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H5N1 Bird Flu: What You Need to Know [1]
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Date: 2025-02
[Originally published: May 16, 2024; Updated: Jan. 7, 2025.]
Note: Information in this article was accurate at the time of original publication. We encourage you to visit the websites of the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and your state and local government for the latest information on H5N1.
Avian influenza A (H5N1), or bird flu, has killed millions of wild birds, and caused sporadic outbreaks among poultry and an ongoing multistate outbreak among cows in the United States. While there has been no known person-to-person transmission of the virus, there have been 67 reported human cases in the U.S. since 2022.
Most of the people who have been infected with bird flu in the U.S. have reported mild illnesses, but one person who was hospitalized with severe illness died in January. That case, in Louisiana, was the first in the country to be linked to a backyard poultry flock. About a month before, a 13-year-old girl in British Columbia who became the first person in North America to become critically ill from H5N1 was taken off of supplemental oxygen after doctors said she no longer required it. (In both cases, genetic sequencing identified a version of the virus that circulates in wild birds and is not the same as the one that has been found in cows).
In other cases, some people have had eye infections, while others reported flu-like symptoms, including chills, coughing, fever, sore throat, and runny nose, according to the Centers for Disease Control and Prevention (CDC).
Most of the human cases of H5N1 have involved people working on farms where they were exposed to sick cows or poultry in California, Colorado, Iowa, Louisiana, Michigan, Oregon, Texas, Washington, and Wisconsin. But there have been other cases where exposure wasn’t clear. In a case in September in Missouri, a person developed the illness despite reporting no contact with sick animals; after an extensive investigation, the CDC reported that it found no evidence that human-to-human spread had occurred.
At the end of October, a pig on a backyard farm in Oregon was found to have the virus, raising a new concern, since pigs can be infected with both bird and human flu at the same time and serve as mixing pots, potentially creating a new flu virus that can spread to humans (more on that below).
Meanwhile, the good news is that H5N1 is not considered a major public health threat in the U.S. at this time. The CDC has categorized the risk to the general public as “low,” and notes that people with exposure to infected animals are at higher risk of infection. The agency reports there are no concerning virologic changes actively spreading in wild birds, poultry, or cows that would raise the risk to human health.
“In the short term, there is very little threat,” says Yale Medicine infectious diseases specialist Scott Roberts, MD. “In the long term, in the coming years or decades, however, I’m much more concerned.” He gives two reasons: One is that there has been a mortality (or death) rate of about 50% in the almost 950 people around the world who have been infected with bird flu between 2003 and 2024.
However, 50% may be an overestimate, Dr. Roberts says, adding that there may be cases where people have no symptoms, are only mildly symptomatic, or haven’t sought care for their symptoms. He also noted that if the virus did spread in humans, the percentage might be significantly lower if preventive approaches, including a vaccine, and treatments were made widely available.
Another reason for concern is that bird flu is now being detected in new animal species. In addition to outbreaks in cows and pigs—both relatively new developments for the bird flu virus— sporadic infections in some wild mammals were first detected in Canada and the U.S. in 2022, and are ongoing. “It’s natural to wonder if it’s only a matter of time before this virus is able to spread among humans,” Dr. Roberts says.
Below, Dr. Roberts answers eight common questions people have about bird flu.
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[1] Url:
https://www.yalemedicine.org/news/h5n1-bird-flu-what-to-know
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