US - Dairy cows test positive for H5N1 avian flu in Texas, Kansas, Idaho, Michigan, New Mexico, Ohio, North Carolina, South Dakota, Colorado - March 24+ One known human case (Texas) April 1

[sharon sanders]

Please see from 2008:

Emerg Infect Dis. 2008 Jul; 14 - Experimental Infection of Cattle with Highly Pathogenic Avian Influenza Virus (H5N1)

[Treyfish]

HPAI detected in Idaho dairy cattle


Find follows diagnoses in New Mexico, Texas and Kansas.

Farm Press Staff
March 29, 2024

Idaho officials say an outbreak of highly pathogenic avian influenza occurred at a dairy cattle operation in Cassia County, which abuts the Utah state line....Officials say the virus may be transmitted from cow-to-cow as well as from infected birds that come in contact with cows.

While HPAI has devastated poultry flocks across the country in recent years, the death loss in cattle is very low and it doesn’t impact all cows in the herd, Kansas State University dairy specialist Mike Brouk has said.

“The highest percentage affected in the herd I’ve seen is about 20& of the animals impacted, lowest is 5%,” Brouk told a dairy association gathering earlier this month....
https://www.farmprogress.com/livesto...o-dairy-cattle

[Treyfish]

Testing cattle for highly pathogenic avian influenza (HPAI)

Thursday, March 28, 2024



On March 25, 2024, the USDA, FDA and CDC announced detection of highly pathogenic avian influenza (HPAI) H5N1 in dairy cattle in TX and KS. This is an evolving situation, currently thought to be spread via wild birds to cattle. Clinical signs have been limited to adult lactating cattle, with the primary sign being a pronounced drop in milk production, a decrease in appetite and rumination, mild respiratory signs, low grade fever, and thickened "colostrum-like" milk. Some cattle have dark tarry stools while others have diarrhea. Milk and nasal swabs from affected cattle have both tested positive for H5N1 clade 2.3.4.4b, the clade currently circulating in wild birds in the US since 2022. Some of the affected farms have also reported high numbers of dead wild birds. The Animal Health Diagnostic Center (AHDC), as a National Animal Health Laboratory Network (NAHLN) laboratory, tests avian and mammalian samples for HPAI by PCR, and forwards all non-negative samples to the National Veterinary Services Laboratories (NVSL) in Ames, Iowa, for confirmation. Currently, there are no quarantines or other regulatory restrictions for detection of HPAI in cattle.

Veterinarians are encouraged to contact the AHDC's Veterinary Support Services to discuss testing options as well as costs with a diagnostic veterinarian. Subsidized testing is available for cases meeting criteria established by the USDA. Please call 607-253-3900 or email vetsupport@cornell.edu for a consultation. Veterinarians in the State of New York are required to contact the New York Department of Agriculture and Markets (518-457-3502) to get approval before submitting samples for testing. Other states may have different polices and veterinarians should inquire with their State Veterinarian's office before submitting samples. When submitting samples, official premises ID must be included in the submission form. Contact the State Veterinarian's office to obtain a premises ID if the farm does not have one.

A sample list is provided here for suspect cattle: Ante-mortem samples from a single farm, listed in order of priority:

1. Milk
   • Individual cow: 5-10 ml per cow, from 10 affected and 10 unaffected cows (do not pool from different cows)
   • Bulk tank: 150 ml per tank
2. Nasal swab in plain red top tube with 0.5 ml saline, or viral transport media from 10 affected and 10 unaffected cattle
3. Serum from 10 affected and 10 unaffected cattle
4. 3-5 dead birds found at affected premises
5. Dead small mammals (for example, farm cats) from premises, up to 3 animals

Post-mortem:

1. Milk and mammary tissue
2. Lymph nodes (supramammary and other)
3. Lung
4. Spleen
5. Diaphragm
6. Optional: full set of fresh and fixed tissues ideally

https://www.vet.cornell.edu/animal-h...%20to%20cattle

[Pathfinder]

USDA, FDA and CDC Share Update on HPAI Detections in Dairy Cattle

Published: Mar 29, 2024

WASHINGTON, March 29, 2024 – The U.S. Department of Agriculture (USDA), Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC), as well as state veterinary and public health officials, are continuing to investigate an illness among dairy cows that is causing decreased lactation, low appetite, and other symptoms.

On Monday, March 25, the agencies confirmed the detection of highly pathogenic avian influenza (HPAI) in two dairy herds in Texas and two dairy herds in Kansas that had cattle exhibiting these symptoms.

USDA’s National Veterinary Services Laboratories (NVSL) has now also confirmed the presence of HPAI in a Michigan dairy herd that had recently received cows from Texas. Presumptive positive test results have also been received for additional herds in New Mexico, Idaho, and Texas; USDA will share updates if those tests are confirmed positive by NVSL. Federal and state agencies continue to conduct additional testing in swabs from sick animals and in unpasteurized clinical milk samples from sick animals, as well as viral genome sequencing, to assess whether HPAI or another unrelated illness may be underlying any symptoms

The NVSL has also confirmed that the strain of the virus found in Michigan is very similar to the strain confirmed in Texas and Kansas that appears to have been introduced by wild birds (H5N1, Eurasian lineage goose/Guangdong clade 2.3.4.4b). Initial testing has not found changes to the virus that would make it more transmissible to humans. While cases among humans in direct contact with infected animals are possible, this indicates that the current risk to the public remains low.

Spread of symptoms among the Michigan herd also indicates that HPAI transmission between cattle cannot be ruled out; USDA and partners continue to monitor this closely and have advised veterinarians and producers to practice good biosecurity, test animals before necessary movements, minimize animal movements, and isolate sick cattle from the herd. Among the dairies whose herds are exhibiting symptoms, the affected animals have recovered after isolation with little to no associated mortality reported.

There continues to be no concern about the safety of the commercial milk supply because products are pasteurized before entering the market, or that this circumstance poses a risk to consumer health. Dairies are required to send only milk from healthy animals into processing for human consumption; milk from impacted animals is being diverted or destroyed so that it does not enter the human food supply. In addition, pasteurization has continually proven to inactivate bacteria and viruses, like influenza, in milk. Pasteurization is required for any milk entering interstate commerce for human consumption. FDA’s longstanding position is that unpasteurized, raw milk can harbor dangerous microorganisms that can pose serious health risks to consumers, and FDA is reminding consumers of the risks associated with raw milk consumption in light of the HPAI detections.

Because of the limited information available about the transmission of HPAI in raw milk, the FDA recommends that industry does not manufacture or sell raw milk or raw/unpasteurized milk cheese products made with milk from cows showing symptoms of illness, including those infected with avian influenza or exposed to those infected with avian influenza. At this time, the FDA is not aware that any milk or food product from symptomatic cows is entering interstate commerce. Furthermore, if milk from cows showing symptoms of illness, including those infected with avian influenza or exposed to those infected with avian influenza is intended to be used to feed calves, FDA strongly encourages that it be heat treated to kill harmful bacteria or viruses, such as influenza, before calf feeding. Food safety information from FDA, including information about the sale and consumption of raw milk, can be found here.

Milk loss resulting from symptomatic cattle to date is too limited to have a major impact on supply and there should be no impact on the price of milk or other dairy products. Further, the U.S. typically has a more than sufficient milk supply in the spring months due to seasonally higher production.

Federal agencies are also working with state and industry partners to encourage farmers and veterinarians to report cattle illnesses quickly so that we can monitor potential additional cases and minimize the impact and risk to farmers, farmworkers, consumers and other animals. Producers are urged to work with their veterinarian to report cattle illnesses quickly and practice enhanced biosecurity measures. More information on biosecurity measures can be found here.

https://www.aphis.usda.gov/news/agency-announcements/usda-fda-cdc-share-update-hpai-detections-dairy-cattle

[Pathfinder]

Highly Pathogenic Avian Influenza Detected in Michigan Dairy Herd

March 29, 2024

Michigan herd is linked to the affected cattle in Texas; producers are strongly encouraged to contact their veterinarian about any animal health concern

LANSING, MI – Today, Michigan Department of Agriculture and Rural Development (MDARD) Director Tim Boring announced the detection of highly pathogenic avian influenza (HPAI) in a dairy herd from Montcalm County. The U.S. Department of Agriculture’s National Veterinary Services Laboratories has confirmed this detection.

Further testing and investigation by state and federal officials have revealed the source of infection. The farm recently received cattle from an affected premises in Texas before that herd showed any sign of disease. When the cattle were moved from Texas to Michigan, the cattle were not symptomatic and did not appear ill. As this national situation continues to develop, it is essential for all producers to contact their veterinarian if they have any concerns regarding the health of their animals, regardless of species.

"We have well-trained staff responding to this situation and I have the utmost confidence in our team. We will continue working with our local, state, and national partners to protect animal and public health," said Director Boring. "Our highest priorities at MDARD remain protecting our food supply and ensuring animal health. As this situation evolves, we will provide critical updates to producers, industry, and all Michiganders.”

“This case does reflect a lot of what is already known about this virus—namely, that it is highly contagious, it continues to be primarily spread by wild birds and contact with infected animals, and mammals can contract the virus,” said State Veterinarian Dr. Nora Wineland, DVM, MS, DACVPM. “MDARD is working diligently and in close collaboration with government partners, producer groups, and Michigan dairy farmers to address the situation and prevent the spread of disease. As more is learned, it is vitally important for producers to work with their veterinarian and isolate sick animals from others, minimize the number of visitors to their farms, prevent contact between their animals and wildlife, and continue to vigilantly monitor the health of their animals.”

HPAI is a highly contagious virus that can be spread directly by infected wild birds/animals or indirectly through any item that has been exposed to the virus—such as equipment, feed, or the clothing and shoes of caretakers. The virus has been detected in various species of mammals—presumably after the animals come into contact with infected birds. To limit the spread of the disease, the affected premises voluntarily stopped movement.

Producers who have concerns about the health of their animals and/or questions regarding how to improve the measures they take to protect animal health on their farm should contact their veterinarian. Also, if cattle producers notice decreased lactation, low appetite, and/or other symptoms in their herds, please contact your veterinarian to determine the next appropriate steps to take.

Analysis of the virus from this case and the other cases of affected cattle has not shown any significant new adaptation to make the virus more transmissible between mammals. Therefore, the public health risk associated with HPAI remains low.

According to the Food and Drug Administration and Centers for Disease and Prevention, the commercial milk supply remains safe due to both federal animal health requirements and pasteurization.

If anyone suspects the presence of HPAI or any other reportable animal disease in their domestic animals, please contact MDARD immediately at 800-292-3939 (daytime) or 517-373-0440 (after-hours).

For more information on the detections of HPAI in cattle, please visit the U.S. Department of Agriculture’s website.

###
...

https://www.michigan.gov/mdard/about/media/pressreleases/2024/03/29/highly-pathogenic-avian-influenza-detected-in-michigan-dairy-herd

[Pathfinder]

Montcalm County, Michigan
/https://en.wikipedia.org/wiki/Montcalm_County,_Michigan

---------------------------------
Dairy cows from commercial Michigan farm infected with bird flu

Published: Mar. 29, 2024, 5:26 p.m.

By Rose White | rwhite@mlive.com

An avian flu that has killed millions of birds over the past two years was confirmed in a herd of Montcalm County dairy cows.
...
The infection stems from a herd of Texas cattle that were brought to a Michigan commercial farm on March 7. State Veterinarian Nora Wineland said the cattle were “perfectly healthy” at the time and passed all veterinary inspections. When the first animal got sick on March 20, samples were submitted to the state lab.

Results confirmed Tuesday, March 26 it was the highly pathogenic avian flu. Further testing established it came from Texas.
...
“The whole genome sequence has been looked at by both us on the animal health side as well as our colleagues on the public health side,” Wineland said. “They say they are not seeing any changes in the whole genome sequence to indicate that it is any more a threat to mammals.”

MDARD did not detail how many Michigan cows were affected.
...
Federal and state agencies are doing additional testing for the bird flu and conducting genome sequencing of infected animals.

“We’re learning more about this virus and what caused it to get into cattle after more than two years of not seeing that,” Wineland said.
...

https://www.mlive.com/public-interest/2024/03/dairy-cows-from-commercial-michigan-farm-infected-with-bird-flu.html

[Treyfish]

Bird flu spreads to dairy cows in Idaho, Michigan and New Mexico


By Lena H. Sun
Updated March 29, 2024 at 10:15 p.m. EDT
|PublishedMarch 29, 2024 at 7:32 p.m. EDT



A highly virulent bird flu first detected in dairy cows in Texas and Kansas this week has spread to additional herds, bringing the number of affected states to five and adding evidence the virus may be spreading cow-to-cow. The strain has been confirmed in Michigan, and presumptive positive tests have been reported from Idaho and New Mexico, federal officials said Friday.

Earlier in the day, the U.S. Department of Agriculture reported incorrectly that presumptive positive tests had also been found in Ohio…..

While cases among humans in direct contact with infected animals are possible, this indicates that the current risk to the public remains low,” the agency statement said...


But in an interview, state veterinarian Scott Leibsle said avian flu was detected in the Idaho cattle after the farm imported cows from a Texas herd that had shown symptoms ofHPAI.

“Cow-to-cow transmission is definitely playing a role in how this disease progresses. To what extent, we don’t know yet,” Leibsle said. It’s clear that infected wild birds spread the disease to herds in Texas and Kansas, he said. “But the herd of cattle that came up from Texas to Idaho, the birds didn’t follow,” the state veterinarian said.
….
https://www.washingtonpost.com/healt...d-flu-cows/

[Treyfish]

'"not all dairy producers will want to wait one, two, three weeks” for dairy cows to recover. Some producers may decide to send the animals to slaughter as beef animals'

https://wapo.st/43G8v95

[Michael Coston]

CDC Guidance released overnight

https://www.cdc.gov/flu/avianflu/hpa...endations.html

Highly Pathogenic Avian Influenza A(H5N1) Virus in Animals: Interim Recommendations for Prevention, Monitoring, and Public Health Investigations

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Summary
Background
Recommendations for the Public
Recommendations for Farmers
Recommendations for Clinicians
Recommendations for State Health Departments
Recommendations for Surveillance and Testing
Recommendations for Infection Prevention and Control
Recommendations for Influenza Antiviral Treatment and Chemoprophylaxis
Vaccinations
Attribution Statement

Summary

The purpose of this guidance is to outline CDC’s recommendations for preventing exposures to highly pathogenic avian influenza (HPAI) A(H5N1) viruses, infection prevention and control measures including the use of personal protective equipment, testing, antiviral treatment, patient investigations, monitoring of exposed persons, including persons exposed to sick or dead wild and domesticated animals and livestock with suspected or confirmed infection with highly pathogenic avian influenza (HPAI) A(H5N1) virus, and antiviral chemoprophylaxis of exposed persons. These recommendations are based on information available as of March 2024 and will be updated as needed when new information becomes available.

Background

Although human infections with HPAI A(H5N1) virus are rare, having unprotected exposure to any infected animal or to an environment in which infected birds or other animals are or have been present can pose a risk of infection. Therefore, people with work or recreational exposures to H5N1 virus-infected animals may be at increased risk of infection and should follow recommended precautions.

The panzootic of HPAI A(H5N1) viruses in wild birds has resulted in outbreaks among commercial poultry, backyard bird flocks, and spread to infect wild terrestrial and marine mammals, as well as domesticated animals. Sporadic human infections with HPAI A(H5N1) virus have been reported in 23 countries since 1997 with a case fatality proportion of >50%, but only a small number of H5N1 cases have been reported in humans since 2022. Most human infections with H5N1 virus have occurred after unprotected exposures to sick or dead infected poultry. There is no evidence of sustained human-to-human H5N1 virus transmission, and limited, non-sustained human-to-human H5N1 virus transmission has not been reported worldwide since 2007.

Influenza A viruses infect the respiratory and gastrointestinal tracts of birds causing birds to shed the virus in their saliva, mucous, and feces. Influenza A viruses can also infect the respiratory tract of mammals and cause systemic infection in other organ tissues. Human infections with avian influenza A viruses can happen when enough virus gets into a person’s eyes, nose, or mouth or is inhaled. People with close or prolonged unprotected contact with infected birds or animals or their contaminated environments are at greater risk of infection. Illnesses in people from HPAI A(H5N1) virus infections have ranged from mild (e.g., upper respiratory symptoms) to severe illness (e.g., pneumonia, multi-organ failure) resulting in death.

Since 2022, many different wild bird species have been reported with HPAI A(H5N1) virus infection, including terrestrial, seabird, shorebird, and migratory species. In the United States, HPAI A(H5N1) virus detections in wild birds have been reported in 50 states or territories, and outbreaks in commercial poultry or backyard bird flocks associated with high mortality have been reported in 48 states since February 2022.

A wide range of terrestrial and marine mammals have been reported with HPAI A(H5N1) virus infection in multiple countries, typically resulting in neurologic signs of disease and death. HPAI A(H5N1) virus infection has been reported in wild mammals such as foxes, bears, seals, and sea lions, and in domesticated animals, including pets such as cats and dogs, farmed mink and foxes, and livestock such as goats and cows. In the United States, HPAI A(H5N1) virus detections in mammals have been reported in more than 20 states.

At this time, CDC considers the human health risk to the U.S. public from HPAI A(H5N1) viruses to be low; however, people with close or prolonged, unprotected exposures to infected birds or other animals, or to environments contaminated by infected birds or other animals, are at greater risk of infection. CDC considers HPAI A(H5N1) viruses to have the potential to cause severe disease in infected humans and recommends the following:

Recommendations for the Public

People should avoid unprotected (not using respiratory or eye protection) exposures to sick or dead animals including wild birds, poultry, other domesticated birds, and other wild or domesticated animals, as well as with animal feces, litter, or materials contaminated by birds or other animals with suspected or confirmed HPAI A(H5N1) virus infection. People should not prepare or eat uncooked or undercooked food or related uncooked food products, such as unpasteurized (raw) milk, or raw cheeses, from animals with suspected or confirmed HPAI A(H5N1) virus infection (avian influenza or bird flu).

Personal protective equipment (PPE) should be worn when in direct or close contact (within about six feet) with sick or dead animals including poultry, wild birds, backyard bird flocks, or other animals, animal feces, litter, or materials potentially contaminated with HPAI A(H5N1) viruses. PPE includes a properly fitted unvented or indirectly vented safety goggles, disposable gloves, boots or boot covers, a NIOSH-Approved particulate respirator (e.g., N95® filtering facepiece respirator, ideally fit-tested), disposable fluid-resistant coveralls, and disposable head cover or hair cover.

People exposed to HPAI A(H5N1)-virus infected birds or other animals (including people wearing recommended PPE) should monitor themselves for new respiratory illness symptoms, including conjunctivitis (eye redness), beginning after their first exposure and for 10 days after their last exposure. Influenza antiviral post-exposure prophylaxis may be considered to prevent infection, particularly in those who had unprotected exposure to HPAI A(H5N1)-virus infected birds or other animals (see below). Persons who develop any illness symptoms after exposure to HPAI A(H5N1) virus infected birds or other animals should seek prompt medical evaluation for possible influenza testing and antiviral treatment by their clinician or public health department. Symptomatic persons should isolate away from others, including household members, except for seeking medical evaluation until it is determined that they do not have HPAI A(H5N1) virus infection.

Recommendations for Farmers; Poultry, Backyard Bird Flock, and Livestock Owners; and Worker Protection

To reduce the risk of HPAI A(H5N1) virus infection, poultry farmers and poultry workers, backyard bird flock owners, livestock farmers and workers, veterinarians and veterinary staff, and responders should avoid unprotected direct physical contact or close exposure with sick or dead birds or other animals, carcasses, feces, milk, or litter from sick birds or other animals potentially infected or confirmed to be infected with HPAI A(H5N1) virus.

Farmers, workers, and responders should wear recommended PPE such as an N95 filtering facepiece respirator, eye protection, and gloves, and perform thorough hand washing after contact. (e.g., see: PPE recommended for poultry workers) when in direct contact with sick or dead birds or other animals, carcasses, feces, or litter from potentially infected birds or other animals, and when going into any buildings with or that have had sick or dead birds or other animals, carcasses, feces, or litter from potentially infected birds or other animals. Workers should receive training on and demonstrate an understanding of when to use PPE; what PPE is necessary; how to properly put on, use, take off, dispose of, and maintain PPE; and PPE limitations. Employers subject to Occupational Safety and Health Administration (OSHA) regulations should comply with applicable standards as highlighted on the OSHA Avian Influenza – Standards page.

Recommendations for Clinicians

Clinicians should consider the possibility of HPAI A(H5N1) virus infection in persons showing signs or symptoms of acute respiratory illness who have relevant exposure history. See: Brief summary for Clinicians. This includes persons who have had contact with potentially infected sick or dead birds, livestock, or other animals within the week before symptom onset (e.g., handling, slaughtering, defeathering, butchering, culling, preparing for consumption or consuming uncooked or undercooked food or related uncooked food products, including unpasteurized (raw) milk or other unpasteurized dairy products), direct contact with water or surfaces contaminated with feces, unpasteurized (raw) milk or unpasteurized dairy products, or parts (carcasses, internal organs, etc.) of potentially infected animals; and persons who have had prolonged exposure to potentially infected birds or other animals in a confined space. Clinicians should contact the state public health department to arrange testing for influenza A(H5N1) virus, collect recommended respiratory specimens (see below) using PPE, consider starting empiric antiviral treatment (see below), and encourage the patient to isolate at home away from their household members and not go to work or school until it is determined they do not have avian influenza A virus infection. Testing for other potential causes of acute respiratory illness should also be considered depending upon the local epidemiology of circulating respiratory viruses, including SARS-CoV-2.

Recommendations for State Health Departments

State health department officials should investigate potential human cases of HPAI A(H5N1) virus infection as described below and should notify CDC within 24 hours of identifying a case under investigation. Rapid detection and characterization of novel influenza A viruses in humans remain critical components of national efforts to prevent further cases, to allow for evaluation of clinical illness associated with them, and to assess the ability of these viruses to spread from human to human. State Health Department officials, including the State Public Health Veterinarian, should collaborate with State Department of Agriculture and State Wildlife officials using a One Health approach when relevant to investigate suspected HPAI A(H5N1) infections in people linked with animals.

Recommendations for Surveillance and Testing

People exposed to HPAI A(H5N1)-infected birds or other animals (including people wearing recommended PPE) should be monitored for signs and symptoms of acute respiratory illness beginning after their first exposure and for 10 days after their last exposure.

Patients who meet Epidemiologic criteria AND either Clinical OR Public Health Response criteria below should be tested for HPAI A(H5N1) virus infection by reverse-transcription polymerase chain reaction (RT-PCR) assay using H5-specific primers and probes at your state or local public health department.

Epidemiological Criteria

Persons with recent exposure (within 10 days) to HPAI A(H5N1) virus through one of the following:

• Exposure to HPAI A(H5N1) virus infected birds or other animals defined as follows:

• • Close exposure (within six feet) to birds or other animals, with confirmed avian influenza A(H5N1) virus infection. Bird or other animal exposures can include, but are not limited to handling, slaughtering, defeathering, butchering, culling, or preparing birds or other animals for consumption, or consuming uncooked or undercooked food or related uncooked food products, including unpasteurized (raw) milk,

OR

Direct contact with surfaces contaminated with feces, unpasteurized (raw) milk or other unpasteurized dairy products, or bird or animal parts (e.g., carcasses, internal organs) from infected birds or other animals

OR

• • Visiting a live bird market with confirmed bird infections or associated with a case of human infection with HPAI A(H5N1) virus.
  • Exposure to an infected person – Close (within six feet) unprotected (without use of respiratory and eye protection) exposure to a person who is a confirmed, probable, or symptomatic suspected case of human infection with HPAI A(H5N1) virus (e.g., in a household or healthcare facility).
  • Laboratory exposure (unprotected exposure to HPAI A(H5N1) virus in a laboratory)

Clinical Criteria

Persons with signs and symptoms consistent with acute upper or lower respiratory tract infection, or complications of acute respiratory illness without an identified cause. In addition, gastrointestinal symptoms such as diarrhea are often reported with HPAI A(H5N1) virus infection. Examples include but are not limited to:

• Mild illness (e.g., cough, sore throat, eye redness or eye discharge such as conjunctivitis, fever or feeling feverish, rhinorrhea, fatigue, myalgia, arthralgia, headache)
• Moderate to severe illness: (e.g., shortness of breath or difficulty breathing, altered mental status, seizures)
• Complications: pneumonia, respiratory failure, acute respiratory distress syndrome, multi-organ failure (respiratory and kidney failure), sepsis, meningoencephalitis

Public Health Response Criteria

Testing of asymptomatic persons for HPAI A(H5N1) virus infection is not routinely recommended. As part of public health investigations, asymptomatic persons, such as close contacts of a confirmed case of HPAI A(H5N1) virus infection, might be tested after consultation with CDC.

Preferred Clinical Specimens

For persons with suspected HPAI A(H5N1) virus infection, the following specimens should be collected as soon as possible after illness onset or when deemed necessary: a nasopharyngeal swab and a nasal swab combined with an oropharyngeal swab (e.g., two swabs combined into one viral transport media vial). The nasopharyngeal swab and the combined nasal-throat swabs should be tested separately. If these specimens cannot be collected, a single nasal or oropharyngeal swab is acceptable. If the person has conjunctivitis (with or without respiratory symptoms), both a conjunctival swab and nasopharyngeal swab should be collected. Patients with severe respiratory disease also should have lower respiratory tract specimens (e.g., an endotracheal aspirate or bronchoalveolar lavage fluid) collected, if possible. For severely ill persons, multiple respiratory tract specimens from different sites should be obtained to increase the potential for HPAI A(H5N1) virus detection.

Recommendations for Infection Prevention and Control

Standard, contact, and airborne precautions are recommended for patients presenting for medical care or evaluation who have illness consistent with influenza and recent exposure to birds or other animals potentially infected with HPAI A(H5N1) virus. For additional guidance on infection prevention and control precautions for patients who might be infected with HPAI A(H5N1) virus, please refer toguidance for infections with novel influenza A viruses associated with severe disease.

Recommendations for Influenza Antiviral Treatment and Chemoprophylaxis

Treating Symptomatic Persons with Bird or Other Animal Exposures

Outpatients meeting epidemiologic exposure criteria who develop signs and symptoms compatible with influenza should be referred for prompt medical evaluation, testing, and empiric initiation of antiviral treatment with oseltamivir as soon as possible. Clinical benefit is greatest when antiviral treatment is administered early, especially within 48 hours of illness onset.

Hospitalized patients who are confirmed, probable, or suspected cases of human infection with HPAI A(H5N1) virus, regardless of time since illness onset are recommended to initiate antiviral treatment with oral or enterically administered oseltamivir as soon as possible. Antiviral treatment should not be delayed while waiting for laboratory testing results.

For detailed guidance on dosing and treatment duration, please see Interim Guidance of the Use of Antiviral Medications for the Treatment of Human Infection with Novel Influenza A Viruses Associated with Severe Human Disease.

Chemoprophylaxis of Persons with Exposure to HPAI A(H5N1) Virus: Chemoprophylaxis with influenza antiviral medications can be considered for any person meeting epidemiologic exposure criteria. Decisions to initiate post-exposure antiviral chemoprophylaxis should be based on clinical judgment, with consideration given to the type of exposure, duration of exposure, time since exposure, and known infection status of the birds or animals the person was exposed to.

Antiviral chemoprophylaxis is not routinely recommended for personnel who used proper PPE and experienced no breaches while handling sick or potentially infected birds or other animals or decontaminating infected environments (including animal disposal).

If antiviral chemoprophylaxis is initiated, oseltamivir treatment dosing (one dose twice daily) is recommended instead of the antiviral chemoprophylaxis regimen for seasonal influenza. For specific dosage recommendations for treatment by age group, please see Influenza Antiviral Medications: Summary for Clinicians. Physicians should consult the manufacturer’s package insert for dosing, limitations of populations studied, contraindications, and adverse effects. If exposure was time-limited and not ongoing, five days of medication (one dose twice daily) from the last known exposure is recommended.

Monitoring and Antiviral Chemoprophylaxis of Close Contacts of Persons with HPAI A(H5N1) virus infection: Recommendations for monitoring and chemoprophylaxis of close contacts of infected persons are different than those that apply to persons who meet bird or other animal exposure criteria. Post-exposure prophylaxis of close contacts of a person with HPAI A(H5N1) virus infection is recommended with oseltamivir twice daily (treatment dosing) instead of the once daily pre-exposure prophylaxis dosing. For detailed guidance, please see Interim Guidance on Follow-up of Close Contacts of Persons Infected with Novel Influenza A Viruses and Use of Antiviral Medications for Chemoprophylaxis.

Vaccination

No human vaccines for prevention of HPAI A(H5N1) virus infection are currently available in the United States. Seasonal influenza vaccines do not provide any protection against human infection with HPAI A(H5N1) viruses.

Last Reviewed: March 29, 2024

[Pathfinder]

Questions and Answers Regarding Milk Safety During Highly Pathogenic Avian Influenza (HPAI) Outbreaks

• Content current as of:
  03/29/2024
• Regulated Product(s)
  • Food & Beverages
  • Milk/Milk Product

March 29, 2024

The U.S. Food and Drug Administration (FDA) is closely working with the U.S. Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS), the Centers for Disease Control and Prevention (CDC) and state partners to investigate an illness among older dairy cows in Texas, Kansas, and Michigan that is causing decreased lactation, low appetite, and other symptoms.

As of Friday, March 29, the agencies confirmed the detection of highly pathogenic avian influenza (HPAI) in two dairy herds in Texas, two dairy herds in Kansas and one dairy her in Michigan that had recently received cows from Texas. HPAI was detected in unpasteurized samples of milk and swabs taken for diagnosis of sick cattle on the dairy farms in Texas, Kansas and Michigan. Testing is also underway for two herds in New Mexico and two additional herds in Texas. These samples were submitted as part of an investigation into illness among primarily older dairy cows that is causing decreased lactation, low appetite, and other symptoms. However, these detections are also appearing in some younger lactating cows. Testing is underway for additional dairy herds in New Mexico, Texas, and Idaho which have cows exhibiting similar signs of illness.

At this time, there continues to be no concern about the safety of the interstate commercial milk supply because products are pasteurized before entering the market, or that this circumstance poses a risk to consumer health.

Only milk from heathy animals is authorized for distribution into interstate commerce for human consumption. Additionally, pasteurization has continually proven to inactivate bacteria and viruses, like influenza, in milk. Pasteurization is required for any milk entering interstate commerce. Milk from impacted animals is being diverted or destroyed so that it does not enter the human food supply. Milk loss resulting from symptomatic cattle to date is too limited to have a major impact on supply and there should be no impact on the price of milk or other dairy products. The FDA will continue to work with our partners and provide updates as necessary.

More information about the detections, as well as information about biosecurity measures producers can take to protect their animals from HPAI is available at USDA, FDA and CDC Share Update on HPAI Detections in Dairy Cattle | USDA-APHIS.

The FDA will continue to work with our partners and provide updates as necessary.



On this page:

• Highly Pathogenic Avian Influenza (HPAI)
• Milk Safety and Supply
• Raw Milk/Cheese Concerns
• Industry Involvement
• Federal Government Response

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Highly Pathogenic Avian Influenza (HPAI)


What is HPAI and why is it a problem?

Highly Pathogenic Avian Influenza (HPAI) is a highly contagious and often deadly disease of poultry, caused by the avian influenza virus also known as bird or avian flu. HPAI can be transmitted by wild birds to domestic poultry and other bird and animal species. Although bird flu viruses do not normally infect humans, sporadic human infections have occurred. It is important to note that “highly pathogenic” refers to severe impact in birds, not necessarily in humans. Milk Safety and Supply


Is the milk available in the retail market safe to drink?

The FDA does not currently have concerns about the safety and availability of pasteurized milk products nationwide. Pasteurization has continually proven to inactivate bacteria and viruses, like influenza, in milk and is required for any milk entering interstate commerce. We are continuing to monitor the situation and will provide updates on our website if necessary.

Is this situation impacting the availability of milk?

At this time, milk loss resulting from symptomatic cattle is too limited to have a major impact on supply and there should be no impact on the price of milk or other dairy products. The FDA is not aware that this incident is impacting the availability of pasteurized milk products nationwide. We will continue to monitor the supply chain impacts and will update this page as necessary.

What about cheese sold at retail?

Again, the FDA does not currently have concerns about the safety and availability of pasteurized milk products, including pasteurized cheese, sold nationwide. Pasteurization has continually proven to inactivate bacteria and viruses, like influenza, in milk and milk products such as cheese. We are continuing to monitor the situation and will provide updates on our website if necessary. Also, see questions regarding cheese made from raw/unpasteurized milk. Raw Milk/Cheese Concerns


Are there concerns about HPAI and raw, unpasteurized milk?

Based on the limited research and information available, we do not know at this time if Highly Pathogenic Avian Influenza (HPAI) can be transmitted through consumption of unpasteurized (raw) milk and products (such as cheese) made from raw milk from infected cows. However, we have long known that raw milk can harbor dangerous microorganisms (germs) that can pose serious health risks to consumers. According to the CDC, from 1998 through 2018, there were 202 outbreaks linked to drinking raw milk, resulting in 2,645 illnesses and 228 hospitalizations. These outbreaks have typically been caused by the presence of bacteria such as Campylobacter, Cryptosporidium, E. coli, Salmonella, or Listeria monocytogenes in the raw milk. For more information about how consumers can protect themselves from these risks see our Raw Milk.

Because of the limited information available about the transmission of HPAI in raw milk, the FDA recommends that industry does not manufacture or sell raw milk or raw milk cheese products made with milk from cows showing symptoms of illness, including those infected with avian influenza or exposed to those infected with avian influenza.

Additionally, as it is prohibited to sell raw milk for human consumption in interstate commerce, each state has its own regulations regarding the sale and distribution of raw milk within the state. Therefore, we defer questions or concerns about raw milk to the state authorities in which the raw milk is sold.

What about raw, unpasteurized cheese that has undergone aging?

FDA regulations require a 60-day aging process for unpasteurized cheese to ensure food safety, as the aging process is important to inactivate bacteria and viruses. However, because we have limited research and information on whether HPAI can be transmitted through raw milk or raw milk products, such as cheese, the FDA recommends that industry does not manufacture or sell raw milk or raw/unpasteurized milk cheese products made with milk from cows showing symptoms of illness, including those infected with HPAI or exposed to those infected with avian influenza, even if the cheese will undergo the 60-day aging process.

Do consumers need to do anything different to protect against HPAI in food?

At this time, the FDA is not aware that any milk or milk products from symptomatic cows is entering interstate commerce as milk from impacted animals is being diverted or destroyed so that it does not enter the human food supply. Additionally, pasteurization has continually proven to inactivate bacteria and viruses, like influenza, in milk. Pasteurization is required for any milk entering interstate commerce. FDA’s longstanding position is that unpasteurized, raw milk can harbor dangerous microorganisms that can pose serious health risks to consumers, and FDA is reminding consumers of the risks associated with raw milk consumption in light of the HPAI detections. Safe food handling and preparation is always important and more information about best practices can be found at Safe Food Handling. Industry Involvement


Is there anything more that dairies should be doing at this time to protect the food supply?

Farms should continue to monitor their dairy cows for signs of illness to ensure that milk from sick cows does not enter into interstate commerce. Producers that identify illness in their cows should work with the State Animal Health Official's officeExternal Link Disclaimer to submit samples for diagnostic testing.

Is there anything more dairies should be doing at this time to protect their dairy cows?

It is critically important that farmers practice good biosecurity measures and contact their Area Veterinarian in Charge and/or State Animal Health OfficialExternal Link Disclaimer with concerns about preventing HPAI. Additional general information about biosecurity on dairies precautions are available at Enhanced Biosecurity Training | Secure Milk SupplyExternal Link Disclaimer. Producers should continue to closely monitor their cattle for illness, including decline in milk production, and immediately separate sick animals. Milk from these cows should be discarded. If this milk is intended to be used to feed calves, FDA strongly encourages that it be pasteurized or otherwise heat treated to kill harmful bacteria or viruses, including influenza before it is fed. Federal Government Response


Which federal agencies are involved with this response?

The USDA-APHIS is leading this response from the animal health perspective while coordinating closely with FDA concerning milk and animal feed safety, and the Centers for Disease Control and Prevention (CDC) who is monitoring this incident from a disease control and prevention aspect. For additional information, see USDA, FDA and CDC Share Update on HPAI Detections in Dairy Cattle | USDA-APHIS.

https://www.fda.gov/food/milk-guidance-documents-regulatory-information/questions-and-answers-regarding-milk-safety-during-highly-pathogenic-avian-influenza-hpai-outbreaks#:~:text=Because%20of%20the%20limited%20information,or%20exposed%20to%20those%20infected

[sharon sanders]

hat tip @vinodscaria

This was originally published in 2023 and cows are not mentioned.


Updated public health resource pack for countries experiencing outbreaks of influenza in animals published!

30 March 2024
Departmental news

Reading time: 1 min (357 words) Human infections with animal influenza viruses, though rare, have been reported sporadically. Recently, there have been increasing reports of deadly outbreaks among mammals with mainly influenza A(H5N1) viruses. Several countries in Central and South America were confronted for the first time with introduction of H5N1 viruses in their country. This resource provides WHO country offices and national institutions with an update of the key information needed to advise countries during influenza outbreaks or detections in animals.

The publication has chapters on the roles of the animal and public health sectors in reducing human exposure to animal influenza viruses and reducing the risk of human infections, risk communication, food safety, surveillance for human cases, and collecting samples from and clinical management of suspected human cases. It was developed with technical input from partners at the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (WOAH) and the Joint WOAH-FAO Scientific Network on Animal Influenza (OFFLU), as well as subject matter experts within and outside of WHO.

Prevention and control measures in animals will minimize the circulation of animal influenza viruses, thus reducing the risk of zoonotic human infections and disease. Such measures should be developed and implemented in an integrated way, with the public and animal health sectors working together at all levels, applying a One Health approach.

Reducing human exposure to animal influenza viruses and preventing human disease should focus on the interface between humans, animals and the environment. When outbreaks or detections in animals are reported, surveillance to detect possible human cases should be intensified

If a person is suspected of having zoonotic influenza, the health authorities should be notified, and appropriate clinical case management provided.

When human infections do occur, they must be investigated and monitored closely. A thorough investigation and immediate public health actions should be implemented. The important role of risk communication and community engagement is highlighted, including messaging to general public and at-risk groups, specific messages for culling activities, food safety and drinking water and the role of vaccination for humans.

Link: Public health resource pack for countries experiencing outbreaks of influenza in animals: revised guidance


https://www.who.int/news/item/30-03-...mals-published!

[Michael Coston]

The USDA/APHIS Unveils HPAI in Livestock Website







#17,978

The first confirmation of HPAI in dairy cattle came just 7 days ago, and already at least 5 states (Texas, Kansas, Michigan, New Mexico, and Idaho) have reported infected herds. Agencies are scrambling to provide guidance (see CDC Interim Recommendations) even as they begin to assess the situation and evaluate the risks.

While the overriding message from government agencies has been one of reassurance, there is much we don't know about the long-term impact of this discovery. There are hints the virus may be transmitting from cow-to-cow - and while only dairy cows are implicated right now - we don't know how widespread the virus has become.

None of this means that the virus is ready for prime time, but this is another milestone for a virus that over the past few years has repeatedly exceeded our expectations both in terms of its geographic spread and host range.

Over the weekend the USDA/APHIS added a 4th category of HPAI tracking to their website; Livestock.

While it doesn't currently list outbreaks (as it does with Confirmations in Wild birds, Commercial and Backyard flocks, and Wild Mammals), it does provide a growing array of Biosecurity Guidance Resources along with links to CDC and FDA guidance.






A small sampling includes:



And.









Over the next few days we will hopefully learn a lot more about this HPAI incursion into cattle, but for now it is important that people take the biosecurity advice on offer seriously.

And that advice isn't just for farmers.

As we saw last week, in CDC Updated Advice On Bird Flu in Pets and Other Animals - while the risks are currently pretty low - HPAI has at least some potential to affect anyone, no matter where they live.

https://afludiary.blogspot.com/2024/04/the-usdaaphis-unveils-hpai-in-livestock.html

[Pathfinder]

Government of Canada

Highly pathogenic avian influenza (HPAI) in livestock


The Canadian Food Inspection Agency (CFIA) has not detected highly pathogenic avian influenza (HPAI) in dairy cattle or other livestock in Canada. We are monitoring the situation closely.

The risk of HPAI transmission to humans remains low.

The United States Department of Agriculture (USDA) has informed the CFIA of the detection of HPAI in unpasteurized milk from sick dairy cattle in some US states.

Affected cows are showing clinical signs that include a decrease in milk production and thicker consistency milk.

The animals appear to recover after a period of illness. It is suspected that wild birds may have introduced the virus.

More information on the situation in the US is available from the USDA Animal and Plant Health Inspection Service (APHIS):

• USDA APHIS: Highly pathogenic avian influenza (HPAI) detections in livestock

Information for consumers


Cow's milk and milk products that have been pasteurized remain safe to consume.

Pasteurization kills harmful bacteria and viruses (including influenza) while retaining the nutritional properties of milk. Pasteurization ensures the milk we drink is safe. Information for producers


You can help protect your animals and yourself and prevent the spread of disease by:

• monitoring cattle for clinical signs, including a sudden decrease in milk production
• contacting your veterinarian for any suspected cases
• practicing good biosecurity measures, such as:
  • isolating sick animals and new animals that join your farm
  • minimizing contact with wild birds on your farm
  • regularly inspecting your farm and cleaning up any loose feed
  • reporting dead birds to the Canadian Wildlife Health Cooperative
  • changing boots when entering barns
  • regularly sanitizing livestock enclosures, waterers, and feeders, and
  • limiting visitors to your farm
• contacting your provincial or national associations for any enhanced biosecurity protocols that may be available

More information on biosecurity is available on the National Biosecurity Standards: Animal biosecurity page. For example, you'll find:

• animal-specific standards
• protocols
• practices and
• a self-assessment checklist

Information for veterinarians


Veterinarians are encouraged to contact their local CFIA animal health office if there is a high degree of suspicion of HPAI.

What to look for:

• a sudden decrease in milk (especially in older cows)
• thicker consistency milk, similar to colostrum
• little to no signs of mastitis (a negative or trace positive result from the California Mastitis Test [CMT])
• decrease in feed consumption
• drop in rumen motility
• dry manure or constipation (diarrhea has been observed occasionally)
• fever (sometimes)
• a history of dead wild birds on the property

Date modified: 2024-03-31

https://inspection.canada.ca/animal-health/terrestrial-animals/diseases/reportable/avian-influenza/latest-bird-flu-situation/hpai-in-livestock/eng/1711895796746/1711895797730

[sharon sanders]

hat tip @fla_medic


Texas DSHS

@TexasDSHS
·
8m
The Texas Department of State Health Services has confirmed a human case of avian influenza A (H5N1) virus in Texas. The case does not change the risk for the public, which remains low. For more information, visit https://bit.ly/4agPoEK.

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3

2

[Treyfish]

Bird flu detected in person who had contact with infected dairy cattle in Texas

By Lena H. Sun
and
Rachel Roubein
April 1, 2024 at 1:11 p.m. EDT Dairy cattle feed at a farm in 2017 near Vado, N.M. Milk from dairy cows in Texas and Kansas has tested positive for bird flu.

A personin Texas is being treated for bird flu, thesecond human case of an illness caused by a highly virulent virus that has rampaged through sickened dairy cows in five states in recent weeks, federal and state officials said Monday.
The patient, who experienced eye inflammation as their only symptom, was tested for flu late last week with confirmatory testing performed by the Centers for Disease Control and Prevention over the weekend. The patient is being treated with the antiviral drug oseltamivir. .... https://www.washingtonpost.com/healt...ase-cow-texas/

[Treyfish]

First human case of avian flu in Texas raises alarm


Potential cow-to-cow avian flu transmission in Idaho is worrying pandemic experts.
By ADAM CANCRYN and DAVID LIM

04/01/2024 01:21 PM EDT
A Texas dairy worker has tested positive for the avian flu, marking the first identified human case of an illness in the U.S. that has sickened cattle across several states over the past few weeks.

The infection is worrying public health experts who for decades have cautioned that avian flu could pose a serious threat.
The case is the only one state and federal officials have identified, and there is no evidence that it is being spread among humans. The illness is mild and the worker is expected to recover, said two people familiar with the matter, who were granted anonymity because the information has not yet been made public. W....
“Initial testing has not found changes to the virus that would make it more transmissible to humans,” the CDC, FDA and USDA said in a press release. “While cases among humans in direct contact with infected animals are possible, this indicates that the current risk to the public remains low.”

snip

But Rick Bright, who led the Biomedical Advanced Research and Development Authority and raised alarm about the Trump administration’s early response to the Covid-19 pandemic, said he is not comforted by those assurances.

“They would have to do a lot of testing before I would drink milk from one of these farms at this point,” Bright said....

“The bigger picture is that this virus is not cooling off,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health. “We’ve been worrying about this virus for 20 years, more than 20 years. And in th....


https://www.politico.com/news/2024/0...rious%20threat.