QUICK TAKE ON BIRD FLU

Bird flu is caused by the Highly Pathogenic Avian Influenza A (H5N1) Virus.

Who gets it?

Birds are primarily infected. Most wild birds can be infected without appearing ill.  If it spreads to poultry (chickens, ducks, turkeys and geese) the birds may become very ill and die. When outbreaks in large flocks occur, the birds are all euthanized in an attempt to stop the spread. This may involve euthanizing millions of birds. With the spread of this disease our food sources may be more expensive or limited.

Most common songbirds do not become infected with viruses that are dangerous and spread to poultry or people.

Although it is primarily an avian disease, it is transmitted to many animals and there have been outbreaks in dairy cows in contact with infected chickens, and in wildlife that presumably scavenged infected dead birds.

Migratory waterfowl, swans, geese, ducks, shorebirds, chickens and turkeys are all susceptible. Recently two grizzly bears in Montana were found ill and euthanized, both had bird flu. In Washington State, mountain lions in the wild died of bird flu and 20 large cats in a sanctuary including cougars and a Bengal tiger were killed. It has also infected goats, polar bears in the Arctic, fur seals in Antarctica, raccoons, foxes skunks, ferrets, cats and dogs.

Humans have developed the bird flu, typically from close exposure to sick fowl. One person died who had high exposure and chronic health problems.

How is it spread?

Body fluids from infected or dead birds spread the disease through close contact in flocks and to people handling sick or dead birds by contact or breathing in droplets or dust.

How can you prevent spreading the virus?

People handling sick or dead birds should wear N95 masks that fit tightly to the face and wear gloves. Protective clothing may also be needed.

 Humans have become infected by breathing the virus in droplets in the air or dust, and by touching contaminated surfaces, then touching their eyes, nose or mouth. Wash hands, surfaces and tools with soap and water. Also use anti-bacterial/anti-viral sprays to clean surfaces.

If you are a backyard flock owner there are online guidelines available. Pets and flocks need to be monitored closely. Report concerns to your veterinarian and the health department.

What are the symptoms?

Animal and bird behavior: inactivity, sleeping more than usual, poor balance, walking in circles, tremors, and seizures. Birds may breathe with the beak open, wing drooping, feathers fluffed, discharge around beak, nostrils, eyes.

Human symptoms: fever, chills, cough sore throat, trouble breathing, headache, runny nose, eyes tearing with redness and discharge from the eyes, muscle aches and diarrhea. The symptoms usually begin within ten days of exposure. Infections should be reported to the state health department.

What is the treatment for humans?

Antiviral medications such as Tamiflu can be used to treat and prevent bird flu after known contact such as unprotected exposure (ex. not wearing a mask or eye protection).

What about consuming milk, chicken and eggs?

Do not eat infected fowl or drink raw unpasteurized milk. Do not eat ice cream or cheese made from raw milk. More testing is required to determine safety of these products.

Poultry and eggs must be cooked to 165 degrees to kill bacteria and viruses. Cooking beef and other meats to 165 degrees for safety.

Is vaccination available?

The US has a stockpile of vaccine developed for H5N1 infection but they have not been tested in clinical trials and immunization is not recommended at this time.  Several companies are working on an mRNA vaccine and Moderna received a large grant to update its mRNA vaccine. These are all being tested in people for safety and effectiveness. There are numerous subtypes of flu. Current studies include the two most common subtypes in humans, A & B plus the bird flu influenza A- H5N1 subtype.   

CDC recommends getting the seasonal flu vaccine. It does not cover H5N1, but you would have reduced severity of the seasonal flu. It could also decrease the probability of mutation of the bird flu virus to a form that would more easily infect humans if you developed a co-infection of bird flu and influenza simultaneously.

At this time the spread to humans is low but mutations in the avian virus can evolve as it did with COVID-19 allowing it to more easily infect humans. Monitoring and reporting are very important for containment and to minimize spread particularly in major outbreaks in commercial dairies and businesses raising fowl.

Are we ready for a pandemic?

No. Clinical testing needs to be completed for H5N1 vaccine effectiveness and safety. The Trump administration just stopped NIH and CDC activities including research and the weekly MMWR publication (Morbidity and Mortality Weekly Report) so it will be difficult to get current data on study information and on emerging infections.

References: CDC U.S, Centers for Disease Control and Prevention including-

https://www.cdc.gov/bird-flu/prevention/hpai-interim-recommendations.html

https://www.cdc.gov/bird-flu/situation-summary/index.html

Betty Kuffel, MD