We must prepare now for avian flu

Humans have no known immunity to a virus in wild birds that last year spread rapidly to cattle and poultry, forcing millions of chickens and some livestock to be euthanized. It's one reason the cost of eggs is high. Nationally, this avian flu sickened at least 66 people in 2024, mostly dairy farmworkers who came in contact with diseased animals and contaminated milk. Most cases have been mild, but two infections late last year were more severe and more concerning.

There is no immediate cause for alarm, yet a sense of urgency is emerging about being prepared.

A man in southwest Louisiana whose backyard flock of chickens was infected by a wild bird died last week from the virus; he had underlying health problems that made him more vulnerable. A 13-year-old girl in British Columbia, Canada, was so severely ill from bird flu exposure that she was placed on a ventilator, the first known case of the virus infecting a human's lower respiratory tract. The teenager has since recovered. In both cases, the virus mutated in their bodies with both individuals displaying a similar new strain, raising fears that human-to-human transmissions could occur. Scientists say this is possible if someone infected with avian flu also contracts a seasonal flu that the mutation can latch onto. 

In response to the death in Louisiana, the World Health Organization reiterated on Tuesday that the worldwide overall risk of infection is low.

On Thursday, the Johns Hopkins Center for Outbreak Response Intervention confirmed its assessment of two months ago that farmworkers are at high risk of contracting H5N1 but the immediate risk to the general population is low. Still, the center warned, "the long term consequences of continued, uncontrolled transmissions presents a high risk to all populations."

NATION NOT READY

Distressingly, there is little confidence among scientists that the United States is ready to handle an H5N1 outbreak. Wasn't one of the lessons of the COVID-19 pandemic the need to be vigilant and prepared?

One of the best responses to this viral threat is to have a vaccine ready and rapid diagnostic test kits widely available. That would save lives and avoid another painful COVID-like shutdown of society.

Needed preparations include establishing vigorous surveillance by state and local health authorities to spot emerging strains, ensuring hospitals are ready for a surge of cases, and developing rapid home-testing kits. Testing of both milk and dairy cows moving interstate is now mandated, but states that are milk producers and allow the sale of raw milk should be required to test all raw milk sold in bulk. Recently, tainted raw milk was available in a retail store in California. The United States Department of Agriculture advises against drinking raw milk, which some claim tastes better while improving digestion and resistance to allergies. However, tests have shown that animals that drank infected raw milk contracted the H5N1 virus. Clearly, awareness efforts about the dangers of consuming unpasteurized milk should be increased.

VACCINE PARAMOUNT

The most important preparation is developing, producing and distributing an effective vaccine. The Centers for Disease Control and Prevention, which currently has 200 scientists tasked with avian flu research, is working on a vaccine for a new strain of this pathogen. Meanwhile, the current store of about 5 million H5N1 vaccine doses targeting the existing strain should be voluntarily offered to farmworkers who are most vulnerable, as experts suggest. Finland, which experienced an H5N1 outbreak on fur farms in 2023, has already done so.

Earlier this month, the Biden administration, which had been rightly criticized for a slow response to H5N1, doubled to $306 million the funding it sends to state and local governments to help with regional preparedness. Moderna, one of the manufacturers of a coronavirus vaccine, got a $176 million grant from the Department of Health and Human Services to develop a pre-pandemic mRNA vaccine for its large-scale manufacturing platform.

These preparedness concerns rise as President-elect Donald Trump soon starts another term. Though credited with creating Operation Warp Speed to get the COVID-19 vaccine developed and distributed, Trump has a mixed record on his overall pandemic response. Trump has disparaged the National Institutes of Health and the CDC and has threatened to slash their budgets.

It would be a big mistake to diminish or drive away a talented and dedicated federal workforce with harsh rhetoric and funding cuts. Even more worrisome is Trump's nomination of Robert F. Kennedy Jr. to run HHS, which oversees public health agencies. Kennedy is a known vaccine skeptic, advocates the drinking of raw milk, and has said he wants NIH to focus on chronic diseases rather than infectious diseases. There is no reason, bolstered by the needed resources, that the federal government can't do both.

During Kennedy's confirmation hearing, the Senate must question him closely on an H5N1 pandemic response plan to minimize the risk of another outbreak. If his answers aren't satisfactory, he must not be confirmed.

Let's hope H5N1 burns itself out and that by the beginning of next year that particular combination of letters and numerals is forgotten. But we can't allow pandemic fatigue to catch us off guard. Optimism is no substitute for preparation.

The nation's health should be a bipartisan concern, driven by an understanding of science and free from ideological objections.