TheCDC is working to protect against bird flu

The Texas bird flu outbreak and vaccine options: All Things Considered’s Ari Shapiro x-Rays with Dr. Mandy Cohen

On Monday, a person in Texas tested positive for bird flu — also known as the highly pathogenic avian influenza — after coming in contact with dairy cattle presumed to be infected.

The current outbreak of H5N1 only involves a handful of humans, and there are no cases of human-to-human transmission.

All Things Considered host Ari Shapiro spoke to Dr. Mandy Cohen, the director of the Centers for Disease Control and Prevention, about the potential risks and the government’s response.

Cohen: Well, the good news is the United States has been preparing for avian flu outbreaks for more than 20 years. We invested in our ability to test and treat it, in order to prevent it. The strain we are seeing right now is the same strain we have seen before. And we believe from all of our laboratory testing that our test will pick this up. We have both doses of the treatment, which works, in our country’s stockpile. There are vaccine candidates that are ready to go. So it’s very different than what we experienced, for example, at the beginning of COVID, when we’re seeing a brand new novel virus where we didn’t have tests, we didn’t have treatment and we didn’t have vaccine.

Do you think a risk of cases going under the radar will arise because people are afraid to report it? Whether it’s farm owners who don’t want their operation to be shut down or farm workers who might not have health coverage.

This change does seem to have happened when the virus jumped from a cow to the person, but there’s nothing altogether alarming about it, says Angie Rasmussen.

Cohen: We have never seen a transmission from a human-to-human. That is something we are watching for very closely. And so there may be trigger points where we would move to thinking about scaling up vaccine. But remember, there’s always a tradeoff there – if we move to manufacturing one type of vaccine, it may be at the expense of being able to manufacture that vaccine for the seasonal flu. Something affects us as well. So, we can increase in size if we need to. And again, we’ve already started down that process and we’ll keep monitoring to see if we need to trigger and do that.

New perspectives on bird flu in the wild and in the fields of avian feces, respiration, and mucosal exposure

Cohen: The FDA states that our milk is safe due to the pasteurization process. Unpasteurized and raw milk remains a risk, but the vast majority of our milk supply is safe because of pasteurization.

New wild bird species have been affected by the current outbreak. The virus has also popped up more often in mammals, both in the wild and on farms, and at times led to a wave of infections and death.

The director of the Center for One Health Research at the University of Washington says that “we are in fairly unprecedented, uncharted territory” in relation to bird flu.

Sequencing of the virus in the Texas patient did show “minor changes,” includung one mutation associated with viral adaptation to mammals that’s appeared in other human cases, according to a report from the Centers for Disease Control and Prevention.

“It doesn’t look like there’s any indication that this has adapted itself to spread efficiently between humans, and to routinely cause severe disease,” says Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan.

Severe illness has been reported in other countries due to recent human infections. “This is a virus that doesn’t infect humans very well, but can — not all the time — cause very significant disease when it does.”

If you’re around a lot of birds, and you’re exposed to bird feces, you’ll be exposed to more of that.

H5N1 doesn’t spread among humans because it isn’t able to attack the upper respiratory tract, like the seasonal flu.

However, the virus can bind to receptors in the lower respiratory tract. This may be one reason that people who develop respiratory infections with bird flu “can get very, very sick with severe pneumonia because those receptors are located deep in the lungs,” says Rasmussen.

The recent case in Texas also raises the possibility of “mucosal exposure,” meaning the person may have come in contact with the virus and then touched their eyes, although the details and what that might mean for tranmission are unclear, she says.

“If this is not being transmitted from cow to cow, then I would be very surprised.” says Joe Armstrong, a vesge at the University of Minnesota.

But scientists worry about sustained mammal to mammal transmission of avian influenza because that gives the virus more opportunities to adapt to that host and acquire mutations that could make it better suited to mammals.

Louise Moncla says that the virus had evolved a couple of adaptive changes that haven’t yet been seen in cows.

She says there is no data that proves cows are an important host for the human and bird viruses.

Source: What to know about the risks of the bird flu outbreak

What do we really need to know about avian influenza epidemics? Dr. Mandy Cohen, CDC Director, and Dr. Jeffrey Jha

“In general, we have not paid a lot of attention to these workers, even though they’ve often been sort of like the canary in the coal mine, the first evidence of a transmission event,” says Rabinowitz.

‘The United States has been preparing for avian flu outbreaks for more than 20 years,” CDC director Dr. Mandy Cohen told NPR’s All Things Considered. When we first got COVID, we didn’t have tests, treatment or the vaccine, so it is very different from what we experienced now.

Immune-stimulating ingredients, known as adjuvants, can be added to these older vaccines in order to broaden the immune response so that it better covers mismatched strains. Dr. Chen says that the university’s School of Medicine could make new vaccines using the new technology.

Dr. Jha is dean of the school of public health at Brown University, he says he is not surprised if more cases occur in humans.

He says it’s not time to mobilize a larger response because the chances that will be needed are very low.

“If you are seeing it widespread in farm workers, you want to think about vaccinating farm workers. If you start seeing it in non farm workers with evidence of human-to-human transmission, that’s when you start wanting to think about vaccinating a much broader set of the population,” he says.