Key warning signs about bird flu are going in the wrong direction
S E E D E D C O N T E N T
The Summary
- The bird flu outbreak took several concerning turns this year, with the number of human cases up to at least 64.
- Experts outlined several indicators that the virus' spread is going in the wrong direction.
- Among them are recent detections of the virus in wastewater and signs of dangerous mutations.
The simmering threat of bird flu may be inching closer to boiling over.
This year has been marked by a series of concerning developments in the virus' spread. Since April, at least 64 people have tested positive for the virus — the first U.S. cases other than a single infection in 2022. Dairy cow herds in 16 states have been infected this year. The Centers for Disease Control and Prevention confirmed the country's first severe bird flu infection on Wednesday, a critically ill patient in Louisiana. And California Gov. Gavin Newsom declared a state of emergency this week in response to rampant outbreaks in cows and poultry.
"The traffic light is changing from green to amber," said Dr. Peter Chin-Hong, a professor of medicine at the University of California, San Francisco, who studies infectious diseases. "So many signs are going in the wrong direction."
No bird flu transmission between humans has been documented, and the CDC maintains that the immediate risk to public health is low. But scientists are increasingly worried, based on four key signals.
For one, the bird flu virus — known as H5N1 — has spread uncontrolled in animals, including cows frequently in contact with people. Additionally, detections in wastewater show the virus is leaving a wide-ranging imprint, and not just in farm animals.
Then there are several cases in humans where no source of infection has been identified, as well as research about the pathogen's evolution, which has shown that the virus is evolving to better fit human receptors and that it will take fewer mutations to spread among people.
Together, experts say, these indicators suggest the virus has taken steps toward becoming the next pandemic.
"We're in a very precarious situation right now," said Scott Hensley, a professor of microbiology at the University of Pennsylvania.
Widespread circulation creates new pathways to people
Since this avian flu outbreak began in 2022, the virus has become widespread in wild birds, commercial poultry and wild mammals like sea lions, foxes and black bears. More than 125 million poultry birds have died of infections or been culled in the U.S., according to the U.S. Agriculture Department.
About 125 million poultry birds have succumbed to the virus or been culled since 2022.Ulises Riuz / AFP via Getty Images file
An unwelcome surprise arrived in March, when dairy cows began to fall ill, eat less feed and produce discolored milk.
Research showed the virus was spreading rapidly and efficiently between cows, likely through raw milk, since infected cows shed large amounts of the virus through their mammary glands. Raccoons and farm cats appeared to get sick by drinking raw milk, too.
The more animals get infected, the higher the chances of exposure for the humans who interact with them.
"The more people infected, the more possibility mutations could occur," said Jennifer Nuzzo, a professor of epidemiology and the director of the Brown University School of Public Health's Pandemic Center. "I don't like giving the virus a runway to a pandemic."
Until this year, cows hadn't been a focus of influenza prevention efforts.
"We didn't think dairy cattle were a host for flu, at least a meaningful host," Andrew Bowman, a professor of veterinary preventive medicine at Ohio State University, told NBC News this summer.
But now, the virus has been detected in at least 865 herds of cows across at least 16 states, as well as in raw (unpasteurized) milk sold in California and in domestic cats who drank raw milk.
A lab manager prepares milk samples for testing at the Animal Health Diagnostic Center at Cornell University on Dec. 10.Michael M. Santiago / Getty Images
"The ways in which a community and consumers are directly at risk now is in raw milk and cheese products," Chin-Hong said. "A year ago, or even a few months ago, that risk was lower."
Cases with no known source of exposure
The majority of the human H5N1 infections have been among poultry and dairy farmworkers. But in several puzzling cases, no source of infection has been identified.
The first was a hospitalized patient in Missouri who tested positive in August and recovered. Another was a California child whose infection was reported in November.
Additionally, Delaware health officials reported a case of H5N1 this week in a person without known exposure to poultry or cattle. But CDC testing could not confirm the virus was bird flu, so the agency considers it a "probable" case.
In Canada, a British Columbia teenager was hospitalized in early November after contracting H5N1 without any known exposure to farm or wild animals. The virus' genetic material suggested it was similar to a strain circulating in waterfowl and poultry.
Such unexplained cases are giving some experts pause.
"That suggests this virus may be far more out there and more people might be exposed to it than we previously thought," Nuzzo said.
Rising levels of bird flu in wastewater
To better understand the geography of bird flu's spread, scientists are monitoring wastewater for fragments of the virus.
"We've seen detections in a lot more places, and we've seen a lot more frequent detections" in recent months, said Amy Lockwood, the public health partnerships lead at Verily, a company that provides wastewater testing services to the CDC and a program called WastewaterSCAN.
Earlier this month, about 19% of the sites in the CDC's National Wastewater Surveillance System — across at least 10 states — reported positive detections.
It's not possible to know if the virus fragments found came from animal or human sources. Some could have come from wild bird excrement that enters storm drains, for example.
"We don't think any of this is an indication of human-to-human transmission now, but there is a lot of H5 virus out there," said Peggy Honein, the director of the Division of Infectious Disease Readiness & Innovation at the CDC.
Lockwood and Honein said the wastewater detections have mostly been in places where dairy is processed or near poultry operations, but in recent months, mysterious hot spots have popped up in areas without such agricultural facilities.
"We are starting to see it in more and more places where we don't know what the source might be automatically," Lockwood said, adding: "We are in the throes of a very big numbers game."
One mutation away?
Until recently, scientists who study viral evolution thought H5N1 would need a handful of mutations to spread readily between humans.
But research published in the journal Science this month found that the version of the virus circulating in cows could bind to human receptors after a single mutation. (The researchers were only studying proteins in the virus, not the full, infectious virus.)
Fatinah Albeez, a research associate with the Broad Institute's Sabeti Lab, tests milk samples for bird flu in Boston.Boston Globe / Getty Images
"We don't want to assume that because of this finding that a pandemic is likely to happen. We only want to make the point that the risk is increased as a result of this," said paper co-author Jim Paulson, the chair of molecular medicine at Scripps Research.
Separately, scientists in recent months have identified concerning elements in another version of the virus, which was found in the Canadian teenager who got seriously ill. Virus samples showed evidence of mutations that could make it more amenable to spreading between people, Hensley said.
A CDC spokesperson said it's unlikely the virus had those mutations when the teen was exposed.
"It is most likely that the mixture of changes in this virus occurred after prolonged infection of the patient," the spokesperson said.
The agency's investigations do not suggest that "the virus is adapting to readily transmit between humans," the spokesperson added.
The viral strain in the United States' first severe bird flu case, announced on Wednesday, was from the same lineage as the Canadian teen's infection.
Dr. Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases, said the CDC is assessing a sample from that patient to determine if it has any concerning mutations.
Hensley, meanwhile, said he's concerned that flu season could offer the virus a shortcut to evolution. If someone gets co-infected with a seasonal flu virus and bird flu, the two can exchange chunks of genetic code.
"There's no need for mutation — the genes just swap," Hensley said, adding that he hopes farmworkers get flu shots to limit such opportunities.
Future testing and vaccines
Experts said plenty can be done to better track bird flu's spread and prepare for a potential pandemic. Some of that work has already begun.
The USDA on Tuesday expanded bulk testing of milk to a total of 13 states, representing about 50% of the nation's supply.
Nuzzo said that effort can't ramp up soon enough.
"We have taken way too long to implement widespread bulk milk testing. That's the way we're finding most outbreaks on farms," she said.
At the same time, Andrew Trister, chief medical and scientific officer at Verily, said the company is working to improve its wastewater analysis in the hope of identifying concerning mutations.
The USDA has also authorized field trials to vaccinate cows against H5N1. Hensley said his laboratory has tested a new mRNA vaccine in calves.
A caretaker collects a blood sample from a dairy calf vaccinated against bird flu at the National Animal Disease Center research facility in Ames, Iowa, on July 31.USDA Agricultural Research Service / AP
For humans, the federal government has two bird flu vaccines stockpiled, though they would need Food and Drug Administration authorization.
Nuzzo said health officials should offer the vaccines to farmworkers.
"We should not wait for farmworkers to die before we act," she said.
Additionally, scientists are developing new mRNA vaccines against H5N1. This type of vaccine, which was first used against Covid-19, can be more quickly tailored to particular viral strains and also scaled more quickly.
Hensley's lab in May reported that one mRNA vaccine candidate offered protection against the virus to ferrets during preclinical testing. Another candidate under development by the CDC and Moderna has also showed promising results in ferrets, which are often used as a model for humans to study influenza.
"Now we just have to go through the clinical trials," Hensley said.
CORRECTION (Dec. 22, 2024, 5:10 p.m. ET): A photo caption in a previous version of this article misstated when the Agriculture Department ordered that the country's milk supply be tested. It was Dec. 6, not last week.
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We are headed for another serious pandemic and with the current populist anti-vax bullshit still running rampant a lot of people who shouldn't will probably die because they've bought into the propaganda.
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I don't think enough people are aware of the threat H5N1 poses. Those who've contracted it thus far in the U.S. and Canada have been lucky, with the first severe case only being reported last week. (CDC Newsroom link)
In other places around the world, the fatality rate has been rather high, on the order of 50-60%.
It doesn't seem to spread among humans yet, but we may only be one or two mutations (or some gene swapping with regular influenza, per the article) away from a very serious situation.
I wonder if the government has learned anything from the last pandemic and has stockpiled supplies ahead of time instead of scrambling to react after the fact. Hope someone has their head screwed on somewhere in that bureaucracy.
Last week in the meeting with the guy responsible for setting up stockpiles, Senator Tuberville said everyone knows someone who died from getting the COVID vaccine. We may have anti-vaxxers in charge who will do the opposite.
I don't even know anyone who died from Covid.
As for the Tuberville quote, that isn't quite what he said, although it may have been his intent. Hard to say. Not a fan of taking quotes without the necessary context to understand it in as gospel.
In any case, I prefer that there are some that question the majority opinion but I'd prefer it come from experts in the field and that they back it with data. Not sure if a retired football coach turned Senator qualifies.
Personally, I think vaccines work, some better than others. While there are those that say they are either fake science or that the side effects are not worth the risk, I don't think that is the main point of the vaccine argument. I think it comes down to two issues, both are important and, unfortunately, can work against the other.
First, does, or should the government be able to force citizens to immunize? This is a big issue for a lot of people. They think "How can I be forced to take something I don't believe in just because someone else does?"
The second issue is personal responsibility to the group as a whole. Do I have a moral obligation to the group to do something I don't want to do and/or don't believe in?
Personally, I don't want to be forced to take something I don't want to take or don't necessarily believe will be of much use, but I will if I'm reasonably confident it won't hurt me. I could be wrong and the potential benefit to the group makes it worth it. I feel the tension between the two. I don't want to be forced, but I also recognize my responsibility to the group.
Unfortunately, there are a lot of people out there that only care about one or the other.
I personally know (knew) three. Two held the irrational belief that masks and vaccines were unnecessary control measures. Both were decent human beings, charitable, honest, personable. One was in his late 50s, the other in his early 40s (and a fitness / nutrition buff). The third was an elderly lady.
Yes!
"Group' = Community or Country; responsibility to.
My uncle died from Covid. He was in poor health, though.
I've known 2 people with long Covid. One was a former employee. She caught it from her husband a month before the vaccine was available. A year later, she still got short of breath if she walked very far.
Another is a patient who went from fairly healthy to needing oxygen 24/7. No improvement in 4 years, so she'll likely be toting an oxygen tank for life.
That is so sad.
My younger friend who died from COVID was into conspiracy theories. In our last conversation he told me that he had done research and there is a doctor who has claimed all of his patients were unvaccinated, healthy and that wearing masks is what causes people to get sick. He told me that he had never been sick a day in his life until he started wearing masks. I wish I had been less polite and more strongly encouraged him to not focus on alt-science, but I am pretty sure no facts I offered would have made a difference. We see every day how some get ideas in their heads and no level of facts or logic will make a different.
May I suggest she see a cardiologist to check for heart disease?
Both of the people I know who have long Covid have seen specialists. My former employee, who is doing better now, saw a cardiologist. The patient has seen a cardiologist and pulmonologist.
I doubt very much that anything you'd said would have made a difference at all, other than to create bad feelings.
Avian influenza brings out my sense of irony. The first AI outbreak I saw while living in poultry country was eye-opening. The lengths poultry farmers would go to in order to avoid spread were remarkable. No visitors to poultry farms, especially if they'd been to other poultry farms. Vehicle tires were disinfected if a vehicle had to enter a farm. Poultry farmers stopped socializing to avoid spreading it. A flock euthanized due to AI was a huge financial loss.
Enter Covid, and all that caution and concern were "government overreach".
... natural selection.
I posted this article because I have been aware of this since my kids were young. Their pediatrician was a virologist, too, and at that time, they said that they couldn't produce a vaccine, since vaccines (at the time) were made in eggs, and the eggs would die before they could get vaccines. Since this would be a new virus in the human population, our bodies would not be able to identify it before it made us sick and the death rate would be over 50%. I do hope that they develop a vaccine and stockpile it, or we will see misery on an unprecedented level.
I'm allergic to eggs and used to become ill after I got a flu shot. I don't get them anymore ...
I'm not anti-vax or conspiracy driven, but whenever I had gotten a flu shot before, I got sick, so what's the point. I let my Dr talk me into a pneumonia shot 2 years ago, because "it can be deadly to people my age" and I was sick for more than a week.
I usually get a bit achy after a flu shot, but not as sick as with the flu.
The second dose of the Covid vaccine kicked my ass.
I recently got my first shingles vaccine, and am dreading the second dose. But I'll get it, because shingles is misery.
I am getting that 'sinking' feeling again. . . . And Lordy, there is yet another vaccine (shot!) to add to this collection of shots already?!!
The H5N1 virus was first identified in domesticated waterfowl in Southern China during the 1990s. That's where the name 'bird flu' came from. So, this virus has spread from China over the last 30 years and no one could do anything about it. (Sound familiar?) And Dr. Peter Chin-Hong is the only expert the press could find to discuss the pandemic threat that medical science has been incapable of addressing. What an amazing coincidence.
COVID was so much fun that the medical community is repeating the same mistakes. The rather obvious precaution to prepare for the coming pandemic is to shut down bars, restaurants, tourist attractions, and sporting events. Prohibit public gatherings. Require double or triple masking. Mandate that everyone be vaccinated with the best candidate vaccine on a regular schedule. But we can't shut down travel, we can't isolate California, and we certainly can't begin stockpiling medical supplies.
Medical science and the government cannot do anything except nag, scold, brow beat, guilt trip, and gaslight the public until an absolute crisis emerges to justify autocratic power over society. We're just on our own until the government checks start rolling in. Then, when the money is sufficient for institutional science to begins actually doing something, it's all going to be our fault anyway.
You know, the least that could be done would be requiring all milk be pasteurized. California could impose that requirement without waiting for the Federal government. But, no, the political optics would be bad for a Democrat's political future. And the press couldn't find experts with Chinese heritage to stir up controversy, spread fear, and generally make a gaslighting ass of themselves. That's the COVID model. And COVID began in China, too.
We just have to kick the can down the road until January than we can blame trump for it.
Well, that does seem to be significant motivation for some reporting. Why so little attention is given to the greatest hygienic advancement of humankind boggles rational thought.
Cooking food kills pathogens and destroys natural toxins. Common beans are toxic when uncooked or undercooked. Raw potatoes contain toxins that cause gastrointestinal distress. And, obviously, undercooked or raw meat can transmit pathogens. The nutrition of many common foods are improved by cooking.
With the type of information being disseminated by institutional medicine, it would be wise to question whether or not they are smarter than cavemen. When the greatest advancement by institutional medicine has been shoving a digital camera up a patient's butt for $20,000, it seems reasonable to question their motives, too.
There's a very active movement in support of raw milk. Its followers believe that pasteurization kills enzymes (which aren't alive to start with) and makes milk less healthy. They have had an unfortunate success in getting raw milk sales legalized in many states.
When WV legalized raw milk, some state legislators celebrated by drinking raw milk in chambers, then got the trots.
I'm indifferent to those that want to risk their family's health due to conspiracy theories, because I consider the end results a type of poetic justice to those most deserving. I do feel sorry for the children that have to rely on irrational parents to make the best life decisions for them though.
I grew up on raw milk. When I was old enough, I had to milk the cow. The point being, if you don't know the cow then you'd better pasteurize the milk.
Institutionalized medicine used COVID as justification for suspending a number of freedoms and civil liberties. Institutional medicine used fear, guilt, and gaslighting to shift all responsibility onto the public and to dodge scrutiny of institutional medicine's own recommendations and half-baked theories. Institutional medicine deliberately threatened the social and economic security of the public to obtain power over society and impose a scientific morality onto the public. The intellectuals argued the public was too stupid to understand the consequences of its own ignorance. Only the keepers of institutional truth had the right to make the decisions. And well over a million still died. Institutional medicine intervened so it can't be God's fault, can it?
So, now people want raw milk (supposedly God's and Mother Nature's own remedy) because institutional medicine is an untrustworthy moralizer that shills for big pharma and corporate farming. And we're supposed to blame the public for that, too.
Sure, Nerm. People have been demanding raw milk since before Covid because of Covid lockdowns and masks.
You know, you could have just agreed with my agreement, and acknowledged that raw milk activists are the problem here, but no. You has to make it about Covid persecution complexes.