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This month the California Gov. Gavin Newsom declared a state of emergency after epidemiologists confirmed the spread of bird flu in 34 people. Louisiana also reported one serious case, causing the U.S. Centers for Disease Control and Prevention, and others in the health community to closely monitor the outbreak.
As of Friday there were 64 human cases throughout the country, and none in Utah, according to the CDC.
For some, the announcement made four years after the start of the COVID-19 pandemic lockdown can be anxiety-inducing. Experts from Utah say that this is a “very different landscape than COVID.”
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The outbreak of H5N1, most commonly known as bird flu, isn’t as novel as the coronavirus was during its peak, Dr. Ben Bradley, assistant professor at the University of Utah and medical director at Salt Lake City-based ARUP laboratories, said in a virtual call with reporters on Friday.
“We’ve been much more proactive in addressing this outbreak,” Bradley said, “in part because we’ve been able to monitor it more quickly.”
There’s already the capacity to detect the flu in laboratories across the country with seasonal influenza virus testing — though it wouldn’t be able to make the distinction of the H5 virus, Bradley said. In fact, commercial labs and device manufacturers received funding to expand the capacity to test the virus.
Additionally, the Food and Drug Administration has loosened some of its regulations to expedite testing capacity.
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Mutations in the H5N1 virus can result in different symptoms across the flu cases. There is still a small amount of data, Dr. Bobbi Pritt, chair of the College of American Pathologists’ Council on Scientific Affairs said on Friday. But the D1.1 genotype is the one seen in the human cases in the U.S. and Canada that have been severe, she said. That’s also a genotype seen in wild birds.
The B3.13 strain, often seen in dairy herds, is mostly associated with milder symptoms like conjunctivitis, Pritt said. However, when these types of viruses are replicating within a person or animal, it could have ongoing mutations that can be easily transmitted.
“At this point, the B3.13 strain doesn’t seem to be associated with severe disease, but we’ll have to keep an eye on that,” she said.
Bird flu red flags
If you are looking for red flags that may indicate an outbreak may be more serious, search for mystery cases, Bradley said.
Most of the human cases reported since the spring happened among poultry and dairy workers, according to the CDC. However, two cases don’t have a clear link to dairy cattle or poultry exposure.
“Those things are certainly concerning for me, because we would like to see that there’s a clear epidemiological link to a bird or poultry or something like that,” he said. “So if we would be seeing more of those cases, that’s something that would lead me to be concerned.”
While there are over 60 confirmed cases among humans, the total number of those infected is still uncertain. Not knowing the full picture is also concerning for Bradley. And one big challenge to monitoring the outbreak is the livelihood of those who are most vulnerable to the virus.
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“We are dealing with kind of marginalized populations here, folks whose livelihood depends on them going to work and not being sick. So that also raises challenges for testing this kind of vulnerable population,” he said. “And that’s something else that we’ve really needed to, from a public health standpoint, make efforts towards testing.”
There aren’t any mutations that make Pritt worry about a potential wider spread between humans. However, there are many animals infected, and with every host, the possibility of mutations expands, she said.
She also remains watchful of some other mammals, including domestic cats and, especially, pigs, since they can get infected with both bird and human influenza viruses.
“And then you kind of have like this mixing pot where the two viruses can share genetic material and create new viruses. So that’s always a concern as well, hence the need for continued monitoring,” she said. “Even though at this point we’re saying, no need to panic.”
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