Immunizations
How America Lost Control Of The Bird Flu, Setting The Stage For Another Pandemic
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 875 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 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. "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. "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."
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, as 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 in May.
"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 he suspected that 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.
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 hadn't heard about the bird flu, never mind tests for it.
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."
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 President-elect Donald Trump comes into office in January, farmworkers may be even less protected. Trump's pledge of mass deportations will have repercussions whether they happen or not, said Tania Pacheco-Werner, director of the Central Valley Health Policy Institute in California.
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."
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 have been 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. Bird flu tests could be run only by the CDC and public health labs until this month, even though commercial and academic diagnostic laboratories had inquired about running tests 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.
Get CNN Health's weekly newsletterCurtailing 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."
Concern Grows Over Whether Bird Flu Could Lead To A Pandemic: What To Know
H5N1 bird flu, a type of avian influenza, has infected dozens of people in the U.S., and spread to eight states and Canada this year.
As concern grows over whether bird flu could lead to another pandemic or lockdown, California has now declared a state of emergency after the virus was found in more dairy cows.
Hundreds of dairies have been infected, the California Department of Food and Agriculture reports.
The emergency proclamation will "ensure government agencies have the resources and flexibility they need to respond quickly to this outbreak" with testing and monitoring, Gov. Gavin Newsom said in a statement on Dec. 18.
The risk to the public remains low, he added.
Earlier in December, California announced a broad recall of raw milk and cream after the virus was found in some raw milk dairy.
The state is home to 34 human cases of bird flu, or more than half of the country's total, according to the CDC. None are linked to raw milk.
Bird flu severe case in LouisianaThe same day that California announced its state of emergency, the the Centers for Disease Control and Prevention confirmed the first severe human case linked to bird flu in the U.S. In Louisiana.
The patient is in the hospital after being exposed to sick and dead birds in backyard flocks suspected to have been infected with H5N1, according to the Louisiana Department of Health.
The person, who is over age 65 and had underlying medical problems, is in critical condition with severe respiratory illness, Emma Herrock, a spokeswoman for the Louisiana Health Department, told NBC News.
"Previously, the majority of cases of H5N1 in the United States presented with mild illness, such as conjunctivitis, and mild respiratory symptoms and fully recovered," Dr. Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases, said during a media briefing on Dec. 18.
"It's notable that this is the first human case of H5N1 associated with a backyard or noncommercial flock."
Investigators believe exposure to the virus happened on the Louisiana patient's property, Daskalakis added. He declined to comment about the person's symptoms.
A "sporadic case" of severe H5N1 bird flu illness is not unexpected, the CDC said in a news release, noting the infection has previously been associated with severe human illness and death in other countries during and before 2024.
"This case does not change CDC's overall assessment of the immediate risk to the public's health from H5N1 bird flu, which remains low," the agency noted.
Bird flu in humansDr. Peter Chin-Hong, an infectious disease physician at UCSF Health, says he's very concerned about the severe case in Louisiana.
"I'm not saying this is a cause for panic right now. But in the medium-term, I think all the signs are pointing to the temperature rising with bird flu in terms of its potential impact on humans," Chin-Hong told NBC News.
There have been 61 confirmed cases in the U.S. In total.
Almost all human bird flu patients have had contact with infected animals, but two cases in North America are getting particular attention because it's not known how they were exposed to the virus: a teenager in Canada and a person in Missouri.
The Canadian teen remained in critical condition at the end of November, weeks after symptoms started, and was being treated for acute respiratory distress at a children's hospital in British Columbia after testing positive for H5N1 bird flu, the country's first human case, the CBC reported.
The patient "was a healthy teenager prior to this" with no underlying conditions, the province's health officer, Dr. Bonnie Henry, said in a news conference. The young person's deterioration was "quite rapid," she added.
"It reminds us that in young people, this is a virus that can progress and cause quite severe illness," Henry noted.
Could bird flu cause the next pandemic? Here's what to know about raw milk and bird flu, symptoms, how to protect yourself and more.
Raw milk recall amid bird flu outbreakThe recall was implemented after "multiple bird flu virus detections" were found in products from Fresno's Raw Farm, LLC, the California Department of Public Health announced.
All sizes of Raw Farm milk and cream produced between Nov. 9 and Nov. 27, have been pulled from store shelves, according to the notice. The affected lot numbers are 20241109 through 20241127.
The California Department of Public Health has also placed the farm under quarantine.
There are no reports of anyone getting sick, but consumers "should immediately return" any of the recalled products they may have in their fridge, the agency added.
Raw milk, which is not pasteurized, can expose people to germs and lead to serious health risks, the Centers for Disease Control and Prevention has warned.
Consumers don't realize the raw milk they buy is not from a single cow, but pooled from many cows, says Dr. Ian Lipkin, an expert on emerging viral threats.
"If one cow in that group has H5N1, then it gets distributed to many, many more people," Lipkin, professor of epidemiology at the Columbia University Mailman School of Public Health, tells TODAY.Com. "It's not a good situation."
Drinking or accidentally inhaling raw milk containing bird flu virus may lead to illness, California health officials warn. So can touching your face after touching the contaminated milk.
Pasteurized milk is safe to drink because pasteurization kills the bird flu virus and other germs, the experts emphasize.
The U.S. Department of Agriculture has ordered testing of milk for the virus, requiring that raw milk samples nationwide be collected and shared with the agency.
What is bird flu?Like people, birds can get the flu, and the avian influenza viruses that make birds sick can sometimes infect other animals like cows and, rarely, people, the National Library of Medicine explains.
H5 is one family of bird flu viruses. It has caused widespread flu in wild birds worldwide and is causing outbreaks in poultry and U.S. Dairy cows, the CDC notes. Some farm workers exposed to those animals have also gotten sick.
H5 has nine subtypes, including H5N1, the strain responsible for the recent illnesses.
Bird flu in the USA: Which states have cases?There have been 61 confirmed human cases in eight states in the U.S. During the 2024 outbreak, according to the CDC.
Human cases of bird flu have been reported in eight states.TODAY Illustration / Getty Images They've been reported in:
Probable cases have also been reported in Arizona and Delaware, though the CDC was unable to confirm the presence of H5N1 in those samples in its laboratory.
Almost all U.S. Patients had contact with infected cattle, poultry, backyard flocks, wild birds or other animals.
There's been no confirmed person-to-person spread.
Bird flu outbreak 2024"We do have an outbreak of human infections of H5N1," says Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security and a spokesperson for the Infectious Diseases Society of America.
The current public health risk from H5 bird flu is low, the CDC says. Its flu monitoring systems currently show no signs of unusual flu activity in people, including the H5N1 virus, or any unusual flu-related trends in emergency department visits.
But the agency is "watching the situation carefully" — as are experts in the field.
Lipkin calls it an important health concern.
"Emerging infectious diseases are unpredictable. If you told me 20 years ago that we were going to have major problems with coronaviruses, I wouldn't have predicted that," Lipkin says.
"So nobody knows what's going to happen with this particular flu."
Human infection with bird flu can happen when virus gets into a person's eyes, nose or mouth, or is inhaled, according to the CDC. The illness can range from mild to severe and can be deadly.
Human H5N1 cases in the U.S. Have been relatively mild, perhaps because people are mostly getting infected through their eyes, Adalja notes.
It might happen when a dairy worker is milking an infected cow and gets squirted in the face with the milk, for example.
"You're getting infected from the eyes rather through the respiratory route," Adalja tells TODAY.Com. That may be "less risky than respiratory inhalation" of the virus, he adds, when it can go to the lungs.
Is bird flu a global health emergency?No, the World Health Organization doesn't currently categorize the bird flu outbreak as a global health emergency. Outbreaks that do fall into this category include COVID-19, cholera, dengue, Marburg virus and mpox.
The state of California recently declared a state of emergency over bird flu.
Could bird flu turn into a pandemic?Experts say it's unlikely this particular strain of bird flu would lead to a pandemic because it doesn't have the ability to spread efficiently between people.
H5N1 has been infecting humans since 1997, so it's had time to evolve, but still doesn't easily jump from person to person, Adalja points out.
"I don't think that this is the highest risk bird flu strain," he says. "You can't say the risk is zero. But of the bird flu viruses, it's lower risk."
Lipkin had a similar take.
"Nobody ever wants to say never because you can be wrong," he cautions. "Could this virus evolve to become more transmissible? Yes. Has it done so thus far? No. Do I personally think it's going to be responsible for the next pandemic? No. Could it be? Yes."
One concerning development is that a pig in Oregon tested positive for H5N1 in October — the first time the virus has been detected in swine in the U.S., NBC News reported.
It's worrisome because pigs can become infected with both bird and human viruses at the same time, allowing mutated strains to emerge.
"Pigs are considered a mixing vessel for flu viruses. So we always worry when a pig gets infected with a bird flu strain because pigs can also be infected with other strains," Adalja says.
"Those strains can all recombine in the pig as a mixing vessel and then something different will come out."
Since there are many different avian influenza strains, one of them may be able to cause a pandemic at some point in the future, Adalja adds.
The bird flu strain he's more worried about as a pandemic risk is H7N9, which was first reported in humans in China in 2013 and expanded to more than 1,500 people by 2017. This virus also doesn't spread easily from person to person, but when people do get infected, most become severely ill, the World Health Organization warns.
The most recent human H7N9 virus infection was reported in China in 2019, according to the CDC.
Could there be a lockdown due to bird flu?A lockdown due to bird flu is not likely for this strain, since H5N1 isn't posing a threat to the general public, both experts say.
If that were to change, people should realize lockdowns, like those during COVID-19, are not the "go-to measure" for an infectious disease emergency, Adalja says, calling them "very blunt tools."
Instead, proactive measures — such as more aggressive testing of farm animals — will allow health officials to be much more precise when it comes to stopping the spread of infection, he notes.
When it comes to lockdowns, there's also the question of how far authorities are willing to go.
"If H5N1 were to become a major health problem, we would have to talk about (containment)," Lipkin says. "But I don't think that this incoming administration is going to be amenable to that."
What is the treatment for bird flu?It's oseltamivir, also known as Tamiflu, the same antiviral medication used for ordinary cases of flu.
It's important to start that drug as soon as possible after symptoms start for it to have impact, Lipkin says. Some close contacts of people who've been infected with H5N1 have also received the drug as a precautionary measure to prevent infection.
Is there a bird flu vaccine?Four vaccine candidates for dairy cows have been approved for field trials, according to the U.S. Department of Agriculture.
In poultry, four potential bird flu vaccines began to be tested in 2023, Reuters reported.
When it comes to humans, the CDC says the U.S. Government is developing vaccines against H5N1 viruses "in case they are needed."
The agency adds it has H5 candidate vaccine viruses that could be used to produce a vaccine for people, and preliminary analysis shows "they are expected to provide good protection" against H5N1.
There are also some vaccines in the strategic national stockpile that are closely — if not exactly — matched to this particular strain of bird flu, Adalja says.
"There are efforts to make more updated vaccines. But there is no widespread vaccination program being initiated against H5N1 at this time in the U.S.," he notes.
In the summer of 2024, Finland became the first country in the world to offer bird flu vaccinations for people at risk of exposure, including workers at fur and poultry farms.
Finland bought vaccines for 10,000 people, each requiring two injections, Reuters reported.
In December 2024, the United Kingdom announced it has secured more than 5 million doses of human H5 influenza vaccine. The purchase will "boost the country's resilience in the event of a possible H5 influenza pandemic," the UK Health Security Agency said in a statement.
What does bird flu do to humans?Bird flu in humans can cause no symptoms, or anywhere from mild to severe symptoms, according to the CDC. Most people who have been infected with bird flu have reported mild symptoms, such as eye infections and flu-like symptoms, according to Yale Medicine.
The CDC lists the following bird flu symptoms:
Yes, bird flu can be deadly.
The mortality rate of bird flu in humans, based on the roughly 900 confirmed people infected with the virus between 2003 and 2024, is about 50%, according to Yale Medicine.
However, it's likely that many more people have been infected without knowing it because they had no or mild symptoms, so the mortality rate could be much lower than 50%. And the mortality rate would likely drop even further if treatment and vaccines were made more wildly available, should human-to-human spread start to occur.
How does bird flu spread to humans?There are several ways the bird flu virus can spread from animals to people, according to the CDC:
The people most at risk for H5N1 bird flu are dairy and poultry workers who might be around infected animals, Adalja says. They should wear personal protective equipment while working on farms affected by the virus, the CDC advises.
When it comes to the general public, "don't consume raw milk, full stop" since H5N1 is viable in it, Lipkin says. Pasteurized milk can eliminate the risk of infection, he notes.
Properly cooked chicken is safe to eat, but wash your hands with soap and water after handling raw chicken, he adds.
It might be wise to skip petting zoos or events where you can learn how to milk a cow, Adalja adds.
Avoid direct contact with sick or dead wild birds, poultry and other animals, the CDC advises.
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Feb. 22, 2024 — First large-scale analysis of optimal timing for flu shots finds October is the best month for children to get vaccinated against influenza. Study of 800,000 pediatrician visits leverages links ...
Feb. 19, 2024 — The prospect of the worrisome triple threat of COVID, RSV and flu was assuaged last year by the effectiveness of flu vaccines. Two recent studies from the Centers for Disease Control and ...
Feb. 13, 2024 — Researchers have shed new light on how viral evolution, population immunity, and the co-circulation of other flu viruses shape seasonal flu ...
Feb. 6, 2024 — Influenza A viruses with induced resistance to a new candidate antiviral drug were found to be impaired in cell culture and weakened in animals, according to a new ...
Dec. 21, 2023 — Researchers have identified a previously unrecognized class of antibodies -- immune system proteins that protect against disease -- that appear capable of neutralizing multiple forms of flu virus. ...
Oct. 31, 2023 — Recent preclinical results indicate novel next-generation vaccine candidates protect against multiple strains of influenza and last longer than vaccines currently in ...
July 27, 2023 — A new study of the strain of influenza A responsible for the 2009 H1N1 pandemic -- pdm09 -- shows that the virus has passed from humans to swine about 370 times since 2009, and subsequent circulation ...
July 24, 2023 — While the incidence of influenza-associated neuropsychiatric events in children in the United States is unknown, the controversy over the use of a common antiviral medication typically administered ...
Apr. 13, 2023 — New research has found that First Nations populations around the world are significantly more likely to be hospitalized and die from influenza compared to non-Indigenous ...
Feb. 16, 2023 — The United States, the largest importer of wildlife in the world, is not prepared for future spread of animal-borne, or zoonotic, diseases due to gaps among governmental agencies designed to combat ...
Nov. 25, 2022 — An experimental mRNA-based vaccine against all 20 known subtypes of influenza virus provided broad protection from otherwise lethal flu strains in initial tests, and thus might serve one day as a ...
Nov. 16, 2022 — Children with a severe form of epilepsy should be vaccinated against the flu due to the high risk of seizures being triggered by an influenza infection, according to a new ...
Nov. 15, 2022 — The study showed that over the entire year the influenza vaccine reduced pneumonia by 40 per cent and hospitalization by 15 per cent in patients with heart failure. During influenza season in the ...
Nov. 2, 2022 — Researchers have discovered a high prevalence of COVID-19 co-infections in central Missouri during the 2021-2022 flu season, with a monthly co-infection rate as high as 48 percent among individuals ...
Sep. 7, 2022 — Getting an annual flu shot may be associated with a lower risk of stroke, according to a new ...
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