CDC wants more, faster testing for bird flu as outbreak grows

By India Edwards, HealthDay News
Jan. 17, 2025 

A Centers for Disease Control and Prevention advisory, issued Thursday, recommends that health care providers perform a second test for bird flu within 24 hours of hospital admission for any patient suspected of having seasonal or H5N1 avian influenza. Adobe stock/HealthDay


The U.S. Centers for Disease Control and Prevention is urging health care workers to accelerate bird flu testing for patients hospitalized with flu symptoms, as the H5N1 avian influenza outbreak continues to grow in the United States and Canada.

The advisory, issued Thursday, recommends that health care providers perform a second test for bird flu within 24 hours of hospital admission for any patient suspected of having seasonal or H5N1 avian influenza -- otherwise known as bird flu.

It also emphasizes immediately starting antiviral treatment, such as Tamiflu, without waiting for test results.

Delays in diagnosing bird flu can complicate public health investigations, delay treatment for exposed individuals and affect hospital infection control, according to a report in the The Washington Post.

Related

First bird flu patient in U.S. dies in Louisiana
HHS to award $306 million for bird flu monitoring, preparedness

Patients who are not tested promptly may struggle to remember where they may have been exposed seven to 10 days before becoming sick, as well as others they may have exposed, said Dr. Nirav Shah, the CDC's principal deputy director.

"The more time that passes, the more [a patient's] memories fade," he told The Post.

Bird flu has sickened more people in the ongoing outbreak.

Earlier this month, a Louisiana man became the first U.S. resident to die from bird flu, and a Canadian girl spent two months hospitalized with severe illness. Public health officials have also confirmed an increasing number of bird flu infections in domestic cats linked to raw pet food or raw milk exposure

Who's most at risk? The CDC continues to stress that the risk of bird flu is low for the general public.

However, an updated public health risk assessment notes that certain groups face a higher risk, including: farm workers handling sick animals or by-products; owners of backyard flocks; animal care workers; veterinarians; and public health staff working on avian flu outbreaks

Seasonal flu cases remain high nationwide, making it essential to distinguish between standard influenza and avian influenza quickly.

Most hospitals lack the capability to test for bird flu on-site and must send specimens to public health labs, which can delay results.

"By the time test results come back, the patients may already be discharged and their household contacts may no longer be candidates for effective antiviral treatment," Shah explained.

As of Thursday, 67 people have been infected by bird flu, most of them dairy or poultry workers, all of whom recovered. However, the Louisiana man who died had direct contact with sick birds in his backyard flock.

The CDC recommends the following measures to curb the spread of bird flu: accelerate testing for hospitalized patients with flu symptoms; avoid direct contact with sick or dead wild birds, poultry and other animals; ensure healthcare workers use protective equipment when treating suspected bird flu cases; and send specimens for H5N1 testing to public health labs immediately.

More information

The U.S. Centers for Disease Control and Prevention provides guidance on bird flu prevention.

Copyright © 2025 HealthDay. All rights reserved.

FDA begins testing raw cheese for bird flu

Gustaf Kilander
Tue 31 December 2024 

FDA begins testing raw cheese for bird flu

The Food and Drug Administration (FDA) has started to test cheese for cases of bird flu.

Federal health officials have started to gather samples of aged raw cow’s milk cheese to test for the infectious disease, the FDA said Monday. The collection of the samples started toward the end of this month and is set to be finished by the end of March. The agency noted that it may extend the collection period if needed.

This comes after the Department of Agriculture issued a federal order earlier in December stating that samples of raw milk would be collected and shared with the FDA to be tested for the disease, according to ABC News.

The FDA has said that it’s set to gather 300 samples of raw cow’s milk cheese which has been aged for at least two months.

The samples will then be examined using a PCR test that searches for genetic material from the virus. The tests are set to be completed within a week of collection, the FDA has said. Samples that are found to have the virus will then be subjected to viability testing, which is conducted by injecting part of the virus into an embryonated egg and looking at whether it grows or multiplies, ABC noted.

Cheese with raw milk is made using unpasteurized milk. The FDA noted that in the U.S., raw milk cheese is allowed but it has to be aged for at least 60 days to lessen the risk of pathogens.

The FDA said that positive samples for viable viruses will be "evaluated on a case-by-case basis,” and that the agency may impose measures "such as a recall, follow-up inspection or other possible responses to protect public health."

Previously, the FDA has shared warnings regarding drinking raw milk, which is made without pasteurization, the process that removes viruses and bacteria.

A sign for the Food And Drug Administration is seen outside of the headquarters on July 20, 2020 in White Oak, Maryland. The FDA has started to test cheese for bird flu (Getty Images)

The agency views unpasteurized cheeses and other products made using raw milk as “high-risk.”

Previous studies by federal health officials have revealed that pasteurization kills the bird flu virus. About 99 percent of commercial milk produced on American dairy farms adheres to a pasteurization program.

"Because we have limited research and information on whether [highly pathogenic avian influenza] viruses can be transmitted through raw milk or raw milk products, such as cheese, the FDA recommends that industry does not manufacture or sell raw milk or raw/unpasteurized milk cheese products made with raw milk from cows showing symptoms of illness, including those infected with HPAI viruses or exposed to other cows infected with avian influenza viruses," the FDA told ABC.

Pasteurization kills bacteria by heating milk to a specific temperature and has been a practice in the U.S. for over a century.

The first human case of the bird flu in the U.S. was reported in April. Sixty-six human cases had been reported in seven states as of Tuesday, according to data from the CDC. California has the highest number of cases — 36. Nearly all of the cases have been in close contact with infected animals and most of the cases have been mild.

Up to 5 house cats sick after bird flu found in 2nd raw pet food brand: Health officials

YOURI BENADJAOUD
Updated Tue 31 December 2024 


PHOTO: Three influenza A (H5N1/bird flu) virus particles (rod-shaped). Note: Layout incorporates two CDC transmission electron micrographs that have been inverted, repositioned, and colorized by NIAID. Scale has been modified. (CDC and NIAID)

A second brand of raw pet food sold in farmers markets in California has been found to contain bird flu, according to Los Angeles County health officials. One house cat has been confirmed positive with the virus, and the four cats living in the same house are presumed to be sick, as well.

Last week health officials alerted consumers about a separate brand of raw pet food linked to the death of a cat in Oregon.

The most recent cases involve a brand called Monarch Raw Pet Food, LA County officials said in a press release Tuesday.

A list of locations where the raw pet food was sold was listed on the product website.

PHOTO: Three influenza A (H5N1/bird flu) virus particles (rod-shaped). Note: Layout incorporates two CDC transmission electron micrographs that have been inverted, repositioned, and colorized by NIAID. Scale has been modified. (CDC and NIAID)

MORE: FDA begins testing aged raw cow's milk cheese samples nationwide for bird flu

Health officials in L.A. warned against feeding pets raw food following the detection of bird flu in a raw pet food brand last week.

Earlier this month, officials confirmed bird flu in four house cats in another household. They consumed raw milk, became sick and died, officials said.

MORE: Oregon house cat died after eating pet food that tested positive for bird flu

Cats infected with H5 bird flu can develop severe illness that can include neurologic signs, respiratory signs or liver disease that can rapidly lead to death.

There have been no human cases of bird flu associated with house cats, L.A. officials said.

MORE: CDC confirms 1st case of severe bird flu in US

Health officials say the overall risk of H5 bird flu to the public remains low.

Most human cases of bird flu in the U.S. involve people who had direct contact with infected cattle or livestock.

Overall, there have been 66 confirmed cases of bird flu involving humans across 10 states, according to Centers for Disease Control and Prevention data. California has the highest number of cases with 37.

Most bird flu cases affecting humans in the U.S. have been mild, and patients have typically recovered after receiving antiviral medication.

Federal health officials have begun testing raw cow's milk cheese and raw milk nationwide to test for bird flu.

H5N1

Bird flu may now be spreading between humans, WHO fears

Joe Pinkstone
Fri, 24 February 2023 

Bird flu vaccine Cambodia health security science ducks avian influenza - Tang Chhin Sothy/AFP via Getty Images

The World Health Organisation is “really concerned” the current bird flu outbreak may now be spreading between people for the first time in more than 25 years.

The WHO has ordered a new bird flu vaccine to be made in response to the rapid spread of the strain of H5N1 avian influenza causing the current outbreak.

An 11-year-old girl died of bird flu in Cambodia this week while her father is also infected and 11 others are under observation, with some showing symptoms. Experts are worried the large cluster might mean that the virus has now evolved to be able to be passed from one human to another.

While captive and wild birds have been decimated worldwide by the current H5N1 strain there has so far been no evidence that it can pass between mammals.

If the virus has been able to cross the species gap from birds to humans then concern around bird flu and its potential to cause a pandemic will escalate.

No sustained transmission of bird flu has ever occurred but limited human-to-human transmission was reported in Hong Kong in 1997.

experts - AFP

Dr Sylvie Briand, WHO director of epidemic and pandemic preparedness and prevention, said that the Cambodian outbreak was causing more alarm than isolated cases that have popped up in the intervening two decades.

“When you have only one case, you imagine that it's because this case was exposed to animals, either alive or dead. So for us it means it is a zoonotic infection,” she said on Friday.

“But when you see that there are a number of potential cases surrounding this initial case, you always wonder what has happened. Is it because maybe the initial case has transmitted the disease to other humans?

“And so we are really concerned about the potential human-to-human transmission coming from this initial spillover from animals.

“This is currently the investigation that is ongoing in the contacts of this girl in Cambodia. We are first trying to see if those contacts have H5N1 infection and that's why we are waiting for the laboratory confirmation of those cases.

“Secondly, once we have this confirmation, we will try to understand if those people have been exposed to animals or if those people have been contaminated by the initial case.”

Posters - Cambodia Ministry of Health

WHO staff have now been deployed on the ground in Cambodia and the results of these assessments will dictate the next steps.

Dr Richard Webby, director of the WHO Collaborating Centre for Studies on the Ecology of Influenza in Animals, added that “in response to the spread of H5N1 and a little bit of evolution” a new vaccine specifically against the currently dominant strain is now to be developed.

“We are putting another H5 virus vaccine candidate into production and that will start soon,” he said.

Dr Webby added that the current stockpile of candidate virus vaccines - which could be deployed into full-fledged jab drives should the animal infection be proven to have made the jump to spread among people - is also being assessed to see whether it works against the currently dominant form of bird flu.

Evidence suggests that if the current strain behind the ongoing avian pandemic did jump to people then the existing stockpile would work well against it, even if it may take six months to create the updated jab.

“There has been a little bit of work looking at some of the serum collected from people who took part in vaccine trials to some of these earlier H5 clades and several of those people actually worked quite well with some of the recently circulating viruses,” Dr Webby said.

“From a vaccine stockpile and response point of view, I think this is encouraging and suggests the human response to some of the vaccines does induce a broad immunity that cross-reacts with a lot of the clades we are seeing.”

Dr Wenqing Zhang, WHO Global Influenza Programme chief, added that there were almost 20 current H5 vaccines licensed for pandemic use, and the new one would add to this armoury.

chickens - Jamie McDonald/Getty Images

The WHO announcement comes after the UKHSA commissioned Covid-like modelling for bird flu should person-to-person transmission be found in the UK.

The UKHSA has activated a new technical group to create modelling for a potential human outbreak of bird flu, which includes Prof Neil Ferguson, who was instrumental in the first Covid lockdown in 2020, and UKHSA chief medical adviser Prof Susan Hopkins.

The UKHSA is also looking into bird flu lateral flow tests, documents show, as well as investigating what is the best lab-based test to pick up the virus.

A source close to the matter told the Telegraph that a host of permutations were being drawn up, including a U-shaped severity curve, akin to seasonal flu; a Covid-like scenario where the oldest and most frail are more likely to die; and the possibility that it is dangerous to all people, like Spanish flu.

One of the scenarios being investigated by officials is if the virus is relatively mild, with an infection fatality rate of 0.25 per cent, similar to Covid.

The most severe hypothesis is if the virus is as deadly in people as the 1918 Spanish flu pandemic, with a fatality rate of around 2.5 per cent, and a hospitalisation rate of one in 20.

Some estimates of bird flu’s fatality rate in humans are as high as 60 per cent but experts say this may be misleading and inflated by sampling bias from when H5N1 first emerged 20 years ago.

The modelling marks an escalation in preparedness by health authorities as the country’s worst ever bird flu outbreak continues to ravage poultry farmers and wild bird colonies alike.

Covid-style model for bird flu pandemic drawn up by health officials


Joe Pinkstone
Thu, 23 February 2023 

Ducks gather at a farm in Snoa village outside Phnom Penh, Cambodia, Thursday, Feb. 23, 2023 

- Heng Sinith

Health officials are drawing up Covid-esque modelling to see what would happen if the current bird flu pandemic evolved to be able to spread from human-to-human.

There is currently no evidence that the H5N1 avian influenza strain that has killed hundreds of thousands of birds in Britain can spread between mammals.

A nationwide housing order has been in place since November mandating that all captive birds be kept inside, which has led to a decrease in infections.

But the UKHSA has now activated a new technical group to create modelling for a potential human outbreak of bird flu.

The group features UKHSA’s own experts as well as some external academics who were prominent in the Covid response.

'Bird flu lateral flow tests'

The 26-person strong group includes UKHSA Chief Medical Advisor Prof Susan Hopkins; Imperial’s Prof Neil Ferguson, who has worked on bird flu for decades but is best known for his Spring 2020 projections which brought about the first Covid lockdown; and Prof Munir Iqbal, head of the Avian Influenza Group at The Pirbright Institute.

The UKHSA is also looking into bird flu lateral flow tests, documents show, as well as investigating what is the best lab-based test to pick up the virus.

“To facilitate preparedness, planning and improvements to surveillance, scenarios of early human transmission are being developed,” the UKHSA says in a technical briefing.

A source close to the matter told the Telegraph that a host of permutations are being drawn up, including a U-shaped severity curve, akin to seasonal flu; a Covid-like scenario where the oldest and most frail are more likely to die; and the possibility that it is dangerous to all people, like Spanish flu.
Models currently 'completely hypothetical'

The findings come after it was reported an 11-year-old girl died of bird flu in Cambodia and 12 other people have been infected.

Prof Iqbal said the UKHSA models were currently “completely hypothetical” as all available data indicates there is no ability for the virus to spread between people.

One of the scenarios being investigated by officials is if the virus is relatively mild, with an infection fatality rate of 0.25 per cent, similar to Covid.

The most severe hypothesis is if the virus is as deadly in people as the 1918 Spanish flu pandemic, with a fatality rate of around 2.5 per cent, and a hospitalisation rate of one in 20.

Some estimates of bird flu’s fatality rate in humans are as high as 60 per cent but experts say this may be misleading and inflated by sampling bias from when H5N1 first emerged 20 years ago.

The modelling marks an escalation in preparedness by health authorities as the country’s worst ever bird flu outbreak continues to ravage poultry farmers and wild bird colonies alike.
H5N1 now 'the world’s biggest pandemic threat'

Sir Jeremy Farrar, a former member of Sage and Chief Scientist designate of the World Health Organization, said the avian H5N1 virus is now the world’s biggest pandemic threat.

He called this week for governments to make vaccines against the virus as a precaution.

Amid the backdrop of the ongoing Covid Inquiry the news of fresh modelling for a potential viral outbreak is likely to cause alarm among both the public and policymakers.

The modelling from UKHSA will likely be key in deciding if any actions are required to curb spread, should the unlikely event of human-to-human transmission occur.

Colorized transmission electron micrograph of avian influenza A H5N1 viruses

 - Phanie / Alamy Stock Photo

“The aims right now are to determine what level of surveillance we need to detect an event at an early stage,” a scientific source told The Telegraph.

“We haven't really seen very many people in Europe getting infected [with H5N1 avian influenza] and the people who have been infected have been very mildly ill or completely asymptomatic.

“It’s still H5N1 but it's evolved in enormous amount since it first emerged in Southeast Asia literally 20 years ago and it may have evolved more to be a virus which is well adapted at infecting a very wide range of species of birds, but less well adapted to infecting, certainly people, but maybe mammals.

“But we don’t know enough to be sure about that, which is why this work is going on but I think the risk is perhaps lower than it was.”

Scientists are concerned that with so much virus in birds, mammals are now more prone to eat an infected carcass and become infected that way. It is then possible that the virus evolves inside the infected mammals to be able to spread.

“The modelling right now is very focused on how much surveillance we need, in particular in hospitals which will pick up the severe cases, to be able to be sure that we can pick up an outbreak situation within a certain timescale,” a source said.

“There's no modelling of how bad the epidemic could be, or what we would do in terms of policy responses.”

CDC confirms sixth Colorado bird flu case


Six poultry workers in Colorado have tested positive for the bird flu, the U.S. Centers for Disease Control and Prevention announced Friday. File Photo by Bill Greenblatt/UPI | License Photo


July 20 (UPI) -- A sixth person has contracted the bird flu in Colorado due to contact with infected birds, the U.S. Centers for Disease Control and Prevention announced.

The afflicted party is a co-worker of five poultry workers who likely contracted the bird flu while working directly with infected birds, the CDC reported Friday.

The Colorado Department of Public Health and Environment on Sunday reported the infected workers were killing or removing selected birds to control the potential spread of the bird flu.

The CDC said the affected workers have been offered medication that can fight the virus.

Related

Five poultry workers diagnosed with bird flu in Colorado
Bird flu virus on cow milking equipment poses infection risk
Finland to be world's first nation to administer bird flu vaccine


Testing done on one of the affected workers shows the bird flu strain is closely related to one in Michigan.

The CDC said that's a "reassuring" sign that suggests the bird flu is not mutating or otherwise adapting due to the antiviral medication used to treat those who become infected.

The CDC has a team of veterinarians, epidemiologists, clinicians and an industrial hygienist helping investigate the Colorado bird flu outbreak.

A total of 10 human cases of the bird flu have been reported in the United States since April, according to the CDC.

The six Colorado poultry workers are the only ones so far identified as contracting the disease from birds

The other four cases are due to exposures that occurred on dairy farms.

An estimated 19.32 million birds belonging to 34 commercial flocks and 16 backyard flocks have been affected by the bird flu, the U.S. Department of Agriculture reported.

More cattle also are being reported with the bird flu with 157 dairy cow herds located in 13 states testing positive for the bird flu.

The CDC says the bird flu's risk to the nation's population is low.

The Colorado Health Department says poultry products are safe for consumption when handled and cooked properly.

People can protect themselves against the bird flu virus by avoiding raw or unpasteurized milk and staying away from dead or sick animals, animal dung and animals' bedding.

Bird flu UK 2021 outbreak ‘largest ever’ as dozens of cases recorded in chickens and wild birds across country


Half a million birds have been culled to stop the spread of avian flu, with UK chief vet ‘very concerned’ about scale of winter 2021 outbreak

By Henry Sandercock
Thursday, 9th December 2021, 2:25 pm



Half a million birds have had to be culled to prevent the spread of bird flu (image: Shutterstock)

Around half a million birds have had to be culled as the UK battles what has been called the “largest ever” outbreak of bird flu.

Dozens of highly pathogenic avian flu cases have been recorded across England, Scotland, Wales and Northern Ireland despite the introduction of UK-wide prevention measures in November.

It has ripped through poultry farms, wild bird populations of geese, ducks and swans, as well as a number of birds of prey.

While bird flu’s risk to humans remains low, there have been warnings the virus could jump across if people come into close contact with infected birds.

Concern over case numbers

The UK’s chief veterinary officer Christine Middlemiss said there are 40 infected poultry farm premises in the UK - 33 in England, three in Wales, two in Scotland and two in Northern Ireland.

These cases have been brought into the country by migratory birds which are flying south for the winter months from places like Russia and Eastern Europe.

Bird flu outbreaks in the UK are not uncommon and tend to occur between autumn and spring, although the fact that they are occurring so early on in the migratory season has taken experts by surprise.

Environment Secretary George Eustice described the 2021 bird flu outbreak as the “largest ever” in the UK (image: Getty Images)

Dr Middlemiss told BBC Radio 4’s Today programme there was a “phenomenal level” of bird flu and that it had “huge human, animal and trade implications”.

She said she was “very concerned” about bird flu, and that having 40 infected premises is “a really high number for the time of year”.

The vet said around 500,000 birds have had to be culled.

“I know that sounds a huge number, and of course for those keepers affected it’s really devastating.

“But in terms of food supply impact it’s actually relatively a very small number in terms of egg supply, meat, chicken and so on.”

According to the Department for Environment, Food and Rural Affairs (Defra) figures, more than 1.1 billion chickens were killed for their meat in the UK in 2020.

Speaking in the House of Commons, Environment Secretary George Eustice said: “Each year the UK faces a seasonal risk in incursion of avian influenza associated with migratory wild birds.

“While we have that each year, I have to say this year we are now seeing the largest-ever outbreak in the UK.”

‘Bird lockdown’ needed until spring

An Avian Influenza Prevention Zone, which requires farmers and birdkeepers to follow strict biosecurity standards, was declared across the UK on 3 November.

This then became a nationwide housing order on 29 November - a measure that is essentially a lockdown for poultry and pets as they are stopped from going outside.

It means that when you pick up British free range eggs or chicken in the supermarket, the animal might not actually have been reared that way.

However, this shouldn’t apply to turkey products as most turkeys were killed and processed before the housing order was introduced.

Dr Middlemiss said “we are going to need to keep up these levels of heightened biosecurity” until the spring.

Defra has said the new housing measures will be kept under regular review.

Advice for people with chickens or bird feeders

People who keep chickens and want to feed wild birds need to make sure everything is kept “scrupulously clean” and “absolutely separate” to avoid infecting their own flocks, Dr Middlemiss advised.

The risk to human health from bird flu remains very low, according to public health advice, and there is a low food safety risk.

An RSPB spokesperson said: “Everyone should take care to maintain good hygiene when feeding garden birds, regularly cleaning feeders outside with mild disinfectant, removing old bird food, spacing out feeders as much as possible, and washing your hands.”

Bird flu UK 2021: Defra ‘bird lockdown’ explained amid outbreaks of avian flu across the UK

Can humans catch bird flu? Avian influenza symptoms in chickens, and what causes virus - as UK cases confirmed

Bird flu: What is the avian flu strain H10N3 found in China - and could it be a risk to humans?

INDIA
Bird Flu in Kerala: 12,000 ducks were culled in Kerala’s Alappuzha district, restrictions imposed in affected areas

By: FE Online |
December 11, 2021 2:38 PM

Use and sale of eggs, meat and manure of ducks, chickens, quails and domestic birds in the affected area has also been prohibited in the affected area.



Last year too, the district reported the influenza outbreak but was contained for being localized in nature. (PTI Image)

A total of 12,000 ducks were culled in ward number 10 of the Thakazhi gram panchayat in Kerala’s Alappuzha district after the state reported bird flu cases on Thursday. The culled birds were buried safely within a radius of one kilometre in the 10th ward of Thakazhi panchayat. The animal rearers will be compensated according to the government norms, animal husbandry minister J Cinchu Rani in the state capital said.

The ward number 10 of the Thakazhi gram panchayat and the area has been declared as a containment zone, strict restrictions on movement on people and vehicles has been imposed. Use and sale of eggs, meat and manure of ducks, chickens, quails and domestic birds in the affected area has also been prohibited in the affected area.

Alapuzha District Collector chaired an emergency meeting on Friday and decided to step up its measures to prevent the bird flu from spreading to other areas like Champakulam, Nedumudi, Muttar, Viyapuram, Karuvatta, Thrikkunnapuzha, Thakazhi, Purakkad, Ambalapuzha South, Ambalapuzha North, Edathva panchayats and Harippad Municipality areas where restrictions are applicable.

While the Rapid Response Teams will be deployed in the affected areas and distribute preventive medicines to the people, the Department of Animal Welfare will ensure the service of Rapid Response Teams and bury the birds.

The Assistant Forest Conservator on the other hand will monitor and examine whether the migrant birds in the affected areas were infected with the disease. The animal husbandry department has been asked to submit daily reports on bird flu prevention activities.

The state animal husbandry department confirmed bird flu (H5N1) influenza) on Thursday after reports of some samples sent to the National Institute of High-Security Animal Disease in Bhopal turned in. A total 140 samples were sent for test and 26 samples tested positive for bird flu.

Last year too, the district reported the influenza outbreak but was contained for being localized in nature. Bird Flu can spread to humans in rare conditions, and if it happens, it can trigger a person to person transmission, experts said.

Scapegoating Wild Birds Won’t Solve Avian Flu: We Need Radical Farming Reform

As we reflect on the wonder of migratory birds, and the spotlight focuses on how our cities and communities can be made more bird-friendly, we must also consider how our food system is posing a threat to their very existence.


South Korean health officials inspect a rice field frequented by migrating birds in Seosan, 130 kilometers (78 miles) southwest of Seoul, on November 24, 2006.
(Photo: Jeon Young-Han/AFP via Getty Images)

Peter Stevenson
May 10, 2025

Common Dreams

For migratory and other wild birds, bird flu is a disaster. The U.S. Centers for Disease Control and Prevention, or CDC, states that 169 million U.S. poultry have been affected by highly pathogenic bird flu since January 2022. Yet worldwide, tens of millions of wild birds have died of bird flu—which has also spread to mammals, including over 1,000 US. dairy herds.

Saturday 10 May is World Migratory Bird Day, a global event for raising awareness of migratory birds and issues related to their conservation. The poultry industry and governments like to blame wild birds for bird flu. However, the Scientific Task Force on Avian Influenza and Wild Birds—which includes the United Nations Food and Agriculture Organization (FAO) and the World Organization for Animal Health (WOAH) stresses that wild birds are in fact the victims of highly pathogenic bird flu; they do not cause it. As a recent study states, “This panzootic did not emerge from nowhere, but rather is the result of 20 years of viral evolution in the ever-expanding global poultry population.”

Until recently, the bird flu viruses that circulate naturally in wild birds were usually of low pathogenicity; they generally caused little harm to the birds. It is when it gets into industrial poultry sheds—often on contaminated clothing, feed, or equipment—that low pathogenic avian influenza can evolve into dangerous highly pathogenic avian influenza.

Governments worldwide appear to have no strategy for how to end these regular bird flu outbreaks other than to hope they will eventually die down.

Industrial poultry production, in which thousands of genetically similar, stressed birds are packed into a shed, gives a virus a constant supply of new hosts; it can move very quickly among the birds, perhaps mutating as it does so. In this situation, highly virulent strains can rapidly emerge. The European Food Safety Authority warns that it is important to guard against certain low pathogenic avian influenza subtypes entering poultry farms “as these subtypes are able to mutate into their highly pathogenic forms once circulating in poultry.”

Once highly pathogenic avian influenza strains have developed in poultry farms, they can then be carried back outside—for example, through the large ventilation fans used in intensive poultry operations—and spread to wild birds. The Scientific Task Force states that since the mid-2000s spillover of highly pathogenic bird flu from poultry to wild birds has occurred “on multiple occasions.”

So, low pathogenic bird flu is spread from wild birds to intensive poultry where it can mutate into highly pathogenic bird flu, which then spills over to wild birds and can even return back to poultry in a growing and continuing vicious circle.

Following its evolution in farmed poultry, the highly pathogenic virus has adapted to wild birds, meaning that it is circulating independently in wild populations, with some outbreaks occurring in remote areas that are distant from any poultry farms.
Is There a Health Risk for Humans?


While the health risk to humans from bird flu may be low, it cannot be ignored. Highly pathogenic avian influenza has spread to mammals including otters, foxes, seals, dolphins, sea lions, dogs, and bears. Worryingly, it has been found in a Spanish mink farm where it then was able to spread from one infected mink to another.

The U.S. Department of Agriculture has said that cow-to-cow transmission is a factor in the spread of bird flu in dairy herds. The ability for bird flu to move directly from one mammal to another is troubling as a pandemic could ensue if it could move directly from one human to another.

Scientists at Scripps Research reveal that a single mutation in the H5N1 virus that has recently infected U.S. dairy cows could enhance the virus’ ability to attach to human cells, potentially increasing the risk of passing from person to person.

A 2023 joint statement from the World Health Organization, the FAO, and WOAH stated that, while avian influenza viruses normally spread among birds, “the increasing number of H5N1 avian influenza detections among mammals—which are biologically closer to humans than birds are—raises concern that the virus might adapt to infect humans more easily.”

Some mammals may also act as mixing vessels, leading to the emergence of new viruses that could be more harmful.
Pigs as Mixing Vessels

Pigs can be infected by avian and human influenza viruses as well as swine influenza viruses. Pigs can act as mixing vessels in which these viruses can reassort (i.e. swap genes) and new viruses that are a mix of pig, bird, and human viruses can emerge. The U.S. CDC explains that if the resulting new virus infects humans and can spread easily from person to person, a flu pandemic can occur.
Need for a Coherent Strategy to End Bird Flu

Governments worldwide appear to have no strategy for how to end these regular bird flu outbreaks other than to hope they will eventually die down. There is no sign of this happening. Without an exit strategy we are likely to face repeated, devastating outbreaks of bird flu for years to come. We need an action plan to restructure the poultry and pig sectors to reduce their capacity for generating highly pathogenic diseases.

We need to:Move to a poultry sector with smaller flocks and lower stocking densities to give the birds more space. Transmission and amplification of bird flu would be much less likely in such conditions.

End the practice of clustering a large number of poultry farms close together in a particular area. Between-farm spread is a major contributor to the transmission of highly pathogenic bird flu.

End the use of birds genetically selected for very fast growth. Such birds have impaired immune systems making them more susceptible to disease.

In light of pigs’ capacity for acting as mixing vessels for human, avian, and swine influenza viruses, the pig sector too needs to be restructured to make it less vulnerable to the transmission and amplification of influenza viruses. As with poultry, this would involve reducing stocking densities, smaller group sizes, and avoiding concentrating large numbers of farms in a particular area.

As we reflect on the wonder of migratory birds, and the spotlight focuses on how our cities and communities can be made more bird-friendly, we must also consider how our food system is posing a threat to their very existence. Failure to rethink industrial farming leaves us vulnerable, with the continued devastation of wild birds and poultry, and perhaps even a human pandemic.

Peter Stevenson is the chief policy adviser of Compassion in World Farming.
Full Bio >

 

Less than half of US parents think they have accurate information about bird flu

National Poll: 2 in 5 parents wish the government was doing more to prevent a bird flu outbreak; 1 in 3 have taken action to protect their family against it

Michigan Medicine - University of Michigan

Facebook

XLinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Parent confidence in state and federal government's ability to handle bird flu

view more 

Credit: Sara Schultz, University of Michigan Health C.S. Mott Children's National Poll on Children's Health

With soaring egg prices and ongoing bird flu headlines, many parents are uncertain about the risks and facts surrounding the virus, a national poll suggests.

Most parents say they don’t know if there have been cases of bird flu in their state, and less than half feel that they are able to find accurate and current information about it, according to the University of Michigan Health C.S. Mott Children’s Hospital National Poll on Children’s health.

“Many parents may hear about bird flu in the news but don’t feel well-informed or know if they should be taking action to protect their families,” said Mott Poll Co-Director Sarah Clark, M.P.H.

“This report highlights the challenge for parents to keep track of an emerging health situation and understand its potential threat to their child’s health.”

Bird flu, or H5N1, which was reported in the U.S. in March 2024, is widespread in wild birds worldwide that transmit infection to poultry and dairy cows. H5N1 infections in humans have so far been limited to those who come in close contact with infected animals, including U.S. farmworkers.

While the current public health risk has been deemed low, with no evidence of transmission from human to human, the outbreak has increased public concern about the potential for broader transmission. 

Previous outbreaks of H5N1, including one in 2003-2005, highlight this possibility.

Steps parents believe protect families from avian flu

While one in five parents say the media is making too big a deal about the virus, two in five wish the government was doing more to prevent an outbreak, according to the nationally representative report based on responses from 2,021 parents of children aged 18 and under.

Another one in three parents have taken action to protect their family against bird flu, the poll suggests, but not all strategies are evidence-based.

A little less than a quarter of parents say they’re being more careful about general hygiene while 13% are more cautious handling eggs, chicken and beef. Another 12% are avoiding contact with birds and other wild animals while 7% are eating less eggs, chicken, and beef.

“Some parents indicated they have cut back on eating poultry products like eggs and chicken,” Clark said. “However, as long as eggs and meat are fully cooked, there’s no evidence that bird flu is spread through these products.”

Among the 68% of parents who haven’t taken preventive actions, their main reasons are that they already have good hygiene practices, don’t know the recommendations or don’t feel at risk.

Confidence in containing the virus

Nearly half of parents rate themselves as very concerned about the rising cost of eggs and meat associated with bird flu, and over a quarter are very concerned about bird flu spreading from animals to humans or humans to humans.

A third of parents, however, weren’t confident in the government’s ability to contain bird flu.

Less than 20% of parents expressed high confidence in the state or federal government’s ability to remove infected animals or animal products from the food supply while 22% are very confident the government will be able to inform people about which products should be recalled or thrown away.

“There appears to be a gap in public confidence when it comes to the national response to bird flu,” Clark said. “Misinformation and uncertainty can fuel anxiety, so it’s critical that health officials communicate transparently about containment efforts and food safety to reassure families.”

Keeping up with evolving information can be challenging with parents polled saying their main sources are news reports, followed by social media and internet searches. Fewer got information from family or friends, a government agency or healthcare providers

Reinforcing preventive health measures

Bird flu is an influenza A virus that produces a gastrointestinal infection, causing death from diarrhea and respiratory distress. The version currently circulating in the U.S., known as H5N1 2.3.4.4b, is highly lethal

Because H5N1 is very contagious, it’s become standard practice to cull the entire flock or herd to prevent the spread once it’s discovered in an animal. Millions of chickens have been culled as a preventive measure, contributing to the increased price of eggs.

While the risks of bird flu are greatest for individuals who work with farm animals and their families, Clark says, the situation presents an opportunity for parents to reinforce the principles of good hygiene with their children.

Children should be cautioned to avoid dead animals, she says, and try to avoid animal droppings, which can be hard to detect in yards or sandboxes.

“Parents should teach their child to keep their hands away from their face and remind them to wash their hands with soap and water after touching birds and other animals at a petting zoo or a neighbor’s backyard chicken coop,” Clark said.

Clark recommends that parents practice good hygiene with food, such as cooking eggs and meat to recommended temperatures, and choosing milk and other dairy products that are pasteurized to kill germs.

How America lost control and just set the stage for another pandemic

Experts say they have lost faith in the government’s ability to contain the outbreak.

Chicken farm, Shutterstock

Amy Maxmen, 

KFF Health News

December 20, 2024

Keith Poulsen’s jaw dropped when farmers showed him images on their cellphones at the World Dairy Expo in Wisconsin in October. A livestock veterinarian at the University of Wisconsin, Poulsen had seen sick cows before, with their noses dripping and udders slack.

But the scale of the farmers’ efforts to treat the sick cows stunned him. They showed videos of systems they built to hydrate hundreds of cattle at once. In 14-hour shifts, dairy workers pumped gallons of electrolyte-rich fluids into ailing cows through metal tubes inserted into the esophagus.

“It was like watching a field hospital on an active battlefront treating hundreds of wounded soldiers,” he said.

Nearly a year into the first outbreak of the bird flu among cattle, the virus shows no sign of slowing. The U.S. government failed to eliminate the virus on dairy farms when it was confined to a handful of states, by quickly identifying infected cows and taking measures to keep their infections from spreading. Now at least 845 herds across 16 states have tested positive.

Experts say they have lost faith in the government’s ability to contain the outbreak.

“We are in a terrible situation and going into a worse situation,” said Angela Rasmussen, a virologist at the University of Saskatchewan in Canada. “I don’t know if the bird flu will become a pandemic, but if it does, we are screwed.”

To understand how the bird flu got out of hand, KFF Health News interviewed nearly 70 government officials, farmers and farmworkers, and researchers with expertise in virology, pandemics, veterinary medicine, and more.

Together with emails obtained from local health departments through public records requests, this investigation revealed key problems, including a deference to the farm industry, eroded public health budgets, neglect for the safety of agriculture workers, and the sluggish pace of federal interventions.

Case in point: The U.S. Department of Agriculture this month announced a federal order to test milk nationwide. Researchers welcomed the news but said it should have happened months ago — before the virus was so entrenched.

“It’s disheartening to see so many of the same failures that emerged during the covid-19 crisis reemerge,” said Tom Bollyky, director of the Global Health Program at the Council on Foreign Relations.

Far more bird flu damage is inevitable, but the extent of it will be left to the Trump administration and Mother Nature. Already, the USDA has funneled more than $1.7 billion into tamping down the bird flu on poultry farms since 2022, which includes reimbursing farmers who’ve had to cull their flocks, and more than $430 million into combating the bird flu on dairy farms. In coming years, the bird flu may cost billions of dollars more in expenses and losses. Dairy industry experts say the virus kills roughly 2 to 5% of infected dairy cows and reduces a herd’s milk production by about 20%.


Worse, the outbreak poses the threat of a pandemic. More than 60 people in the U.S. have been infected, mainly by cows or poultry, but cases could skyrocket if the virus evolves to spread efficiently from person to person. And the recent news of a person critically ill in Louisiana with the bird flu shows that the virus can be dangerous.

Just a few mutations could allow the bird flu to spread between people. Because viruses mutate within human and animal bodies, each infection is like a pull of a slot machine lever.

“Even if there’s only a 5% chance of a bird flu pandemic happening, we’re talking about a pandemic that probably looks like 2020 or worse,” said Tom Peacock, a bird flu researcher at the Pirbright Institute in the United Kingdom, referring to covid-19. “The U.S. knows the risk but hasn’t done anything to slow this down,” he added.

Beyond the bird flu, the federal government’s handling of the outbreak reveals cracks in the U.S. health security system that would allow other risky new pathogens to take root, too. “This virus may not be the one that takes off,” said Maria Van Kerkhove, director of the emerging diseases group at the World Health Organization. “But this is a real fire exercise right now, and it demonstrates what needs to be improved.”


A Slow Start

It may have been a grackle, a goose, or some other wild bird that infected a cow in northern Texas. In February, the state’s dairy farmers took note when cows stopped making milk. They worked alongside veterinarians to figure out why. In less than two months, veterinary researchers identified the highly pathogenic H5N1 bird flu virus as the culprit.

Long listed among pathogens with pandemic potential, the bird flu’s unprecedented spread among cows marked a worrying shift. It had evolved to thrive in animals that are more like people biologically than birds.

After the USDA announced the dairy outbreak on March 25, control shifted from farmers, veterinarians, and local officials to state and federal agencies. Collaboration disintegrated almost immediately.


Farmers worried the government might block their milk sales or even demand sick cows be killed, like poultry are, said Kay Russo, a livestock veterinarian in Fort Collins, Colorado.

Instead, Russo and other veterinarians said, they were dismayed by inaction. The USDA didn’t respond to their urgent requests to support studies on dairy farms — and for money and confidentiality policies to protect farmers from financial loss if they agreed to test animals.

The USDA announced that it would conduct studies itself. But researchers grew anxious as weeks passed without results. “Probably the biggest mistake from the USDA was not involving the boots-on-the-ground veterinarians,” Russo said.

Will Clement, a USDA senior adviser for communications, said in an email: “Since first learning of H5N1 in dairy cattle in late March 2024, USDA has worked swiftly and diligently to assess the prevalence of the virus in U.S. dairy herds.” The agency provided research funds to state and national animal health labs beginning in April, he added.


The USDA didn’t require lactating cows to be tested before interstate travel until April 29. By then, the outbreak had spread to eight other states. Farmers often move cattle across great distances, for calving in one place, raising in warm, dry climates, and milking in cooler ones. Analyses of the virus’s genes implied that it spread between cows rather than repeatedly jumping from birds into herds.

Milking equipment was a likely source of infection, and there were hints of other possibilities, such as through the air as cows coughed or in droplets on objects, like work boots. But not enough data had been collected to know how exactly it was happening. Many farmers declined to test their herds, despite an announcement of funds to compensate them for lost milk production.

“There is a fear within the dairy farmer community that if they become officially listed as an affected farm, they may lose their milk market,” said Jamie Jonker, chief science officer at the National Milk Producers Federation, an organization that represents dairy farmers. To his knowledge, he added, this hasn’t happened.

Speculation filled knowledge gaps. Zach Riley, head of the Colorado Livestock Association, said wild birds may be spreading the virus to herds across the country, despite scientific data suggesting otherwise. Riley said farmers were considering whether to install “floppy inflatable men you see outside of car dealerships” to ward off the birds.

Advisories from agriculture departments to farmers were somewhat speculative, too. Officials recommended biosecurity measures such as disinfecting equipment and limiting visitors. As the virus kept spreading throughout the summer, USDA senior official Eric Deeble said at a press briefing, “The response is adequate.”

The USDA, the Centers for Disease Control and Prevention, and the Food and Drug Administration presented a united front at these briefings, calling it a “One Health” approach. In reality, agriculture agencies took the lead.

This was explicit in an email from a local health department in Colorado to the county’s commissioners. “The State is treating this primarily as an agriculture issue (rightly so) and the public health part is secondary,” wrote Jason Chessher, public health director in Weld County, Colorado. The state’s leading agriculture county, Weld’s livestock and poultry industry produces about $1.9 billion in sales each year.

Patchy Surveillance

In July, the bird flu spread from dairies in Colorado to poultry farms. To contain it, two poultry operations employed about 650 temporary workers — Spanish-speaking immigrants as young as 15 — to cull flocks. Inside hot barns, they caught infected birds, gassed them with carbon dioxide, and disposed of the carcasses. Many did the hazardous job without goggles, face masks, and gloves.

By the time Colorado’s health department asked if workers felt sick, five women and four men had been infected. They all had red, swollen eyes — conjunctivitis — and several had such symptoms as fevers, body aches, and nausea.

State health departments posted online notices offering farms protective gear, but dairy workers in several states told KFF Health News that they had none. They also said they hadn’t been asked to get tested.

Studies in Colorado, Michigan, and Texas would later show that bird flu cases had gone under the radar. In one analysis, eight dairy workers who hadn’t been tested — 7% of those studied — had antibodies against the virus, a sign that they had been infected.

Missed cases made it impossible to determine how the virus jumped into people and whether it was growing more infectious or dangerous. “I have been distressed and depressed by the lack of epidemiologic data and the lack of surveillance,” said Nicole Lurie, an executive director at the international organization the Coalition for Epidemic Preparedness Innovations, who served as assistant secretary for preparedness and response in the Obama administration.

Citing “insufficient data,” the British government raised its assessment of the risk posed by the U.S. dairy outbreak in July from three to four on a six-tier scale.

Virologists around the world said they were flabbergasted by how poorly the United States was tracking the situation. “You are surrounded by highly pathogenic viruses in the wild and in farm animals,” said Marion Koopmans, head of virology at Erasmus Medical Center in the Netherlands. “If three months from now we are at the start of the pandemic, it is nobody’s surprise.”

Although the bird flu is not yet spreading swiftly between people, a shift in that direction could cause immense suffering. The CDC has repeatedly described the cases among farmworkers this year as mild — they weren’t hospitalized. But that doesn’t mean symptoms are a breeze, or that the virus can’t cause worse.

“It does not look pleasant,” wrote Sean Roberts, an emergency services specialist at the Tulare County, California, health department in an email to colleagues in May. He described photographs of an infected dairy worker in another state: “Apparently, the conjunctivitis that this is causing is not a mild one, but rather ruptured blood vessels and bleeding conjunctiva.”

Over the past 30 years, half of around 900 people diagnosed with bird flu around the world have died. Even if the case fatality rate is much lower for this strain of the bird flu, covid showed how devastating a 1% death rate can be when a virus spreads easily.

Like other cases around the world, the person now hospitalized with the bird flu in Louisiana appears to have gotten the virus directly from birds. After the case was announced, the CDC released a statement saying, “A sporadic case of severe H5N1 bird flu illness in a person is not unexpected.”

‘The Cows Are More Valuable Than Us‘

Local health officials were trying hard to track infections, according to hundreds of emails from county health departments in five states. But their efforts were stymied. Even if farmers reported infected herds to the USDA and agriculture agencies told health departments where the infected cows were, health officials had to rely on farm owners for access.

“The agriculture community has dictated the rules of engagement from the start,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “That was a big mistake.”

Some farmers told health officials not to visit and declined to monitor their employees for signs of sickness. Sending workers to clinics for testing could leave them shorthanded when cattle needed care. “Producer refuses to send workers to Sunrise [clinic] to get tested since they’re too busy. He has pinkeye, too,” said an email from the Weld, Colorado, health department.

“We know of 386 persons exposed – but we know this is far from the total,” said an email from a public health specialist to officials at Tulare’s health department recounting a call with state health officials. “Employers do not want to run this through worker’s compensation. Workers are hesitant to get tested due to cost,” she wrote.

Jennifer Morse, medical director of the Mid-Michigan District Health Department, said local health officials have been hesitant to apply pressure after the backlash many faced at the peak of covid. Describing the 19 rural counties she serves as “very minimal-government-minded,” she said, “if you try to work against them, it will not go well.”

Rural health departments are also stretched thin. Organizations that specialize in outreach to farmworkers offered to assist health officials early in the outbreak, but months passed without contracts or funding. During the first years of covid, lagging government funds for outreach to farmworkers and other historically marginalized groups led to a disproportionate toll of the disease among people of color.

Kevin Griffis, director of communications at the CDC, said the agency worked with the National Center for Farmworker Health throughout the summer “to reach every farmworker impacted by H5N1.” But Bethany Boggess Alcauter, the center’s director of public health programs, said it didn’t receive a CDC grant for bird flu outreach until October, to the tune of $4 million. Before then, she said, the group had very limited funds for the task. “We are certainly not reaching ‘every farmworker,’” she added.

Farmworker advocates also pressed the CDC for money to offset workers’ financial concerns about testing, including paying for medical care, sick leave, and the risk of being fired. This amounted to an offer of $75 each. “Outreach is clearly not a huge priority,” Boggess said. “I hear over and over from workers, ‘The cows are more valuable than us.’”

The USDA has so far put more than $2.1 billion into reimbursing poultry and dairy farmers for losses due to the bird flu and other measures to control the spread on farms. Federal agencies have also put $292 million into developing and stockpiling bird flu vaccines for animals and people. In a controversial decision, the CDC has advised against offering the ones on hand to farmworkers.

“If you want to keep this from becoming a human pandemic, you focus on protecting farmworkers, since that’s the most likely way that this will enter the human population,” said Peg Seminario, an occupational health researcher in Bethesda, Maryland. “The fact that this isn’t happening drives me crazy.”

Nirav Shah, principal deputy director of the CDC, said the agency aims to keep workers safe. “Widespread awareness does take time,” he said. “And that’s the work we’re committed to doing.”

As Trump comes into office in January, farmworkers may be even less protected. Trump’s pledge of mass deportations will have repercussions, said Tania Pacheco-Werner, director of the Central Valley Health Policy Institute in California, whether they happen or not.

Many dairy and poultry workers are living in the U.S. without authorization or on temporary visas linked to their employers. Such precarity made people less willing to see doctors about covid symptoms or complain about unsafe working conditions in 2020. Pacheco-Werner said, “Mass deportation is an astronomical challenge for public health.”

Not ‘Immaculate Conception’

A switch flipped in September among experts who study pandemics as national security threats. A patient in Missouri had the bird flu, and no one knew why. “Evidence points to this being a one-off case,” Shah said at a briefing with journalists. About a month later, the agency revealed it was not.

Antibody tests found that a person who lived with the patient had been infected, too. The CDC didn’t know how the two had gotten the virus, and the possibility of human transmission couldn’t be ruled out.

Nonetheless, at an October briefing, Shah said the public risk remained low and the USDA’s Deeble said he was optimistic that the dairy outbreak could be eliminated.

Experts were perturbed by such confident statements in the face of uncertainty, especially as California’s outbreak spiked and a child was mysteriously infected by the same strain of virus found on dairy farms.

“This wasn’t just immaculate conception,” said Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies. “It came from somewhere and we don’t know where, but that hasn’t triggered any kind of reset in approach — just the same kind of complacency and low energy.”

Sam Scarpino, a disease surveillance specialist in the Boston area, wondered how many other mysterious infections had gone undetected. Surveillance outside of farms was even patchier than on them, and bird flu tests are hard to get.

Although pandemic experts had identified the CDC’s singular hold on testing for new viruses as a key explanation for why America was hit so hard by covid in 2020, the system remained the same. All bird flu tests must go through the CDC, even though commercial and academic diagnostic laboratories have inquired about running tests themselves since April. The CDC and FDA should have tried to help them along months ago, said Ali Khan, a former top CDC official who now leads the University of Nebraska Medical Center College of Public Health.

As winter sets in, the bird flu becomes harder to spot because patient symptoms may be mistaken for the seasonal flu. Flu season also raises a risk that the two flu viruses could swap genes if they infect a person simultaneously. That could form a hybrid bird flu that spreads swiftly through coughs and sneezes.

A sluggish response to emerging outbreaks may simply be a new, unfortunate norm for America, said Bollyky, at the Council on Foreign Relations. If so, the nation has gotten lucky that the bird flu still can’t spread easily between people. Controlling the virus will be much harder and costlier than it would have been when the outbreak was small. But it’s possible.

Agriculture officials could start testing every silo of bulk milk, in every state, monthly, said Poulsen, the livestock veterinarian. “Not one and done,” he added. If they detect the virus, they’d need to determine the affected farm in time to stop sick cows from spreading infections to the rest of the herd — or at least to other farms. Cows can spread the bird flu before they’re sick, he said, so speed is crucial.

Curtailing the virus on farms is the best way to prevent human infections, said Jennifer Nuzzo, director of the Pandemic Center at Brown University, but human surveillance must be stepped up, too. Every clinic serving communities where farmworkers live should have easy access to bird flu tests — and be encouraged to use them. Funds for farmworker outreach must be boosted. And, she added, the CDC should change its position and offer farmworkers bird flu vaccines to protect them and ward off the chance of a hybrid bird flu that spreads quickly.

The rising number of cases not linked to farms signals a need for more testing in general. When patients are positive on a general flu test — a common diagnostic that indicates human, swine, or bird flu — clinics should probe more deeply, Nuzzo said.

The alternative is a wait-and-see approach in which the nation responds only after enormous damage to lives or businesses. This tack tends to rely on mass vaccination. But an effort analogous to Trump’s Operation Warp Speed is not assured, and neither is rollout like that for the first covid shots, given a rise in vaccine skepticism among Republican lawmakers.

Change may instead need to start from the bottom up — on dairy farms, still the most common source of human infections, said Poulsen. He noticed a shift in attitudes among farmers at the Dairy Expo: “They’re starting to say, ‘How do I save my dairy for the next generation?’ They recognize how severe this is, and that it’s not just going away.”

Healthbeat is a nonprofit newsroom covering public health published by Civic News Company and KFF Health News. Sign up for its newsletters here.KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

This article first appeared on KFF Health News and is republished here under a Creative Commons license.