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Should we be worried about bird flu in Texas? What you should know about H5N1

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Is our next pandemic-causing disease already here?

In April, the Texas Department of State Health Services issued a public health alert for avian influenza, specifically H5N1, after a Texas human case was confirmed in late March. This person had direct contact with a sick dairy cow. The person's main symptom was conjunctivitis and the person has recovered.

Details about the person and the district will not be published.

This case was only the second recent human case in the United States. A person in Colorado became infected in 2022 after contact with diseased poultry.

The Centers for Disease Control and Prevention and local authorities such as Austin Public Health are monitoring the situation and searching for H5N1 cases.

Austin Public Health regularly monitors what illnesses are occurring in the community, including clinics and hospitals, and what is in wastewater, Dr. Desmar Walkes, the Austin-Travis County Health Department.

To date, H5N1 has not been found in people in Austin.

Should we be worried about H5N1 bird flu?

This flu has been around for decades. In 1997, an outbreak in Asia prompted scientists to develop modern pandemic preparedness measures, said Lauren Ancel Meyers, a professor at the University of Texas in the Department of Integrated Biology, the Department of Statistics and Data Sciences and the Dell Department of Population Health Medical School.

She led UT'S The COVID-19 Modeling Consortium has created models that predict the spread and mortality of the disease.

She also founded the Center for Advanced Preparedness and Threat Response Simulation, which develops war games where pathogens are the threat. For her work, she received $27 million from the CDC to develop the infrastructure for better disease prediction.

“It's (H5N1) something I'm worried about,” Meyers said. “I am on high alert. It’s something that may or may not develop into something.”

This new outbreak, first in wild birds and poultry and now in cattle, “is getting closer and closer,” Dr. Brian Metzger, medical director of infectious diseases at St. David's HealthCare.

According to the CDC's most recent report:

  • The disease has been identified in 9,296 wild birds, including in Texas counties but not yet in Central Texas
  • The disease affected 90 million poultry in 48 states, including Texas
  • 33 dairy herds in 8 states, including Texas, where 12 of the herds lived, were infected
  • 2 human cases, both from contact with infected livestock

Meyers and her team are currently modeling what the spread from agriculture to humans might look like. It's a complicated model because, like people, wild birds and cattle also migrate through the country.

“We’re trying to figure it out,” she said.

Why couldn't H5N1 become a pandemic?

Public health officials fear that H5N1 adapts and can spread from person to person. That hasn't happened yet. Even in the 1990s, there were cases of people being exposed to a sick animal.

Austin Public Health is awaiting its first case of person-to-person transmission. “That would trigger those response plans,” Walkes said, including communications about ways to protect yourself.

However, unlike COVID-19, this is a known disease. Current antiviral influenza drugs are believed to work against H5N1 and can be given to people who have been exposed to it even before they show symptoms. “We also have a strategic national stockpile of antivirals in the event of an outbreak,” Walkes said.

Mass production of a vaccine could get underway within a few months. Currently, manufacturers do not plan to add H5N1 to the flu vaccine this fall, but may do so if cases increase.

“We’re in a much better place,” Walkes said, compared to where we were when COVID-19 hit.

How does H5N1 spread?

It is currently transmitted to humans through a sick animal. Either someone touched the animal, its feces or bodily fluids without protective equipment such as a mask and gloves and then touched their eyes or mouth, or they inhaled these animal products.

What are the symptoms in humans?

Flu-like symptoms include:

  • Fever (temperature of 100 degrees or more) or feeling feverish or chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Headache
  • fatigue
  • Eye redness (conjunctivitis)
  • Difficulty breathing/shortness of breath
  • Diarrhea
  • nausea
  • Vomit
  • Seizures

In previous outbreaks and the current one, symptoms can be mild or severe, including hospitalization and death. In some outbreaks, the fatality rate has been as high as 50%, Walkes said.

Anyone who has flu symptoms and has been in contact with a sick or dead animal should notify their doctor of this contact.

What can we do to prevent spread?

  • Do not touch dead or sick animals. Call animal control at 311.
  • Do not drink unpasteurized milk or eat unpasteurized cheese.
  • Keep doing the things we have been doing during COVID-19. Wash your hands frequently.
  • Do not put your hands in your mouth, nose or eyes.
  • Cover your cough.
  • Stay home if you are sick.
  • Wear a mask when we have a high concentration of disease.

What other diseases are on health authorities' radar?

The number of regular flu, RSV and COVID-19 cases have declined since February, but like previous years, COVID-19 cases are expected to increase this summer due to school graduations, summer events and increased travel.

Learn more: End of an era: Austin Public Health changes COVID-19 reporting policy

Three other categories of diseases worry infectious disease specialists:

  • The highly contagious diseases such as measles, mumps and polio against which we vaccinate children. Lower vaccination rates have meant outbreaks continue to occur. People who do not have a health care provider can receive their vaccinations through Austin Public Health's vaccination clinics, austintexas.gov/department/immunizations or by calling 512-972-5520.
  • The bacterial sexually transmitted diseases such as syphilis, which have increased due to the shortage of penicillin-based injections.
  • Mosquito-borne diseases. Climate change is causing changes in the types of mosquitoes we get in the United States. Last year there was native, non-travel malaria in Florida. Metzger worries that other mosquito-borne diseases such as dengue fever and chikungunya fever could emerge in Texas.

Anna Harden

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