that this case has that connection.
This virus has not been reported to spread through casual contact, which would be far more concerning. An example of this would be between people standing next to each other on a bus.
There is fear that H5N1 could be spreading in other ways, such as through the consumption of raw milk or, more dangerously, from person to person, which could result in a much larger outbreak, even in the absence of a known exposure to an infected animal.
According to Jennifer Nuzzo, an epidemiologist who oversees the Pandemic Center at Brown University’s School of Public Health, some H5N1 transmission between household contacts or from a sick patient to medical personnel has occurred in the past, but it hasn’t been sustained. Even more concerning, this virus hasn’t been reported to spread through casual contact, such as between passengers standing next to one another on a bus.
Spread by casual contact would be a step toward overcoming sustained person-to-person transmission, which is Lakdawala’s second barrier for a pandemic. “The last flu virus to do that was in 2009; it spread over the world in a few days,” notes Nuzzo.
The fact that there hasn’t been a significant outbreak of flu-like illness in Missouri since the patient was admitted to the hospital is encouraging. Nuzzo asserts, “I don’t think there’s a whole iceberg out there that we don’t see,” but she and other experts would feel more at ease with more information about the case.
It would also be unfortunate if raw milk were to transmit. Over one-hundredth of Americans surveyed in the late 2010s claimed to drink raw milk every week, despite the majority of US milk being pasteurized, or heated to the point where bacteria and viruses are killed. Although it is unknown at this time if the Missourian who contracted the illness from raw milk, Bhadelia says that this is a far better option than the possibility of person-to-person transmission. Controlling what you eat and drink is easier than controlling who you interact with.
The patient was admitted to the hospital, and the public health authorities announced the case two weeks later.
The US may not have activated its sensitive flu surveillance system, according to Nuzzo, which would have allowed for a quicker diagnosis of bird flu in cases of fever, cough, muscle aches, and other flu-like symptoms.
Having that system activated would mean identifying the spread early on, possibly when it could still be controlled, if there was a significant amount of person-to-person transmission. However, if the system isn’t working, human transmission could spread quickly before it can be stopped with the vaccines and treatments that have been shown to be effective in reducing the severity of flu symptoms and its spread.
The level of infection occurring on US dairy farms is not well disclosed.
More infections among dairy cows increase the likelihood of infections among those who work with them, which increases the potential for H5N1 to mutate into a virus that efficiently spreads among humans.
The majority of states rely on farmers to self-report infections among their herds despite this risk. Self-reporting is uncommon in the agriculture sector due to the general mistrust of the government and public health, and farms are not compelled to test their employees or animals unless specifically required by state agencies. “We won’t have information if these state public health agencies and the state governors are unwilling to say, ‘Hey, there’s an ongoing outbreak that’s causing public health concern, we need to know what’s going on,'” claims Lakdawala.
It doesn’t mean bird flu doesn’t exist in Missouri, according to Nuzzo, even though reports of it have only occurred on poultry farms and not dairy farms. It just indicates that farmers might not be reporting the virus or testing their employees or cows for it.
Another pandemic is unprepared for by us.
Experts fear that if there were another pandemic, particularly one involving a virus spread by air, Americans’ lack of trust in institutions would pose serious problems. That is why, according to Lakdawala, it is especially crucial to take the necessary steps to contain this outbreak. In order to do this, dairy farms would need to implement precautionary measures and have vaccines on hand for individuals who are most vulnerable to infection.
The seasonal flu is upon us.
The US will see a seasonal flu virus outbreak in a few months.
Animals that contract multiple flu viruses at the same time can act as “mixing vessels” for the viruses, facilitating the exchange of genomic segments. This has the potential to result in the development of new viruses that are more pathogenic, easier to spread, and, most importantly, unfamiliar to the human immune system.
H5N1 might be able to clear Lakdawala’s third obstacle as a result. According to Nuzzo, “we don’t want those two viruses to swap genes.”.
What actionable steps you can take.
You can reduce the already minimal risk that you face.
Vaccinate against seasonal flu.
According to Nuzzo, any instance of bird flu infection in humans is a strong argument for seasonal flu vaccination, particularly for those who work on dairy or poultry farms. Anyone protected against seasonal flu is less likely to serve as a breeding ground for the next terrifying strain of Frankenflu.
Steer clear of raw milk.
Raw milk contains a high concentration of H5N1 virus: in April, live virus was found in 14% of raw milk products in the United States; this percentage may have increased as more farms are affected. Although drinking raw milk has never been safe, Nuzzo claims that it is now especially risky and that it is much safer to stick with pasteurized dairy products.
According to Lakdawala, farm festivals in the fall often bring large numbers of animals that may be asymptomatically infected with H5N1. When visiting a farm, Lakdawala advises visitors to avoid getting too close to the animals and to always wash their hands. Wear a face shield and other personal protective equipment (the Centers for Disease Control and Prevention (CDC) has some useful recommendations) if you work on a dairy farm or in a veterinary office to protect yourself from splashes.
Stay safe from infections that pose a high risk.
“Oh my god, and low risk,” are the two main mindsets that people typically have when considering their chances of contracting an emerging infection, according to Bhadelia. It’s better to think of risk as a spectrum, where Covid-19 and mpox presently represent a greater threat to public health than H5N1.
In order to prevent getting sick, Nuzzo advises getting your Covid booster this autumn, donning a mask in crowded areas, and congregating outside rather than indoors. Get vaccinated against mpox if you think it would help.
Currently, the majority of people who have to worry about bird flu are public officials and farm owners. According to Nuzzo, controlling the variables that you can is the best course of action for the majority of people. “Worrying is not a defensive mechanism. “.
