US ‘underprepared’ for bird flu outbreak, epidemiologists warn

The United States is woefully “underprepared” for a bird flu outbreak, experts have warned. This comes after a second human case of bird flu was announced by the US Centers for Disease Control and Prevention (CDC) in connection with an outbreak affecting dairy cows in several states.

Highly pathogenic avian influenza is an infectious viral disease that spreads primarily among wild and domestic birds. But the virus that causes bird flu can sometimes be transmitted to animals, including dairy cows, and in some cases to humans.

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On Tuesday, the CDC issued new recommendations for state and local health officials to continue operating flu surveillance systems at enhanced levels over the summer to identify flu surveillance systems. other human infections with the H5N1 avian influenza virus.

However, epidemiologist and public health policy expert Brian Castrucci said News week that the United States is not prepared for a possible epidemic.

“The United States is underprepared for bird flu because we have not learned the lessons of COVID,” said Castrucci, president and CEO of a public health nonprofit, the Bird Flu Foundation. Beaumont. “Reporting is key to tracking an emerging infection, but there are barriers to reporting.”

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Jessica Malaty Rivera, an epidemiologist and science communications advisor at the deBeaumont Foundation, said the main obstacle here is the lack of data.

“Evidence suggests the outbreaks first appeared late last year, which means we are unlikely to see the scale of the situation,” she said. News week. “We also face a trust issue among farmers who are reluctant to come forward if they are sick and participate in testing for reasons related to document insecurity, language barriers and lack of sick leave. “

Neglecting this human component can lead to under-reporting of human cases, with repercussions on surveillance attempts.

“Pandemic preparedness and response too often comes down to bugs and bacteria, but the human aspect is just as crucial,” Castrucci said. “A federal policy should be in place to protect those who must act to protect us all.

“Federal legislation enacting emergency paid sick leave, immigration amnesty and income insurance to facilitate reporting among those most at risk (is) as critical as testing and surveillance , but (continues) to be less of a priority in preparing our country for a pandemic,” he said.

Compounding our lack of preparedness is the continued shortage of public health workers in the wake of the COVID-19 pandemic.

“Between 2017 and 2021, half of government public health personnel left their jobs,” Castrucci said. “Employees are still recovering from the stress and burnout of COVID. We need at least 80,000 additional public health workers across the country, and that’s just to provide basic public health services. We “We would need a lot more if we faced another nationwide pandemic.”

With this in mind, what threat does avian flu pose to the American public?

“Currently, the risk to the general public remains low,” Rivera said. “Both human cases involved people who had close contact with an infected animal. So far, no human-to-human transmission has been reported, which explains the low number of infections in humans. USDA also indicated that our food supplies, pasteurized commercial milk, poultry and meat, are safe for consumption.

She continued: “People at greatest risk of bird flu are those who are exposed, through work or leisure, to infected animals, particularly dairy cows. In this case, that includes dairy farmers, farm workers, and veterinarians who respond to ongoing outbreaks. »

Therefore, the best way to protect yourself against bird flu is to avoid contact with wild birds, cows and other animals that may have been exposed to or infected with the virus. “In addition, people should avoid drinking raw or unpasteurized milk or consuming animal products from animals suspected or confirmed of avian flu infection,” Rivera said.

The majority of cases of bird flu detected so far in humans have been mild. However, if the last five years have taught us anything, these viruses can evolve quickly.

“Influenza has a complex replication cycle across multiple species,” said Carl Abraham, assistant professor of medicine at the New York Institute of Technology. News week. “This frequently causes genes from different strains to mix within the same host, commonly referred to as recombination events.”

He continued: “Most recombination events result in influenza viruses that are not able to replicate or that replicate less efficiently. However, rare recombination events can increase disease severity, increase transmission or even, as we are seeing with livestock this year, infection with new viruses. It is possible that a recombination event gives avian flu the ability to infect humans.

“If the same virus caused human-to-human transmission, it could have pandemic potential. Again, it would be a rare event, but it is possible,” Abraham said.

Castrucci said policy changes are needed, not just for avian flu but for pandemic preparedness more generally.

“Pandemic threats are coming faster,” he said. “After COVID, we’ve already seen Mpox and now H5N1,” he said. “We must invest in policies, procedures and practices to ensure the country’s continued safety, security and economic prosperity.”

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