Episode 219 - CDC reports Highly Pathogenic Avian Influenza (HPAI) infection in a person in the U.S.
What is up, everybody? This is doctor Joe Armstrong. It is approximately 9 PM on April 1, 2024. My voice is struggling mostly because my kids have brought home whatever sickness was at day care. So apologies for the weird sounding voice.
Dr. Joe Armstrong:Today, we got 2 updates. We got one from the CDC, and we got one from USDA. We're gonna cover the CDC report first. Before we get too far, I wanna make sure we start with that both the FDA and USDA continue to say there are not concerns with the safety of the commercial milk supply at this time. So today, the CDC or the Centers For Disease Control and Prevention announced that a person in the United States tested positive for highly pathogenic avian influenza.
Dr. Joe Armstrong:The person had exposure to dairy cattle in Texas presumed to be infected with high path avian influenza. The good news is the person was reported to have mild symptoms and is recovering. CDC has been monitoring for illness among people exposed to high path avian influenza infected birds since the outbreaks first detected in 2021. Since that time, this is the second person to have been reported to have tested positive for high path avian influenza in the US. There was one other case in a human, and that occurred in 2022 in Colorado, and that was connected to bird exposure.
Dr. Joe Armstrong:In the CDC announcement, there is a ton to unpack. But the main takeaways that we need to talk about tonight are, if you are working with cattle that have tested positive or are suspected to be infected and you are experiencing flu like symptoms, you have to consult your physician. Human cases of influenza must be confirmed with testing. You can't get it figured out with just symptoms. You gotta go in and see your doctor and have them run a test.
Dr. Joe Armstrong:The most common symptoms include fever or feeling feverish, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue, eye redness, also called conjunctivitis, shortness of breath, or difficulty breathing. That's a long list. You don't have to have all of them to be impacted by this. If you notice these things, you've been working with cattle directly with cattle that are positive or you suspect them to be positive, please see your physician. Now I wanna make something clear.
Dr. Joe Armstrong:If you are working with feces or animal carcasses or raw milk, and you know there's a potential for those animals to have been infected, or they are confirmed to be infected, you need to be watching for these symptoms as well. The CDC recommends personal protective equipment when people have to work with sick or dead animals as well as with animal carcasses, raw milk, feces, litter, or materials contaminated by birds or other animals with confirmed or suspected high path avian influenza infection. What does that personal protective equipment include? It includes properly fitted, unvented, or indirectly vented safety goggles, disposable gloves boots or boot covers a NIOSH approved particulate respirator like an n 95 filtering face piece respirator. Ideally, that would be fit tested.
Dr. Joe Armstrong:Disposable fluid resistant coveralls, and a disposable head cover or hair cover Alright. That's what the CDC recommends Some of that is expensive. Yes Some of it might be hard to come by, but it is what CDC is recommending to protect people that are potentially exposed to this virus. At this time, in my opinion, the most important people to consider having that equipment on are anybody working with raw milk. That includes everyone in the parlor.
Dr. Joe Armstrong:That includes people working with calves if they have to work with raw milk at any point in that procedure. It also includes anyone working with the bulk tank, whether that's cleaning or rinsing. That's an important person to have on personal protective equipment as well. So if you have positive animals for high path avian influenza or suspected positive animals for high path avian influenza, you need to be looking at personal protective equipment for you, your employees, everyone that's working with cattle. If we get into a situation where we need to prioritize risk because we have limited personal protective equipment for whatever reason.
Dr. Joe Armstrong:The most important people, in my opinion, are anybody working with raw milk. In addition to that, anybody who's I'd been identified as having some sort of immunosuppression goes to the top of the list as well. That includes anyone pregnant. Overall, you need to be thinking about the ways that this virus could get inside a body. If you look at the list of personal protective equipment that's recommended by CDC, you see goggles, so eyes, disposable gloves because mostly those touch eyes and other parts of your body, boots or boot covers, That's to keep things where they're supposed to be, and you don't track them other places.
Dr. Joe Armstrong:A NIOSH approved particulate respirator like an n 95, so your mouth and your nose. Fluid resistant coveralls, so, again, keeping potential contaminants where they're supposed to be away from you, so you don't track them other places, disposable head cover or hair cover. Again, keeping things where they're supposed to be so that we're not tracking them around to other places. Okay. So then a disclaimer from CDC.
Dr. Joe Armstrong:Even if you're wearing personal protective equipment, you need to be yourself and your employees for any signs or symptoms of illness for 10 days after the last known exposure to birds or animals with confirmed or suspected high path avian influenza. Before we move on, one of the things that we need to talk about here is the population most at risk. There are many people who work on farms, that work in parlors, that work with calves, that have exposure to cattle and raw milk that have moved here from another country. English is not their first language, and they may or may not be willing to seek help medical help when they need it. And they may or may not trust an institution like the government.
Dr. Joe Armstrong:If you are out there and you have employees that fit that description, you need to be advocating for them and watching out for them. Check-in with them. Make sure everything's okay. Make sure they understand what's happening. And if you get into a situation where you have confirmed positives or suspect that you have positives, you need to have them in the loop, and everyone's gotta be on the same page because you need to make sure they're protected.
Dr. Joe Armstrong:That comes back to having that farm culture where you have built that relationship and that trust with the people and the employees on your farm so that when things like this come up, you can talk to them, and everyone can be on the same page. And if you're asking them to bring something potentially problematic to your attention, they feel comfortable doing so. There is a statement in here from CDC that I think we do need to unpack, but we're not gonna get to it tonight. It's just too much for this episode. The statement is candidate vaccine viruses, CVVs, developed against related clade 2.3.4.4b viruses are available for vaccine manufacturing if necessary, and preliminary analysis indicates that they may provide reasonable protection against H5N1 influenza viruses.
Dr. Joe Armstrong:And then immediately following that statement, the CDC says, Seasonal flu vaccines do not provide protection against these viruses. Keep candidate vaccine viruses in your mind. We will come back to that at a later date. I just don't have time to get to it tonight. Alright.
Dr. Joe Armstrong:That wraps up the CDC report. Let's move on to the USDA report. There's not a ton to update here with this report. We have new cases. After that, the messaging is the same as the last report.
Dr. Joe Armstrong:So the USDA announcement stated there continues to be no concern that this circumstance poses a risk to consumer health or that it affects the safety of the commercial milk supply. What is new is that USDA reported they have confirmed the presence of high path avian influenza in a New Mexico dairy herd and 5 additional Texas dairy herds. So for totals, that puts us at confirmed detections in Texas, 7 premises, Kansas, with 2 premises, Michigan, with 1, and New Mexico, with 1. And after that, there really isn't any new information to report that wasn't already covered in the CDC report. I hope this is helpful, everybody.
Dr. Joe Armstrong:If you have comments, questions, scathing rebuttals, those, go to themoosroom@umn.edu. You can call me, 612-624 3610. Not too tired to do the rest of the plugs, but check out our website, extension.umn.edu. Thank you for listening. I'll talk to you soon.
