Second Case of Avian Influenza Confirmed in United States

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A Michigan farmworker who had regular contact with livestock was confirmed to have contracted the virus.

a cow; Image Credit: Pexels, Pixaby

Avian flu has been linked to livestock and now a second case in the US.

Image Credit: Pexels, Pixaby

Today, The Michigan Department of Health and Human Services (MDHHS) announced the state’s first case of influenza A (H5N1) virus otherwise known avian influenza in a person. The identified patient is a farmworker who had regular exposure to livestock infected with influenza A. The infected farmworker diagnosed had mild symptoms and has since recovered. “Michigan has led a swift public health response, and we have been tracking this situation closely since influenza A (H5N1) was detected in poultry and dairy herds in Michigan. Farmworkers who have been exposed to impacted animals have been asked to report even mild symptoms, and testing for the virus has been made available,” Natasha Bagdasarian, MD, MPH, FIDSA, FACP, chief medical executive, for the State of Michigan, said in a statement.

This follows extensive public heath actions over the course of the last few months by the state of Michigan to allow farmworkers to monitor and notify local public health officials should they have symptoms. According to the Centers for Disease Control and Prevention (CDC), the risk to the public remains low; To protect farm and farmworker privacy, additional details are not being provided.

MDARD said it continues to implement a proactive, science-based approach to mitigating the spread of H5N1. Michigan's response to H5N1 has been a one-health approach, working with federal, state and local partners to address animal and public health concerns rapidly. Three US Department of Agriculture (USDA) emergency management teams have been on the ground assisting MDARD in day-to-day responses at all impacted poultry facilities statewide. An epidemiological team from USDA is also deployed to further assist in tracing and testing within dairy herds to be able to provide real-time information.

This news comes less than 2 months after the first human case of avian influenza A in the United States was reported by the Texas Department of State Health Services (DSHS).2 That person became infected following contact with dairy cows presumed to be infected with avian influenza. The person’s primary symptom has been conjunctivitis and is being treated with an antiviral. The person was told to isolate while in recovery.2

Since the first detection of influenza A (H5N1) in dairy cattle on March 29, Michigan has prioritized both the animal and human health aspects of this disease outbreak. Today’s news underscores the continued importance of limiting nonessential farm visits, including farm tours and field trips, as well as the use of personal protective equipment when working with livestock,” MDARD Director Tim Boring, said in a statement.1

Prevention
According to the CDC, the general public should avoid unprotected exposures to sick or dead animals including wild birds, poultry, other domesticated birds, and other wild or domesticated animals (including cattle), as well as with animal carcasses, raw milk, feces, litter, or materials contaminated by birds or other animals with confirmed or suspected HPAI A(H5N1)-virus infection.2

People should not prepare or eat uncooked or undercooked food or related uncooked food products, such as unpasteurized (raw) milk, or products made from raw milk such as cheeses, from animals with confirmed or suspected HPAI A(H5N1)-virus infection.2

And for those who work in farming or with livestock, CDC has a specific page related to preventative measures.

Clinical Considerations
For health care providers, consideration of seeing patients who may have the avian influenza,include persons with the aforementioned exposures to animals as well as having had prolonged exposure to potentially infected birds or other animals in a confined space.2

CDC says for persons with suspected 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 (eg, 2 swabs combined into one viral transport media vial). The nasopharyngeal swab and the combined nasal-throat swabs should be tested separately.” 2

CDC says there are no approved vaccines for prevention of avian influenza in the US, and that the seasonal influenza vaccines do not protect against this form of the flu.2 It is important to note, however, that the US government does has some H5N1 vaccines stored in case of a human outbreak.



References
1. First case of influenza A (H5) detected in Michigan resident. Michigan Health and Human Services news statement. May 22, 2024. Accessed May 22, 2024.
https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2024/05/22/influenza-a-detection
2. Parkinson J. Avian Flu Reported in First American This Year. Contagion. April 2, 2024. Accessed May 22, 2024.
https://www.contagionlive.com/view/avian-flu-reported-in-first-american-this-year

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