Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week. This week my focus is avian influenza, also known as highly pathogenic avian influenza virus A (H5N1), or HPAI. For some time now, we’ve been hearing about H5N1 in birds and then in other mammals, including seals, polar bears, cows, cats, and foxes, among others.
On Monday, April 1, a person, who had close contact with dairy cows in Texas, tested positive for H5N1. This individual only has one symptom — pink eye; clinically we say this is an infection of the conjunctiva (or the tissue surrounding the eye). They are being treated for H5N1 with the antiviral Tamiflu.
So far NONE of the the case’s close contacts have reported any symptoms.
To date — H5NI has been confirmed in cattle in Texas, Kansas, Michigan, Idaho, Ohio, and New Mexico.
This strain of influenza is NOT new. It has been circulating and spreading for the past 20 years. During that time, there have been more than 900 human cases in 23 countries. While the number of species (of birds and mammals) infected with H5N1 and the geographic range of the disease spread is increasing, the risk of infection in humans is really low (at this point in time).
Please note, according to Dr. Mike Osterholm, Director of the Center for Infectious Disease Research & Policy at the University of Minnesota —
“This all could change in a heartbeat with additional mutations. But there’s no evidence this virus has changed.”
Given that we have our first human case of avian influenza in the US in 2024, here are the three things you need to know.
Hoping these posts help to educate and empower you
to be healthy and create healthy communities.
This Is News, NOT An Alarm
The first thing to know — H5N1 has been around for two decades and it is going to continue to spread. As the virus spreads, public health researchers are going to continue to conduct genomic surveillance of the virus — looking for possible genetic changes in the virus that might make it more transmissible or more virulent.
There will be news about H5N1.
When you hear of a new case of H5N1 or a new strain of the virus, this is NOT an immediate cause for concern.
News of a new case is the report of a discovery. Not an alarm bell.
Given the countless headlines and reports about the human case of H5N1, how do we not get bogged down by all of the headlines?
There is no simple answer, but here is what I propose we all do —
First, we acknowledge that H5N1 will continue to spread. When the next case is discussed in the news, we acknowledge it as a discovery. It is NOT an alarm bell.
Second, we must recognize the difference between a report of a discovery versus a public health concern. If/when there is evidence that H5N1 is able to spread from person to person (with ease) or completely evade our immune system, then — and only then — should we begin to think about H5N1 as a public health concern.
Finally, finding a middle ground between complete ignorance and absolute fear is necessary.
This means we must understand what is expected from the virus and that discoveries will be reported. The H5N1 virus will continue to spread. And there will be more human cases (I am guessing). If those discoveries are reported or are headlines, there is no reason to fear.
If there is evidence of person-to-person spread, then we can treat the news as a public health concern.
We should look toward trusted sources of public health information for guidance.
I will ring the alarm bell if/when the time comes. Be sure you are subscribed so you don’t miss a thing —
The Milk Supply Is Safe
While H5N1 has been confirmed in dairy cows in several states, the commercial milk supply is safe. The process of pasteurization, which inactivates bacteria and viruses, keeps our milk safe.
As a general rule of thumb — we should all drink pasteurized milk.
Raw (or unpasteurized) milk can make you really sick.
It is also important to note — at this point, there is NO evidence that the H5N1 virus has infected the beef cattle in the United States. Beef is safe to eat.
Human-Animal Relationships
As we think about what it means to create healthy communities and stay healthy as individuals, it is important to point out that diseases do not just spread from person to person. But viruses can also spread from animal to person and person to animal.
Public health must continue to monitor the health of animals. We need to keep tabs on what viruses are spreading among which species.
It is also essential that we quarantine and isolate animals to prevent the spread of disease among animals and from animals to humans.
This means that we need to think about our relationships with animals.
Animals are part of our Health(eco)system.
We all need a healthy environment in which to live. We need access to care, affordable health care, safe places to exercise, safe schools, access to food, clean drinking water, proper sanitation, buildings with adequate air circulation, healthy animals, and so much more…
Our whole health(eco)system needs to be healthy.
Our definition of what it means to be healthy needs to shift drastically. We need to add to the definition of health and reframe our thinking about being healthy to include individual actions PLUS working towards healthy families, healthy communities, and healthy environments.
When our health is threatened, everything — from our economy to education, our food supply to our vacation destinations, our day-to-day activities to our future plans — is disrupted, threatened, and challenged.
We need to include the health of our pets, barnyard animals, and wild animals in our definition of what it means to create healthy communities.
Questions? Thoughts?
Be sure to share this post with your friends & family who are talking about or asking questions about avian influenza —
Epi(demiology) Matters is written by Dr. Becky Dawson, PhD MPH — an epidemiologist, teacher, mom, wife, and dedicated yogi. She is a tenured professor at Allegheny College, Research Director at a community hospital, and an exclusive contributor (all things health & medicine) at Erie News Now (NBC/CBS). Her goal is to create healthy communities for all. She writes Epi Matters — first & foremost because epidemiology does matter (to all of us) and she hopes that each post will help to educate and empower readers to be healthy and create healthy communities.
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I bet you wanted to say we should all NOT drink unpasteurized milk....
This message caught my attention! I just got over Pink Eye.