CDC warns clinicians to look out for bird flu cases

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The Centers for Disease Control and Prevention is sending a warning to clinicians and state health departments regarding new cases of avian influenza A (H5N1), commonly known as bird flu, saying that while the threat to humans remains low, the situation is being taken "very seriously."

The CDC sent out the warning after a confirmed case of human infection that took place in Texas in March. The U.S. Department of Agriculture recently reported the detection of bird flu in dairy cattle in several states, and on March 27 a worker at a commercial dairy farm in Texas developed conjunctivitis and subsequently tested positive for infection.

The virus had been reported in the area's cattle and wild birds, though there have been no previous reports of the spread of the virus from cows to humans. The patient was not hospitalized and is recovering, but was urged to isolate and received antiviral treatment with oseltamivir. The illness was not detected in his household family members, and to date no human-to-human transmission has been identified in the U.S.

The patient is just the second in the U.S. to test positive for the virus. The first was in April 2022 in Colorado, when someone had contact with poultry that was presumed to be infected.

WHAT'S THE IMPACT?

The CDC offered several recommendations for clinicians, saying they should consider the possibility of infection in people showing signs or symptoms of acute respiratory illness or conjunctivitis, and who have relevant exposure history outlined in Highly Pathogenic Avian Influenza A(H5N1) Virus in Animals: Interim Recommendations for Prevention, Monitoring, and Public Health Investigations.

Symptoms include cough, sore throat, eye redness, fever, headache and fatigue. In moderate cases it can cause shortness of breath, altered mental states or seizures. Complications can range from pneumonia and respiratory failure to multi-organ failure and sepsis.

If there are signs of infection, clinicians should isolate the patient and follow infection-control recommendations, including using PPE;

• Initiate empiric antiviral treatment as soon as possible.
• Notify state and local health department to arrange for testing.
• Collect respiratory specimens from the patient to test for the virus at the state health department.
• Encourage patients to isolate at home away from their household members and not go to work or school until it's determined they're no longer infectious.

Starting empiric antiviral treatment with oral or enterically administered oseltamivir – twice daily for five days – is recommended regardless of time since onset of symptoms, according to the CDC, and should not be delayed while waiting for laboratory test results.

Meanwhile, state health department officials should investigate potential human cases of bird flu infection as described in its recommendations, and notify CDC within 24 hours of identifying a case under investigation.

Overall, people should avoid being near a sick or dead animal, or surfaces contaminated with the animal's feces, litter, raw milk or other byproducts when they are not wearing respiratory or eye protection, the CDC said. And as always, people should not prepare or eat uncooked or undercooked food or related uncooked food products, such as unpasteurized milk or raw cheeses.

THE LARGER TREND

The warning on bird flu follows a February announcement that the CDC was monitoring a new COVID-19 strain, BA.2.87.1.

No clinical cases of BA.2.87.1 have been identified in the U.S. or anywhere outside of South Africa, but the CDC is still monitoring sequences from patient cases and other surveillance systems that include incoming international travelers and wastewater.

Currently, the fastest-spreading COVID-19 variant in the U.S. is JN.1, representing about 21% of new cases as of December.
 

Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.