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Bird flu hit a dead end in Missouri, but it’s running rampant in California

As H5N1 bird flu continues to spread wildly among California dairy herds and farmworkers, federal health officials on Thursday offered some relatively good news about Missouri: The wily avian influenza virus does not appear to have spread from the state's sole human case, which otherwise remains a mystery.

On September 6, the Missouri Health department announced that a person with underlying health conditions tested positive for bird flu, and later testing indicated that it was an H5N1 strain related to the one currently circulating among US dairy cows. But, state and federal health officials were—and still are—stumped as to how that person became infected. The person had no known contact with infected animals and no contact with any obviously suspect animal products. No dairy herds in Missouri have tested positive, and no poultry farms had reported recent outbreaks, either. To date, all other human cases of H5N1 have been among farmworkers who had contact with H5N1-infected animals.

But aside from the puzzle, attention turned to the possibility that the unexplained Missouri case had passed on the infection to those around them. A household contact had symptoms at the same time as the person—aka the index case—and at least six health care workers developed illnesses after interacting with the person. One of the six had tested negative for bird flu around the time of their illness, but questions remained about the other five.

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Human cases of H5N1 confirmed in California amid rapid dairy spread

Two California dairy farm workers who had contact with H5N1-infected cows have contracted an H5 avian influenza virus, the Centers for Disease Control and Prevention confirmed Thursday evening.

In a news release from earlier today, California's health department announced only one presumptive positive case awaiting confirmation from the CDC. In that case, the person's illness was reported to be mild, with the only symptom being conjunctivitis (eye redness). This echoes the experience of other H5N1 human cases in this outbreak. The person is said to be staying at home and taking an antiviral flu medication.

In its media statement Thursday evening, the CDC reported confirming two cases. "At this time, there is no known link or contact between the first and second confirmed cases in California, suggesting these are separate instances of animal-to-human spread of the virus," the CDC said.

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Human cases of H5N1 confirmed in California amid rapid dairy spread

Two California dairy farm workers who had contact with H5N1-infected cows have contracted an H5 avian influenza virus, the Centers for Disease Control and Prevention confirmed Thursday evening.

In a news release from earlier today, California's health department announced only one presumptive positive case awaiting confirmation from the CDC. In that case, the person's illness was reported to be mild, with the only symptom being conjunctivitis (eye redness). This echoes the experience of other H5N1 human cases in this outbreak. The person is said to be staying at home and taking an antiviral flu medication.

In its media statement Thursday evening, the CDC reported confirming two cases. "At this time, there is no known link or contact between the first and second confirmed cases in California, suggesting these are separate instances of animal-to-human spread of the virus," the CDC said.

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More unidentified illnesses linked to unexplained bird flu case in Missouri

More than a month after a person in Missouri mysteriously fell ill with H5-type bird flu, investigators in the state are still identifying people who became ill after contact with the patient, raising questions about the diligence of the ongoing health investigation.

On September 6, Missouri's health department reported the state's first human case of H5-type bird flu, one that appears closely related to the H5N1 bird flu currently causing a nationwide outbreak among dairy cows. But the infected person had no known contact with infected animals—unlike all of the other 13 human cases identified amid the dairy outbreak this year. Those previous cases have all occurred in dairy- or poultry-farm workers. In fact, Missouri has not reported bird flu in its dairy herds nor recent poultry outbreaks.

Given the unexplained source of infection, health investigators in the state have been working to track the virus both backward in time—to try to identify the source—and forward—to identify any potential onward spread. The bird flu patient was initially hospitalized on August 22 but recovered and had been released by the time the state publicly reported the case.

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Bird flu is spreading rapidly in California; infected herds double over weekend

Bird flu is spreading rapidly in California; infected herds double over weekend

Enlarge (credit: Getty | Matthew Ludak)

The H5N1 bird flu appears to be stampeding through dairy farms in California, the country's largest milk producer. Over the weekend, the total number of confirmed infected cow herds stunningly doubled, going from 17 last Thursday to 34 Monday morning, according to state and federal officials.

With the new tally, California now ranks second among all affected states for having the most herds with avian influenza. Only Colorado, which has adopted bulk milk-tank surveillance, has more, with 64 herds confirmed. California's high ranking is despite the fact that it only reported its first three infected herds on August 30, while the dairy outbreak was first confirmed on March 25 and thought to have begun late last year.

To date, 232 herds in 14 states have been infected with the bird flu.

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Person in Missouri caught H5 bird flu without animal contact

The influenza virus from an image produced with transmission electron microscopy. Viral diameter ranges from around 80 to 120 nm.

Enlarge / The influenza virus from an image produced with transmission electron microscopy. Viral diameter ranges from around 80 to 120 nm. (credit: Getty | BSIP)

A person in Missouri with no reported exposure to animals was confirmed to have been infected with H5-type bird flu, the Missouri Department of Health and Senior Services (MDHSS) announced late Friday.

MDHSS reported that the person, who has underlying medical conditions, was hospitalized on August 22 and tested positive for an influenza A virus. Further testing at the state's public health laboratory indicated that the influenza A virus was an H5-type bird flu. The Centers for Disease Control and Prevention has now confirmed that finding and is carrying out further testing to determine if it is the H5N1 strain currently causing a widespread outbreak among US dairy cows.

It remains unclear if the person's bird flu infection was the cause of the hospitalization or if the infection was discovered incidentally. The person has since recovered and was discharged from the hospital. In its announcement, MDHSS said no other information about the patient will be released to protect the person's privacy.

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Bird flu reaches cows in California, the country’s largest milk producer

A cow grazes in a field at a dairy farm on April 26, 2024, in Petaluma, California.

Enlarge / A cow grazes in a field at a dairy farm on April 26, 2024, in Petaluma, California. (credit: Getty | Justin Sullivan)

The outbreak of H5N1 bird flu in US dairy cows has now spread to three herds in California, the largest milk-producing state in the country, with around 1.7 million dairy cows, federal and state health officials have confirmed.

Fourteen states and 197 herds have now been affected by the unprecedented outbreak in dairy cows, which was first confirmed by federal health officials on March 25.

In a statement, the secretary of the California Department of Food and Agriculture, Karen Ross, said the spread of the virus to California was not unexpected. "We have been preparing for this possibility since earlier this year when [Highly pathogenic avian influenza or HPAI] detections were confirmed at dairy farms in other states," Ross said. "Our extensive experience with HPAI in poultry has given us ample preparation and expertise to address this incident, with workers’ health and public health as our top priorities."

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Troubling bird flu study suggests human cases are going undetected

Troubling bird flu study suggests human cases are going undetected

Enlarge (credit: Tony C. French/Getty)

A small study in Texas suggests that human bird flu cases are being missed on dairy farms where the H5N1 virus has taken off in cows, sparking an unprecedented nationwide outbreak.

The finding adds some data to what many experts have suspected amid the outbreak. But the authors of the study, led by researchers at the University of Texas Medical Branch in Galveston, went further, stating bluntly why the US is failing to fully surveil, let alone contain, a virus with pandemic potential.

"Due to fears that research might damage dairy businesses, studies like this one have been few," the authors write in the topline summary of their study, which was posted online as a pre-print and had not been peer-reviewed.

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Human bird flu cases tick up; second Colorado poultry farm reports spread

Human bird flu cases tick up; second Colorado poultry farm reports spread

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A second Colorado poultry farm has reported a case of bird flu in a worker, marking the state's seventh human case this month amid the ongoing outbreak among dairy cows.

Colorado health officials said the seventh case is, for now, a presumptive positive. That means that the person has tested positive at the state level while confirmatory testing is being carried out at the Centers for Disease Control and Prevention.

The presumptive positive worker was at a poultry facility in the state's northeastern Weld County. In recent weeks, six workers at another poultry farm in Weld also tested positive for bird flu. In that facility, a commercial egg layer operation with about 1.8 million birds, workers were infected as they culled chickens known to be infected with the highly pathogenic avian influenza. Genetic testing of the virus in the birds and the workers indicated that they were infected with a strain of H5N1 closely related to the virus found spreading in dairy cattle and to dairy farm workers.

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Five people infected as bird flu appears to go from cows to chickens to humans

Five people infected as bird flu appears to go from cows to chickens to humans

Enlarge (credit: Getty | Edwin Remsberg)

The highly pathogenic avian influenza H5N1 virus that spilled from wild birds into US dairy cows late last year may have recently seeped from a dairy farm in Colorado to a nearby poultry farm, where it then infected five workers tasked with culling the infected chickens

In a press briefing Tuesday, federal officials reported that four of the avian influenza cases have been confirmed by the Centers for Disease Control and Prevention, while the fifth remains a presumptive positive awaiting CDC confirmation.

All five people have shown mild illnesses, though they experienced variable symptoms. Some of the cases involved conjunctivitis, as was seen in other human cases linked to the H5N1 outbreak in dairy cows. Others in the cluster of five had respiratory and typical flu-like symptoms, including fever, chills, sore throat, runny nose, and cough. None of the five cases required hospitalization.

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US prepares for bird flu pandemic with $176M Moderna vaccine deal

US prepares for bird flu pandemic with $176M Moderna vaccine deal

Enlarge (credit: Getty | Justin Sullivan)

The US government will pay Moderna $176 million to develop an mRNA vaccine against a pandemic influenza—an award given as the highly pathogenic bird flu virus H5N1 continues to spread widely among US dairy cattle.

The funding flows through BARDA, the Biomedical Advanced Research and Development Authority, as part of a new Rapid Response Partnership Vehicle (RRPV) Consortium. The program is intended to set up partnerships with industry to help the country better prepare for pandemic threats and develop medical countermeasures, the Department of Health and Human Services said in a press announcement Tuesday.

In its own announcement on Tuesday, Moderna noted that it began a Phase 1/2 trial of a pandemic influenza virus vaccine last year, which included versions targeting H5 and H7 varieties of bird flu viruses. The company said it expects to release the results of that trial this year and that those results will direct the design of a Phase 3 trial, anticipated to begin in 2025.

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Bird flu virus from Texas human case kills 100% of ferrets in CDC study

Bird flu virus from Texas human case kills 100% of ferrets in CDC study

Enlarge (credit: Getty | Yui Mok)

The strain of H5N1 bird flu isolated from a dairy worker in Texas was 100 percent fatal in ferrets used to model influenza illnesses in humans. However, the virus appeared inefficient at spreading via respiratory droplets, according to newly released study results from the Centers for Disease Control and Prevention.

The data confirms that H5N1 infections are significantly different from seasonal influenza viruses that circulate in humans. Those annual viruses make ferrets sick but are not deadly. They have also shown to be highly efficient at spreading via respiratory droplets, with 100 percent transmission rates in laboratory settings. In contrast, the strain from the Texas man (A/Texas/37/2024) appeared to have only a 33 percent transmission rate via respiratory droplets among ferrets.

"This suggests that A/Texas/37/2024-like viruses would need to undergo changes to spread efficiently by droplets through the air, such as from coughs and sneezes," the CDC said in its data summary. The agency went on to note that "efficient respiratory droplet spread, like what is seen with seasonal influenza viruses, is needed for sustained person-to-person spread to happen."

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Third human case of bird flu from cows—this one with respiratory symptoms

Holstein cows at a dairy farm.

Enlarge / Holstein cows at a dairy farm. (credit: Getty | John Carl D'Annibale)

Another dairy farm worker in Michigan has been infected with avian influenza virus, state and federal health officials reported Thursday.

The case marks the third time the outbreak of bird flu in milking cows is known to have spilled over to a human. The dairy farm worker in Michigan, like the others, had close contact with H5N1-infected dairy cows, suggesting another case of cow-to-human transmission.

But the case reported today is notable for being the first one involving respiratory symptoms. In the first two cases, the dairy workers (one in Texas, the other in Michigan) reported only eye infections (conjunctivitis). This third case—also in Michigan but from a different farm—reported upper respiratory symptoms, including cough, congestion, and sore throat, as well as eye discomfort and watery discharge, but not conjunctivitis. The worker was given an antiviral (Tamiflu) and is said to be recovering. No other workers on the farm have shown symptoms, and the worker's household contacts are being monitored.

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Alpacas in Idaho test positive for H5N1 bird flu in another world first

Suri alpacas on a farm in Pennsylvania.

Enlarge / Suri alpacas on a farm in Pennsylvania. (credit: Getty | Susan L. Angstadt)

Four backyard alpacas in southern Idaho have tested positive for highly pathogenic avian influenza (HPAI) H5N1, marking the first time bird flu has been detected in members of the fleecy camelid family, according to the US Department of Agriculture.

On Tuesday, the USDA announced that the agency's National Veterinary Services Laboratories confirmed the infection on a farm in Jerome County on May 16. While the infections are a first for the spitting llama relatives, the USDA said they weren't particularly surprising. The alpacas were in close contact with HPAI-infected poultry on the farm, which were "depopulated" this month. Of 18 alpacas on the affected farm, only four were found to be infected. There were no deaths documented, according to a report the USDA submitted to the World Organization for Animal Health.

Genomic sequencing indicates that the H5N1 virus infecting the alpacas (B3.13) matches both the virus currently circulating among US dairy cows and the virus that infected birds on the farm.

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After mice drink raw H5N1 milk, bird flu virus riddles their organs

Fresh raw milk being poured into a container on a dairy farm on July 29, 2023, in De Lutte, Netherlands.

Enlarge / Fresh raw milk being poured into a container on a dairy farm on July 29, 2023, in De Lutte, Netherlands. (credit: Getty | Pierre Crom)

Despite the delusions of the raw milk crowd, drinking unpasteurized milk brimming with infectious avian H5N1 influenza virus is a very bad idea, according to freshly squeezed data published Friday in the New England Journal of Medicine.

Researchers at the University of Wisconsin-Madison squirted raw H5N1-containing milk from infected cows into the throats of anesthetized laboratory mice, finding that the virus caused systemic infections after the mice were observed swallowing the dose. The illnesses began quickly, with symptoms of lethargy and ruffled fur starting on day 1. On day 4, the animals were euthanized to prevent extended suffering. Subsequent analysis found that the mice had high levels of H5N1 bird flu virus in their respiratory tracts, as well their hearts, kidneys, spleens, livers, mammary glands, and brains.

"Collectively, our data indicate that HPAI [Highly Pathogenic Avian Influenza] A(H5N1) virus in untreated milk can infect susceptible animals that consume it," the researchers concluded. The researchers also found that raw milk containing H5N1 can remain infectious for weeks when stored at refrigerator temperatures.

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