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First US Bird Flu Case to Test Positive Without a Previous Known Exposure to Infected Animal

Uh oh. Bird Flu has been going around on poultry farms.

Now first case without any known exposure to a infected bird. Me thinks not good...
 
DarkNoon said:
Uh oh. Bird Flu has been going around on poultry farms.

Now first case without any known exposure to a infected bird. Me thinks not good...
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My apologies for the late reply. I've been recuperating from a nasty ear infection that has caused me severe vertigo. Thankfully I'm doing better.

The World Health Organization uses a 6-level Pandemic Alert Level to assess the risk that a virus will cause a pandemic. Think of it as similar to the DEFCON system, but with a higher number indicating a greater likelihood of a pandemic. The following descriptions are used:

Phase 1- No animal influenza virus circulating among animals has been reported to cause infection in humans.

Phase 2- An animal influenza virus circulating in domesticated or wild animals is known to have caused infection in humans and is therefore considered a specific potential pandemic threat.

Phase 3- An animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks.

The first three phases are also known as the "pre-pandemic" phase, where it is unknown how likely it is that a pandemic will occur. The next three phases are very specific in their significance, and progress very rapidly. Try to picture what happened as COVID-19 quickly spread outside of China:

Phase 4- Human-to-human transmission of an animal or human-animal influenza reassortant virus able to sustain community-level outbreaks has been verified. Medium to high probability of pandemic. Rapid containment if possible. Prepare for pandemic response.

Phase 5- The same identified virus has caused sustained community-level outbreaks in at least two countries in one WHO region. Public Health Emergency of International Concern most likely declared. Pandemic is considered nearly certain. Prepare for imminent response.

Phase 6- In addition to the criteria defined in Phase 5, the same virus has caused sustained community-level outbreaks in at least one other country in another WHO region. A pandemic is officially in progress.

Based on the criteria above, we are at Phase 3. We have a report of a sporadic isolated case without any known zoonotic exposure. Things would get more complicated if we start to get clusters of infection. At this time, as long as the chains of onward transmission have been broken, I would assess the threat to the general public to be low. However, similar to DEFCON 3, the situation is somewhat fluid, and can change. Now would be a good time to use some of the tools that you've learned from the COVID-19 pandemic. Start stocking up on some good N-95 masks and other essential supplies. The same non-pharmaceutical interventions that we used during the COVID-19 pandemic are effective against pandemic influenza.

I will try to keep you updated about public health threats as much as I can, barring any issues with my personal life. I highly recommend keeping a close eye on the news media, the CDC, and the WHO.
 
willrod1989 said:
My apologies for the late reply. I've been recuperating from a nasty ear infection that has caused me severe vertigo. Thankfully I'm doing better.

The World Health Organization uses a 6-level Pandemic Alert Level to assess the risk that a virus will cause a pandemic. Think of it as similar to the DEFCON system, but with a higher number indicating a greater likelihood of a pandemic. The following descriptions are used:

Phase 1- No animal influenza virus circulating among animals has been reported to cause infection in humans.

Phase 2- An animal influenza virus circulating in domesticated or wild animals is known to have caused infection in humans and is therefore considered a specific potential pandemic threat.

Phase 3- An animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks.

The first three phases are also known as the "pre-pandemic" phase, where it is unknown how likely it is that a pandemic will occur. The next three phases are very specific in their significance, and progress very rapidly. Try to picture what happened as COVID-19 quickly spread outside of China:

Phase 4- Human-to-human transmission of an animal or human-animal influenza reassortant virus able to sustain community-level outbreaks has been verified. Medium to high probability of pandemic. Rapid containment if possible. Prepare for pandemic response.

Phase 5- The same identified virus has caused sustained community-level outbreaks in at least two countries in one WHO region. Public Health Emergency of International Concern most likely declared. Pandemic is considered nearly certain. Prepare for imminent response.

Phase 6- In addition to the criteria defined in Phase 5, the same virus has caused sustained community-level outbreaks in at least one other country in another WHO region. A pandemic is officially in progress.

Based on the criteria above, we are at Phase 3. We have a report of a sporadic isolated case without any known zoonotic exposure. Things would get more complicated if we start to get clusters of infection. At this time, as long as the chains of onward transmission have been broken, I would assess the threat to the general public to be low. However, similar to DEFCON 3, the situation is somewhat fluid, and can change. Now would be a good time to use some of the tools that you've learned from the COVID-19 pandemic. Start stocking up on some good N-95 masks and other essential supplies. The same non-pharmaceutical interventions that we used during the COVID-19 pandemic are effective against pandemic influenza.

I will try to keep you updated about public health threats as much as I can, barring any issues with my personal life. I highly recommend keeping a close eye on the news media, the CDC, and the WHO.
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Thank you for the context of everything. Thank you for your work on viral worries in the world.
 
CDC confirms H5N1 Bird Flu Infection in a Child in California

The Centers for Disease Control and Prevention (CDC) has confirmed a human infection with avian influenza A(H5N1) (H5N1 bird flu) in a child in California. This is the first reported avian influenza H5 virus infection in a child in the United States. Consistent with previously identified human cases in the United States, the child reportedly experienced mild symptoms and received flu antivirals. There were low levels of viral material detected in the initial specimen collected, and follow-up testing of the child several days later was negative for H5 bird flu but was positive for other common respiratory viruses. The child is recovering from their illness. An investigation by the California Department of Public Health (CDPH) into the child's possible H5N1 exposure source is ongoing.

During CDPH's investigation, all household members reported having symptoms and specimens were collected from those people. All test results from members of the household were negative for H5 bird flu, and some family members were positive for the same common respiratory viruses as the child. Contact tracing continues, but there is currently no evidence of person-to-person spread of H5N1 bird flu from this child to others. To date, there has been no person-to-person spread identified associated with any of the H5N1 bird flu cases reported in the United States.

This case was detected through influenza testing and reported to CDPH through influenza surveillance. This is the second U.S. case identified through national surveillance. CDC continues to closely monitor available data from influenza surveillance systems, particularly in states affected by outbreaks in animals, including California, where widespread outbreaks of H5N1 bird flu have been detected in wild birds and domestic poultry since 2022 and dairy herds since August 2024 in that state.

Limited and sporadic human infections with avian influenza H5N1 virus, where animal exposure was not identified, are very uncommon but have occurred, primarily in countries other than the United States. These instances underscore the importance of ongoing surveillance and investigations at the local, state, and Federal levels. Including this most recent case, 55 human cases of H5 bird flu have now been reported in the United States during 2024, with 29 in California.

CDC's risk assessment for the general public is low. However, people with exposure to infected or potentially infected animals, such as birds, dairy cattle, or other animals (including livestock), or to environments contaminated by infected birds or other animals, are at higher risk of infection. CDC recommends avoiding unprotected exposures to sick or dead animals, including wild birds, poultry, other domesticated birds, and other wild or domesticated animals (including cows).

CDC will continue to provide updates as additional information becomes available.
 
Canadian probe into teen's critical H5N1 infection finds no clear source

As a Canadian teen remains in critical care with an H5N1 avian flu infection in a British Columbia hospital, health investigators said today they haven't identified the source, but have found other clues such as virus changes that may have led to a more severe lower respiratory infection.

At a briefing today, Bonnie Henry, MD, MPH, British Columbia's health officer, said an exhaustive search has found no related illnesses. For now, the main part of the investigation is at a standstill while scientists do ongoing work to examine virus mutations and conduct serology tests to see if any asymptomatic illnesses have occurred.

"Our thoughts continue to be with this young person as they remain in critical condition, and their family," she said.

Henry said the teen, sick since November 2 and hospitalized since November 8, remains seriously ill and requires breathing assistance, but is stable and has shown progress over the past few days.

Closest virus match is to wild geese​

Extensive testing of health workers, family and other close contacts, and animals has turned up no further infections. Extensive tests on a pet dog that was sick at the same time were negative for avian influenza, with tests also negative on samples from about 25 animals, numerous environmental samples, and from the family that took care of the dog prior to adoption. Wastewater sampling also found no clues.

Henry said whole-genome sequencing found that the H5N1 virus from the patient belongs to the D1.1 genotype, which is a different genotype than the one that has infected dairy workers in the United States.

Though British Columbia has experienced 54 poultry outbreaks over the past several weeks, phylogenetic analysis by scientists at the BC Centre for Disease Control Public Health Laboratory suggests the patient's sample is fairly distant from the poultry virus and is most closely related—but not identical—to samples from two cackling geese found dead in British Columbia's Fraser Valley in early October.

Phylogenetic findings could hint at an intermediary source to the patient, such as another wild bird or an animal, she said.

Concerns about virus mutations​

Though the detection of no other human cases—including farm workers with direct poultry contact—and no transmission among people is reassuring, Henry said the identification of mutations linked to greater adaptation to humans, including enhanced cell-receptor binding and the binding to cells deep in the lungs, is concerning.

She also noted that the virus may have evolved after infecting the patient. The teen's symptoms began with conjunctivitis, then progressed to a severe respiratory illness. Scientists have obtained serial samples from the patient to identify any mutations that have occurred over the course of the infection.

Serology testing of patient contacts is still under way, but so far all tests have been negative.

The recent identification of H5N1 in a US child in California is a reminder that children may be more vulnerable to H5N1 infections, because their immune systems may not have encountered similar viruses before, Henry said, adding that the identification of the virus this week in a California retail raw milk samples is a warning that the virus can turn up in unexpected places.

More outbreaks in US dairy cows, poultry​

In other H5N1 developments, the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) today confirmed 34 more outbreaks in dairy cattle, all involving California herds. The state has now reported 436 outbreaks, with the latest outbreaks lifting the US total to 650 dairy herds across 15 states.

APHIS also confirmed two more outbreaks in poultry, one a backyard flock housing 70 birds in North Dakota's McHenry County, and the other a backyard flock of 30 birds in Utah's Salt Lake County.
 
For those keeping track, this marks three cases without any known links to other birds or mammals. It is very concerning to see that there is a possible mutation of the virus in the Canadian case. While we are still in Phase 3 according to the WHO's Pandemic Influenza Phases, I would begin to prepare as if we are moving into Phase 4. The community viral load among non-human animals is extremely high and shows signs of accelerating. One could argue that this virus is quickly moving into a "panzootic" phase (think pandemic, but excluding humans).

It is also very concerning that this virus is showing up in raw milk. Please remember that consumption of raw milk is always risky due to the risk of contamination. Pasteurization kills any disease-causing pathogens.
 
willrod1989 said:
For those keeping track, this marks three cases without any known links to other birds or mammals. It is very concerning to see that there is a possible mutation of the virus in the Canadian case. While we are still in Phase 3 according to the WHO's Pandemic Influenza Phases, I would begin to prepare as if we are moving into Phase 4. The community viral load among non-human animals is extremely high and shows signs of accelerating. One could argue that this virus is quickly moving into a "panzootic" phase (think pandemic, but excluding humans).

It is also very concerning that this virus is showing up in raw milk. Please remember that consumption of raw milk is always risky due to the risk of contamination. Pasteurization kills any disease-causing pathogens.
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If Kennedy will be in the Health Department he might push for more raw milk drinking, and then... whoops. If cases become very concerning he might be forced to change his mind about vaccines.
 
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