The increasing threat of bird flu is becoming too big to ignore as it continues to spread to an unprecedented number of species around the world, affecting egg prices as huge swaths of poultry are infected and killed with the virus. This week, police in Pennsylvania even reported 100,000 eggs were stolen from a distributor with an expected value of $40,000.
Although the Centers for Disease Control and Prevention (CDC) maintains the risk of bird flu to be low for the general population, H5N1, the virus responsible, continues to expand its range and the number of species it infects, concerning many that a recombination event will occur and it will turn into a full-blown pandemic like COVID-19.
As of this writing, two strains of highly pathogenic avian influenza (HPAI) have been responsible for millions of cow and poultry deaths in the United States. One strain called B3.13 spreads mostly in cows, and a strain called D1.1 spreads mostly in birds.
However, this week, the U.S. Department of Agriculture (USDA) announced that dairy herds in Nevada had been infected with the strain that most commonly infects birds, which was also associated with a severe infection in a Canadian teenager and the one human death from bird flu that occurred in Louisiana last month. All together, these strains have infected dozens of different species, including at least 67 humans, in an unprecedented spread.
With the world still recovering from the COVID pandemic, most would agree the last thing it needs is another pandemic. Although many have criticized the Biden administration’s response to bird flu as doing too little, too late, others are more concerned that the Trump administration, including Robert F. Kennedy Jr., who is undergoing confirmation to serve as health secretary, could make things worse.
Nevertheless, there are things you can do to understand your risk and protect yourself. Salon asked experts to unpack some common questions that can help you navigate bird flu.
Can you get it from eggs or raw milk?
The pasteurization process and safety standards set by the Food and Drug Administration (FDA) are designed to kill viruses like bird flu, so pasteurized egg and milk products are safe to consume. However, bird flu has been detected in raw milk, and the agency does not recommend people drink raw milk, not just for the potential spread of bird flu but also for other diseases like Salmonella or E. Coli. Raw milk laced with bird flu has killed cats that have consumed it.
“We know that when we have infected cows, the virus concentrates at extremely high levels in the mammary tissue and the milk is teeming with virus,” said Dr. Shira Doron, chief infection control officer for Tufts Medicine in Boston and hospital epidemiologist at Tufts Medical Center. “Luckily for the most part, pasteurization kills the virus, but raw milk would be expected to be absolutely loaded with the virus.”
How can you tell it apart from normal flu if you have symptoms? What should you do if you're infected?
There are not yet readily available tests for the general public to distinguish between regular influenza and bird flu, which may share common symptoms like fever, cough and sore throat. This has made the growing crisis difficult, as seasonal influenza is surging lately and symptoms can sometimes overlap.
One distinctive feature of bird flu in many of the human cases in farmworkers has been conjunctivitis, or pink eye, though to occur when excretions from an infected farm animal (i.e. milk) hit their face.
If you think you have some kind of flu, it is recommended to get tested, as bird flu will be detected on traditional flu tests that can then be funneled through a national surveillance system designed to catch human bird flu cases.
“If you come in ill and have a backyard flock of chickens, we’ll want to get specimens from you to get the virus and send it to the state laboratory, where they will then do molecular fingerprinting,” said Dr. William Schaffner, infectious disease doctor at Vanderbilt University. “The average person and the average doctor in the average hospital can't tell whether you have bird flu and would have to send that specimen off for more sophisticated testing, but the chance of that happening is pretty darn low.”
If you have or live near a chicken coop should you be worried? Can your pets get it?
The H5N1 virus is so prevalent in nature that experts advise everyone to avoid dead or sick birds and call the local health department if you come across them in your yard or elsewhere outside. It’s important to keep your pets away from dead birds as well, as the virus has been shown to transmit to cats and dogs. Raw pet food should also be avoided as it carries a risk.
If you have backyard chickens — which about 13% of U.S. households do — they could be at risk if a migratory bird with H5N1 comes into contact with them. If you are spending time with backyard birds or even spend a lot of time around bird feeders, it’s a good idea to practice the classic protocol for keeping viruses at bay, including washing your hands frequently, wearing gloves and a mask when handling them, and monitoring closely for any signs of sickness.
If any pet chickens do show signs of illness or die, call your local health department for guidance. Experts maintain that the risk of infection is low, although the Louisiana patient, an older individual with underlying health conditions, did die from bird flu that originated from a backyard flock of sick birds.
“This can occasionally happen, but there was no transmission from him to anyone else, and the instances of infection in the U.S. have been pretty few and largely confined to people who work in the poultry or dairy industry,” Schaffner told Salon in a phone interview. “Other infections have been mostly mild so far, and this is not a virus that can readily infect humans — at least not yet.”
On Thursday evening, the New York Times reported that the CDC posted data — that was then abruptly deleted — that found cats infected with bird flu might have spread the virus to humans in the same household and vice versa. It's not clear why the data was removed. "At least 85 domestic cats have been infected since late 2022, according to the U.S. Department of Agriculture. But there had not previously been any documented cases of cats passing the virus to people," the Times reported.
Is there a vaccine? Will flu drugs work against it?
The U.S. stockpiled a bird flu vaccine in 2014 and 2015, but those vaccines were designed with another outbreak in mind that doesn’t quite match what is happening now. However, earlier this month the USDA announced it would begin building another stockpile with vaccines that were updated to the current virus strains circulating.
“Right now, we have farmworkers at a significant risk but acquiring mild disease, and we don’t vaccinate against mild disease,” Doron told Salon in a phone interview. “One trigger [to vaccinate farmworkers] could be if, for example, this Nevada situation ends up causing severe disease.”
One of the best things to do to prevent a bird flu pandemic is getting a regular flu shot because it prevents someone from being infected with both bird flu and seasonal influenza, which could swap genes within the infected person to produce a more deadly or infectious strain of bird flu.
The available data from human bird flu infections shows that regular flu drugs should work against it. However, like with any virus, those who are immunocompromised, older or with underlying conditions could be more at risk to a serious infection, and the earlier a treatment is started the higher its chance of success.
“Tamiflu works for bird flu. It’s not a super powerful drug for regular flu, so it’s probably not going to be a wonder drug for the bird flu,” said Dr. Melanie Ott, a virologist at UC San Francisco. “But if you take it early, it can blunt the worst symptoms and shorten the disease.”
How deadly is bird flu? Should you mask in public?
Since H5N1 first infected humans in 1997, its overall mortality rate among 954 confirmed cases globally has been reported to be about 50% — much, much higher than the death rate of seasonal influenza or COVID. However, this percentage might not be capturing many undetected cases of bird flu, making it an overestimate. Additionally, most of these deaths have historically occurred in rural areas among farmworkers working closely with livestock who might not have access to health care and treatment.
Thus far, one death out of roughly 70 cases in the U.S. would suggest the fatality rate is far lower. However, the concern is that the virus could mutate to become more contagious and dangerous. At population scales, deaths occurring for every 1 in 70 people would still be massive. Death isn't the only negative outcome, of course. Even if people only became mildly sick, the economy could take a major hit as tons of people miss work. The Vancouver teen that was hospitalized by bird flu was on life support and in the hospital for two months. If infections were to occur in a major city or across the country, hospitals could be overrun with patients. While we could be inching closer to such a scenario, we haven't reached that point yet — but should still take it seriously, experts caution.
“We have had more than one seriously ill person, including a child, so I would not underestimate this infection, as it has shown in the past to be very dangerous,” Ott told Salon in a phone interview.
Because person-to-person spread of bird flu has not yet been detected, things are not at a point where mask-wearing has been recommended. However, it could help reduce the spread of other viruses, like COVID and normal flu, which are far more prevalent right now.
What is the federal government doing to stop it? Will it become a pandemic?
Several government agencies have a role to play in protecting the public from bird flu, including the CDC, the USDA, and the FDA. The CDC has a national surveillance system to track the spread of bird flu in humans and can help local health departments investigate potential exposures, while the FDA monitors egg and milk products to make sure they are safe for consumption.
The USDA performs surveillance on wild birds to help understand how the virus is spreading along migratory pathways and also tests dairy and poultry farms for bird flu. In the case that it is detected, the agency can use federal funding to kill a flock and reimburse farmers. However, there are gaps in this system where some farmers don’t report illness, and dairy cows, for example, are only required to be tested when crossing state lines.
Many have argued that these agencies should be doing more to test people and farm animals to understand how the virus is circulating as each infection is essentially another chance for bird flu to evolve into something more dangerous.
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The Biden administration pumped $306 million into the bird flu response before leaving office, but the Trump administration has yet to roll out a plan on how to address bird flu. It remains to be seen if the mutations necessary to make bird flu a pandemic will occur, but in its current state bird flu still remains a complex threat that involves several different federal agencies’ response.
“Any influenza can become a pandemic at any time, but that doesn't mean it will,” Doron said. “It would have to be way more contagious, meaning it would have to really mutate from its current forms to be more readily transmissible between humans to cause a pandemic. And it's just not at all there yet.”
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