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cover of episode What you need to know about bird flu

What you need to know about bird flu

2025/1/8
logo of podcast On Point | Podcast

On Point | Podcast

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Megan Davis
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Nirav Shah
S
Seema Lakdawalla
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Megan Davis: 目前美国H5N1禽流感病例大多散发,尚无证据表明存在人际传播。病毒感染了奶牛,并在其乳房组织中大量繁殖,这出乎意料。H5N1禽流感病毒的2344B进化枝基因型相对稳定,但仍在发生变化,并已从奶牛传播到其他动物和人类。高致病性禽流感病毒对禽类的致病性极强,感染后可能迅速导致大量禽类死亡,因此需要扑杀受感染的禽类。尽管对禽类进行了扑杀,但H5N1禽流感病毒仍在传播,这可能是由于候鸟迁徙造成的。H5N1禽流感病毒已感染多种哺乳动物,这令人担忧,因为这可能增加病毒变异和人际传播的风险。家猫感染H5N1禽流感病毒的病例正在增加,这引发了人们对病毒传播的担忧。生牛奶是奶牛身上最具传染性的产物,不应饮用。 Seema Lakdawalla: 当前H5N1禽流感病毒的特性令人担忧,因为它已经跨物种传播,并在意想不到的部位(奶牛的乳腺组织)持续传播,并导致更严重的疾病。当前H5N1禽流感病毒能够进入血液并在全身传播,这使其传播速度更快,更容易传播。商业化奶牛养殖业为H5N1禽流感病毒的传播创造了条件,即使奶牛生病,也必须挤奶,否则会使其病情恶化。受污染的牛奶可能通过肥料进入农作物,并可能导致病毒传播到鸟类和其他动物,从而促进病毒进化。目前对H5N1禽流感病毒的控制措施不足,可能导致病毒进化并更容易在人际间传播。 Nirav Shah: 目前H5N1禽流感对公众的风险较低,但疫情爆发的风险中等,公众应保持警惕,但不必恐慌。H5N1禽流感与COVID-19不同,人们对H5N1病毒已有几十年的了解,这有助于应对疫情。CDC 正在密切关注H5N1禽流感病毒的传播情况,包括人际传播、对药物的敏感性以及疾病的严重程度等因素。H5N1禽流感病毒在全球的致死率可能高达50%,但在美国目前的疫情中,疾病的严重程度较低。这可能是因为监测和检测能力的提高,以及暴露途径的不同。美国目前约有500万剂针对H5N1禽流感病毒的疫苗,另有500万剂正在生产中,但这些疫苗尚未获得FDA的批准。CDC 正在密切关注H5N1禽流感病毒的情况,并准备在必要时部署疫苗。CDC 对H5N1禽流感病毒的应对措施是及时和充分的,并根据情况不断调整。CDC 从COVID-19疫情中吸取了教训,在应对H5N1禽流感疫情时,改进沟通方式,提高响应速度。

Deep Dive

Key Insights

What is the current status of H5N1 bird flu in the United States?

As of now, there have been 66 human cases of H5N1 in the U.S., with 65 of those cases resulting in conjunctivitis (eye redness) and no severe respiratory symptoms. The virus has primarily affected farmworkers, particularly those in the dairy and poultry industries. There has been no documented human-to-human transmission, and the risk to the general public is considered low.

Why is H5N1 considered a significant concern despite its low human transmission?

H5N1 is highly adaptable and has caused major pandemics in the past. It has shown the ability to jump between species, including from birds to mammals like cows and cats. The virus can evolve rapidly, and if it gains the ability for efficient human-to-human transmission, it could lead to a severe pandemic. The current strain has already caused significant losses in the poultry industry and is affecting dairy cows, raising concerns about food supply chains.

How did H5N1 spread to dairy cows, and why is this unusual?

H5N1 likely spread to dairy cows through a single event involving wild birds, possibly in Texas. This is unusual because cows are not typical hosts for avian influenza. The virus has shown a unique tropism for the mammary glands of cows, leading to high viral loads in milk. This has created new routes of transmission, including to farmworkers and other animals like cats.

What are the risks associated with raw milk in the context of H5N1?

Raw milk from infected cows contains high levels of the H5N1 virus, making it a significant risk for transmission. While no human cases have been definitively linked to raw milk consumption, there have been severe cases in animals, including cats, that consumed raw milk or raw pet food. Public health officials strongly advise against consuming raw milk to prevent potential infection.

What measures are being taken to control the spread of H5N1 in the poultry industry?

The U.S. Department of Agriculture has implemented measures such as culling infected flocks and requiring biosecurity checks before restocking farms. Farms with tight biosecurity measures, including disinfectant baths and controlled environments to prevent wild bird contact, are less likely to experience outbreaks. However, the virus continues to spread, particularly along migratory bird routes.

What is the potential for H5N1 to cause a human pandemic?

While H5N1 has not yet shown efficient human-to-human transmission, its ability to infect multiple mammal species and its high mutation rate make it a potential pandemic threat. Public health officials are closely monitoring the virus for changes that could increase its transmissibility or severity in humans. Vaccines and antiviral medications are being prepared as a precaution.

How is the CDC responding to the H5N1 outbreak compared to COVID-19?

The CDC has taken a more proactive and nimble approach to H5N1, leveraging lessons learned from COVID-19. They have updated testing guidance, increased surveillance, and prepared vaccines and antiviral medications. The agency is also focusing on clear communication and adapting its response as new data emerges, aiming to avoid the missteps seen during the early stages of the COVID-19 pandemic.

What is the fatality rate of H5N1 globally, and why is it lower in the U.S.?

Globally, H5N1 has a fatality rate of up to 50% in some outbreaks. In the U.S., however, cases have been milder, likely due to better surveillance catching mild cases, lower viral exposure doses in farmworkers, and differences in how the virus is transmitted. The CDC is closely monitoring for any changes in severity or transmissibility.

What role do migratory birds play in the spread of H5N1?

Migratory birds are a major vector for H5N1, spreading the virus along flyways, such as the Pacific Flyway in the U.S. This has led to periodic outbreaks in poultry and, more recently, in dairy cows. The virus's ability to persist in wild bird populations makes it difficult to control and increases the risk of spillover into other species.

What is the status of H5N1 vaccines for humans?

The CDC has approximately 5 million doses of an H5N1 vaccine, with another 5 million in production. These vaccines are based on circulating strains and are being tested for effectiveness against new variants. While not yet licensed for widespread use, they are part of a preparedness strategy in case the virus evolves to pose a greater threat to humans.

Shownotes Transcript

A Louisiana resident has died from bird flu. Just as during the COVID outbreak, there's a lot of misinformation circulating about H5N1.

We'll get a clear assessment on bird flu, how it's changing, and efforts to control it.