Will bird flu be the next pandemic?

How the U.S. Lost Control of Bird Flu, Setting the Stage for Another Pandemic​

As the bird flu virus moved into cows and people, sluggish federal action, deference to industry and neglect for worker safety put the country at risk
BY AMY MAXMEN & KFF HEALTH NEWS

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Keith Poulsen’s jaw dropped when farmers showed him images on their cellphones at the World Dairy Expo in Wisconsin in October. A livestock veterinarian at the University of Wisconsin, Poulsen had seen sick cows before, with their noses dripping and udders slack.

But the scale of the farmers’ efforts to treat the sick cows stunned him. They showed videos of systems they built to hydrate hundreds of cattle at once. In 14-hour shifts, dairy workers pumped gallons of electrolyte-rich fluids into ailing cows through metal tubes inserted into the esophagus.


“It was like watching a field hospital on an active battlefront treating hundreds of wounded soldiers,” he said.

Nearly a year into the first outbreak of the bird flu among cattle, the virus shows no sign of slowing. The U.S. government failed to eliminate the virus on dairy farms when it was confined to a handful of states, by quickly identifying infected cows and taking measures to keep their infections from spreading. Now at least 860 herds across 16 states have tested positive.

Experts say they have lost faith in the government’s ability to contain the outbreak.

“We are in a terrible situation and going into a worse situation," said Angela Rasmussen, a virologist at the University of Saskatchewan in Canada. “I don’t know if the bird flu will become a pandemic, but if it does, we are screwed.”


To understand how the bird flu got out of hand, KFF Health News interviewed nearly 70 government officials, farmers and farmworkers, and researchers with expertise in virology, pandemics, veterinary medicine, and more.

Together with emails obtained from local health departments through public records requests, this investigation revealed key problems, including deference to the farm industry, eroded public health budgets, neglect for the safety of agriculture workers, and the sluggish pace of federal interventions.

Case in point: The U.S. Department of Agriculture this month announced a federal order to test milk nationwide. Researchers welcomed the news but said it should have happened months ago — before the virus was so entrenched.

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“It’s disheartening to see so many of the same failures that emerged during the COVID-19 crisis reemerge,” said Tom Bollyky, director of the Global Health Program at the Council on Foreign Relations.

Far more bird flu damage is inevitable, but the extent of it will be left to the Trump administration and Mother Nature. Already, the USDA has funneled more than $1.7 billion into tamping down the bird flu on poultry farms since 2022, which includes reimbursing farmers who’ve had to cull their flocks, and more than $430 million into combating the bird flu on dairy farms. In coming years, the bird flu may cost billions of dollars more in expenses and losses. Dairy industry experts say the virus kills roughly 2% to 5% of infected dairy cows and reduces a herd’s milk production by about 20%.


Worse, the outbreak poses the threat of a pandemic. More than 60 people in the U.S. have been infected, mainly by cows or poultry, but cases could skyrocket if the virus evolves to spread efficiently from person to person. And the recent news of a person critically ill in Louisiana with bird flu shows that the virus can be dangerous.

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Virologists around the world said they were flabbergasted by how poorly the United States was tracking the situation. “You are surrounded by highly pathogenic viruses in the wild and in farm animals,” said Marion Koopmans, head of virology at Erasmus Medical Center in the Netherlands. “If three months from now we are at the start of the pandemic, it is nobody’s surprise.”


Although the bird flu is not yet spreading swiftly between people, a shift in that direction could cause immense suffering. The CDC has repeatedly described the cases among farmworkers this year as mild — they weren’t hospitalized. But that doesn’t mean symptoms are a breeze, or that the virus can’t cause worse.

“It does not look pleasant,” wrote Sean Roberts, an emergency services specialist at the Tulare County, California, health department in an email to colleagues in May. He described photographs of an infected dairy worker in another state: “Apparently, the conjunctivitis that this is causing is not a mild one, but rather ruptured blood vessels and bleeding conjunctiva.”

Over the past 30 years, half of around 900 people diagnosed with bird flu around the world have died. Even if the case fatality rate is much lower for this strain of the bird flu, COVID showed how devastating a one percent death rate can be when a virus spreads easily.


Like other cases around the world, the person now hospitalized with the bird flu in Louisiana appears to have gotten the virus directly from birds. After the case was announced, the CDC released a statement saying, “A sporadic case of severe H5N1 bird flu illness in a person is not unexpected.”

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A fast-growing outbreak of avian flu has upended California’s dairy industry, the nation’s largest producer of milk, infecting most of the state’s herds and putting thousands of farmworkers at risk for contracting the virus.

In just about four months, cows in 645 dairies in California have tested positive for H5N1, even as many ranchers have taken strict precautions to stop the virus from spreading. Gov. Gavin Newsom was concerned enough Wednesday that he declared a state of emergency over the outbreak in California.

The virus is spreading so quickly that dairy farmers are calling it “Covid for cows,” and scientists are racing to figure out how to stop the contagion.

“We’re trying to do everything we possibly can, and this has just been the worst crisis we’ve ever dealt with in the dairy industry in California,” said Anja Raudabaugh, the chief executive of Western United Dairies, a trade organization that represents most of the state’s dairy farms.

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Consuming eggs and pasteurized milk won’t make people sick, according to the Food and Drug Administration. (Raw milk from infected cows, however, has been deemed unsafe, and California recently recalled raw milk products after the virus was detected in samples.)

The most common way humans have contracted bird flu has appeared to be through close contact with infected cattle and poultry. The virus was first detected in cows early this year in Texas, but has since reached herds in 15 other states, including California.




Milk from infected cows has very high levels of the virus, and experts believe that contaminated vehicles, equipment and workers play a role in spreading the virus from farm to farm. Those who milk cows can face high risks because the virus is highly concentrated in infected milk, which can splash into workers’ eyes, said Michael Payne, a veterinary medicine expert at the University of California, Davis.

Farmers took precautions by cutting off contact with other dairy farms, regularly testing their milk for the virus, disinfecting new equipment and preventing workers from other farms from visiting, said Dr. Payne, who studies biosecurity on farms. This fall, cattle ranchers in California also scrambled to isolate their herds because it has been believed that avian flu spreads through close contact between cows.

Yet those measures haven’t always worked.

“Some of them have just done everything right, and they still got infected,” Dr. Payne said. “It’s enormously frustrating. You’ve got producers that upend their entire life and system of management — it’s enough to make you want to throw up your hands.”

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“It was like watching a field hospital on an active battlefront treating hundreds of wounded soldiers,” he said.
Nearly a year into the first outbreak of the bird flu among cattle, the virus shows no sign of slowing. The U.S. government failed to eliminate the virus on dairy farms when it was confined to a handful of states, by quickly identifying infected cows and taking measures to keep their infections from spreading. Now at least 845 herds across 16 states have tested positive.

ExploreLouisiana patient is first severe bird flu case in US
Experts say they have lost faith in the government’s ability to contain the outbreak.

“We are in a terrible situation and going into a worse situation,” said Angela Rasmussen, a virologist at the University of Saskatchewan in Canada. “I don’t know if the bird flu will become a pandemic, but if it does, we are screwed.”



To understand how the bird flu got out of hand, KFF Health News interviewed nearly 70 government officials, farmers and farmworkers, and researchers with expertise in virology, pandemics, veterinary medicine, and more.


Together with emails obtained from local health departments through public records requests, this investigation revealed key problems, including a deference to the farm industry, eroded public health budgets, neglect for the safety of agriculture workers, and the sluggish pace of federal interventions.

Case in point: The U.S. Department of Agriculture this month announced a federal order to test milk nationwide. Researchers welcomed the news but said it should have happened months ago — before the virus was so entrenched.

“It’s disheartening to see so many of the same failures that emerged during the COVID-19 crisis reemerge,” said Tom Bollyky, director of the Global Health Program at the Council on Foreign Relations.

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• The bird flu outbreak took several concerning turns this year, with the number of human cases up to at least 64.
• Experts outlined several indicators that the virus’ spread is going in the wrong direction.
• Among them are recent detections of the virus in wastewater and signs of dangerous mutations.

The simmering threat of bird flu may be inching closer to boiling over.

This year has been marked by a series of concerning developments in the virus’ spread. Since April, at least 64 people have tested positive for the virus — the first U.S. cases other than a single infection in 2022. Dairy cow herds in 16 states have been infected this year. The Centers for Disease Control and Prevention confirmed the country’s first severe bird flu infection on Wednesday, a critically ill patient in Louisiana. And California Gov. Gavin Newsom declared a state of emergency this week in response to rampant outbreaks in cows and poultry.

“The traffic light is changing from green to amber,” said Dr. Peter Chin-Hong, a professor of medicine at the University of California, San Francisco, who studies infectious diseases. “So many signs are going in the wrong direction.”

No bird flu transmission between humans has been documented, and the CDC maintains that the immediate risk to public health is low. But scientists are increasingly worried, based on four key signals.

For one, the bird flu virus — known as H5N1 — has spread uncontrolled in animals, including cows frequently in contact with people. Additionally, detections in wastewater show the virus is leaving a wide-ranging imprint, and not just in farm animals.

Then there are several cases in humans where no source of infection has been identified, as well as research about the pathogen’s evolution, which has shown that the virus is evolving to better fit human receptors and that it will take fewer mutations to spread among people.

Together, experts say, these indicators suggest the virus has taken steps toward becoming the next pandemic.

“We’re in a very precarious situation right now,” said Scott Hensley, a professor of microbiology at the University of Pennsylvania.

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Loren Pechtel said:

This one seems to be nasty for the cows but it doesn't seem to be very transmissible between people. It hasn't blown up from the cases that we have seen. Thus it's more likely to be a milk and beef price issue than a killer.

Click to expand...

Loren Pechtel said:

This one seems to be nasty for the cows but it doesn't seem to be very transmissible between people. It hasn't blown up from the cases that we have seen. Thus it's more likely to be a milk and beef price issue than a killer.

Click to expand...