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US prepares for bird flu pandemic with $176M Moderna vaccine deal

barda, bird flu, dairy cows, dairy farms, H5N1, HHS, influenza, moderna, pandemic, pandemic preparedness, Science, USDA, virus / /

Pandemic fears —

Phase 3 trial is expected to begin next year.

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US prepares for bird flu pandemic with $176M Moderna vaccine deal

The US government will pay Moderna $176 million to develop an mRNA vaccine against a pandemic influenza—an award given as the highly pathogenic bird flu virus H5N1 continues to spread widely among US dairy cattle.

The funding flows through BARDA, the Biomedical Advanced Research and Development Authority, as part of a new Rapid Response Partnership Vehicle (RRPV) Consortium. The program is intended to set up partnerships with industry to help the country better prepare for pandemic threats and develop medical countermeasures, the Department of Health and Human Services said in a press announcement Tuesday.

In an announcement of its own Tuesday, Moderna noted that it began a Phase 1/2 trial of a pandemic influenza virus vaccine last year, which included versions targeting H5 and H7 varieties of bird flu viruses. The company said it expects to release the results of that trial this year and that those results will direct the design of a Phase 3 trial, anticipated to begin in 2025.

The funding deal will support late-stage development of a “pre-pandemic vaccine against H5 influenza virus,” Moderna said. But, the deal also includes options for additional vaccine development in case other public health threats arise.

“mRNA vaccine technology offers advantages in efficacy, speed of development, and production scalability and reliability in addressing infectious disease outbreaks, as demonstrated during the COVID-19 pandemic,” Moderna CEO Stéphane Bancel said in the announcement. “We are pleased to continue our collaboration with BARDA to expedite our development efforts for mRNA-based pandemic influenza vaccines and support the global public health community in preparedness against potential outbreaks.”

US health officials have said previously that they were in talks with Moderna and Pfizer about the development of a pandemic bird flu vaccine. The future vaccine will be in addition to standard protein-based bird flu vaccines that are already developed. In recent weeks, the health department has said it is working to manufacture 4.8 million vials of H5 influenza vaccine in the coming months. The plans come three months into the H5N1 dairy outbreak, which is very far from the initial hopes of containment.

Botched response

The US is badly fumbling its response to the unprecedented outbreak, drawing criticism from US-based and international experts alike. Genetic analyses suggest that the virus has been spreading among the country’s dairy cattle since late last year. But, it wasn’t until months later, on March 25, that the US Department of Agriculture confirmed the first four infected herds in two states (Texas and Kansas). Since then, the outbreak has spread to around 140 herds in 12 states—at least.

Some farms are refusing to test, and experts expect that there is a significant number of undocumented herd infections, particularly given the widespread detection of inactivated H5N1 in the commercial milk supply. Further, of the 140 herds with documented infections, federal officials do not know how many are still actively infected rather than recovered. It is unclear if infected cows can become reinfected, and if so, how quickly after an infection.

While the risk to the general public is considered to be low currently, farm workers are at higher risk of contracting the infection. To date, there have been three confirmed infections among dairy farm workers—one in Texas and two in Michigan, which has had a uniquely robust response to the outbreak. Still, with hundreds to thousands of farm workers at risk of contracting the virus, only 53 people in the country to date have been tested for H5 influenza.

In a presentation in London last month, global health leader Seth Berkley said it was “shocking to watch the ineptitude” of the US response to the H5N1 outbreak. He, like other experts, questioned whether the US public health community has learned or improved from the failures of the COVID-19 pandemic.

Similar to problems during the pandemic, a key barrier to the H5N1 response is resistance from farmers and farm workers to partner with state and federal health officials. Federal agencies have limited authority within states, but they have announced an array of assistance programs for dairy farms, including compensatory funding and access to personal protective equipment for farm workers. They have also issued guidance and restrictions to tighten biosecurity measures. But there has been little voluntary participation on both fronts.

For instance, officials figured out early in the outbreak that movement of cattle, workers, and equipment between farms is the main way H5N1 is spreading among dairies. In April, the USDA required testing of a portion of cows prior to their movement across state lines. But movement within states is governed by states. In a survey last month, which captured data from 54 percent of affected farms at the time, more than 60 percent of farmers said they continued to move cattle off their infected farms after the onset of clinical signs of infection in their animals.

The more the virus expands its footprint across US dairy farms, adapts to its newfound mammalian host, and comes in contact with humans, the more and more chances it has to leap to humans and gain the ability to spread among us.

In HHS’s Tuesday announcement of the Moderna award, Dawn O’Connell, assistant secretary for Preparedness and Response, spoke to the growing concern that the H5N1 outbreak could spark another pandemic. “The award made today is part of our longstanding commitment to strengthen our preparedness for pandemic influenza,” O’Connell said. “Adding this technology to our pandemic flu toolkit enhances our ability to be nimble and quick against the circulating strains and their potential variants.”

US prepares for bird flu pandemic with $176M Moderna vaccine deal Read More »

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Alpacas in Idaho test positive for H5N1 bird flu in another world first

alpacas, bird flu, dairy cows, H5N1, Science, USDA / /

Spit-take —

The alpacas were known to be in close contact with infected birds.

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Suri alpacas on a farm in Pennsylvania.

Enlarge / Suri alpacas on a farm in Pennsylvania.

Four backyard alpacas in southern Idaho have tested positive for highly pathogenic avian influenza (HPAI) H5N1, marking the first time bird flu has been detected in members of the fleecy camelid family, according to the US Department of Agriculture.

On Tuesday, the USDA announced that the agency’s National Veterinary Services Laboratories confirmed the infection on a farm in Jerome County on May 16. While the infections are a first for the spitting llama relatives, the USDA said they weren’t particularly surprising. The alpacas were in close contact with HPAI-infected poultry on the farm, which were “depopulated” this month. Of 18 alpacas on the affected farm, only four were found to be infected. There were no deaths documented, according to a report the USDA submitted to the World Organization for Animal Health.

Genomic sequencing indicates that the H5N1 virus infecting the alpacas (B3.13) matches both the virus currently circulating among US dairy cows and the virus that infected birds on the farm.

According to the Alpaca Owners Association, there are over 264,000 alpacas in the US.

The finding does not increase the threat of H5N1 to the general public, but it again highlights the virus’s alarming ability to readily spread to mammals. The USDA has documented hundreds of cases of H5N1 in a wide range of mammals since May 2022, when the outbreak strain began spreading in North America. In March, the USDA announced the unprecedented outbreak among dairy cows. But the agency has found the virus spreading in mink, raccoons, foxes, cats, seals, bears, mountain lions, bottlenose dolphins, goats, and coyotes, among other animals. With each new species and infection, H5N1 gains new opportunities to adapt to better infect and spread among mammals. And as the virus jumps to mammals in close contact with humans, the risk increases that the virus will have the opportunity to adapt to spread among humans.

The USDA and state officials continue to identify H5N1 in dairy herds. According to the latest data on the USDA’s tracking site, at least 66 dairy herds in nine states have been infected.

Alpacas in Idaho test positive for H5N1 bird flu in another world first Read More »

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After mice drink raw H5N1 milk, bird flu virus riddles their organs

avian influenza, bird flu, CDC, cows, dairy cows, fda, flu, H5N1, Infectious disease, Mice, milk, outbreak, raw milk, Science, USDA, virus / /

Deadly dairy —

No, really, drinking raw milk during the H5N1 outbreak is a bad idea.

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Fresh raw milk being poured into a container on a dairy farm on July 29, 2023, in De Lutte, Netherlands.

Enlarge / Fresh raw milk being poured into a container on a dairy farm on July 29, 2023, in De Lutte, Netherlands.

Despite the delusions of the raw milk crowd, drinking unpasteurized milk brimming with infectious avian H5N1 influenza virus is a very bad idea, according to freshly squeezed data published Friday in the New England Journal of Medicine.

Researchers at the University of Wisconsin-Madison squirted raw H5N1-containing milk from infected cows into the throats of anesthetized laboratory mice, finding that the virus caused systemic infections after the mice were observed swallowing the dose. The illnesses began quickly, with symptoms of lethargy and ruffled fur starting on day 1. On day 4, the animals were euthanized to prevent extended suffering. Subsequent analysis found that the mice had high levels of H5N1 bird flu virus in their respiratory tracts, as well their hearts, kidneys, spleens, livers, mammary glands, and brains.

“Collectively, our data indicate that HPAI [Highly Pathogenic Avian Influenza] A(H5N1) virus in untreated milk can infect susceptible animals that consume it,” the researchers concluded. The researchers also found that raw milk containing H5N1 can remain infectious for weeks when stored at refrigerator temperatures.

Bird flu has not historically been considered a foodborne pathogen, but prior to the unexpected outbreak of H5N1 in US dairy cows discovered in March, it had never been found at high levels in a food product like milk before. While experts have stepped up warnings against drinking raw milk amid the outbreak, the mouse experiment offers some of the first data on the risks of H5N1 from drinking unpasteurized dairy.

Before the mouse data, numerous reports have noted carnivores falling ill with H5N1 after eating infected wild birds. And a study from March in the journal Emerging Infectious Diseases reported that over half of the 24 or so cats on an H5N1-infected dairy farm in Texas died after drinking raw milk from the sick cows. Before their deaths, the cats displayed distressing neurological symptoms, and studies found the virus had invaded their lungs, brains, hearts, and eyes.

While the data cannot definitely determine if humans who drink H5N1-contaminated raw milk will suffer the same fate as the mice and cats, it highlights the very real risk. Still, raw milk enthusiasts have disregarded the concerns. PBS NewsHour reported last week that since March 25, when the H5N1 outbreak in US dairy cows was announced, weekly sales of raw cow’s milk have ticked up 21 percent, to as much as 65 percent compared with the same periods a year ago, according to data shared by market research firm NielsenIQ. Moreover, the founder of California-based Raw Milk Institute, Mark McAfee, told the Los Angeles Times this month that his customers baselessly believe drinking H5N1 will give them immunity to the deadly pathogen.

In normal times, the Centers for Disease Control and Prevention and the Food and Drug Administration strongly discourage drinking raw milk. Without pasteurization, it can easily be contaminated with a wide variety of pathogens, including Campylobacter, Cryptosporidium, E. coli, Listeria, Brucella, and Salmonella.

Fortunately, for the bulk of Americans who heed germ theory, pasteurization appears completely effective at deactivating the virus in milk, according to thorough testing by the FDA. Pasteurized milk is considered safe during the outbreak. The US Department of Agriculture, meanwhile, reports finding no H5N1 in retail beef so far and, in laboratory experiments, beef patties purposefully inoculated with H5N1 had no viable virus in them after the patties were cooked to 145°F (medium) or 160°F (well done).

To date, the USDA has reported that H5N1 has infected at least 58 dairy herds in nine states.

After mice drink raw H5N1 milk, bird flu virus riddles their organs Read More »

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We still don’t understand how one human apparently got bird flu from a cow

bird flu, cattle, CDC, cows, genetic surveillance, H5N1, human case, Infectious disease, mutations, outbreak, pandemic, Science, USDA, viral sequences, viruses / /
Holstein dairy cows in a freestall barn.

Enlarge / Holstein dairy cows in a freestall barn.

The US Department of Agriculture this week posted an unpublished version of its genetic analysis into the spillover and spread of bird flu into US dairy cattle, offering the most complete look yet at the data state and federal investigators have amassed in the unexpected and worrisome outbreak—and what it might mean.

The preprint analysis provides several significant insights into the outbreak—from when it may have actually started, just how much transmission we’re missing, stunning unknowns about the only human infection linked to the outbreak, and how much the virus continues to evolve in cows. The information is critical as flu experts fear the outbreak is heightening the ever-present risk that this wily flu virus will evolve to spread among humans and spark a pandemic.

But, the information hasn’t been easy to come by. Since March 25—when the USDA confirmed for the first time that a herd of US dairy cows had contracted the highly pathogenic avian influenza H5N1 virus—the agency has garnered international criticism for not sharing data quickly or completely. On April 21, the agency dumped over 200 genetic sequences into public databases amid pressure from outside experts. However, many of those sequences lack descriptive metadata, which normally contains basic and key bits of information, like when and where the viral sample was taken. Outside experts don’t have that crucial information, making independent analyses frustratingly limited. Thus, the new USDA analysis—which presumably includes that data—offers the best yet glimpse of the complete information on the outbreak.

Undetected spread

One of the big takeaways is that USDA researchers think the spillover of bird flu from wild birds to cattle began late last year, likely in December. Thus, the virus likely circulated undetected in dairy cows for around four months before the USDA’s March 25 confirmation of an infection in a Texas herd.

This timeline conclusion largely aligns with what outside experts previously gleaned from the limited publicly available data. So, it may not surprise those following the outbreak, but it is worrisome. Months of undetected spread raise significant concerns about the country’s ability to identify and swiftly respond to emerging infectious disease outbreaks—and whether public health responses have moved past the missteps seen in the early stages of the COVID-19 pandemic.

But another big finding from the preprint is how many gaps still exist in our current understanding of the outbreak. To date, the USDA has identified 36 herds in nine states that have been infected with H5N1. The good news from the genetic analysis is that the USDA can draw lines connecting most of them. USDA researchers reported that “direct movement of cattle based upon production practices” seems to explain how H5N1 hopped from the Texas panhandle region—where the initial spillover is thought to have occurred—to nine other states, some as far-flung as North Carolina, Michigan, and Idaho.

Bayes factors for inferred movement between different discrete traits of H5N1 clade 2.3.4.4b viruses demonstrating the frequency of movement.

Enlarge / Bayes factors for inferred movement between different discrete traits of H5N1 clade 2.3.4.4b viruses demonstrating the frequency of movement.

Putative transmission pathways of HPAI H5N1 clade 2.3.4.4b genotype B3.13 supported by epidemiological links, animal movements, and genomic analysis.

Enlarge / Putative transmission pathways of HPAI H5N1 clade 2.3.4.4b genotype B3.13 supported by epidemiological links, animal movements, and genomic analysis.

Putative transmission pathways of HPAI H5N1 clade 2.3.4.4b genotype B3.13 supported by epidemiological links, animal movements, and genomic analysis. [/ars_img]The bad news is that those lines connecting the herds aren’t solid. There are gaps in which the genetic data suggests unidentified transmission occurred, maybe in unsampled cows, maybe in other animals entirely. The genetic data is clear that once this strain of bird flu—H5N1 clade 2.3.4.4 genotype B3.13 —hopped into cattle, it could readily spread to other mammals. The genetic data links viruses from cattle moving many times into other animals: There were five cattle-to-poultry jumps, one cattle-to-raccoon transmission, two events where the virus moved from cattle to domestic cats, and three times when the virus from cattle spilled back into wild birds.

“We cannot exclude the possibility that this genotype is circulating in unsampled locations and hosts as the existing analysis suggests that data are missing and undersurveillance may obscure transmission inferred using phylogenetic methods,” the USDA researchers wrote in their preprint.

We still don’t understand how one human apparently got bird flu from a cow Read More »

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20% of grocery store milk has traces of bird flu, suggesting wider outbreak

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widespread —

The milk is still considered safe, but disease experts are alarmed by the prevalence.

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20% of grocery store milk has traces of bird flu, suggesting wider outbreak

The Food and Drug Administration reported late Thursday that about 20 percent of retail milk samples from around the country tested positive for genetic fragments of the bird flu, aka highly pathogenic avian influenza (HPAI) virus H5N1. While retail milk is still considered to be safe, the finding suggests that the spread of the virus in cows is more extensive than is currently known.

The FDA used a test called quantitative polymerase chain reaction (qPCR), which can only detect the presence of genetic fragments. In pasteurized retail milk, it is highly likely that those genetic snippets are merely remnants of virus particles destroyed during pasteurization. The FDA is currently conducting additional testing using egg inoculation tests, a gold standard for detecting a live virus, to confirm the effectiveness of pasteurization. Meanwhile, the director of the National Institute of Allergy and Infectious Diseases, Jeanne Marrazzo, told reporters Wednesday that tests at the agency’s federal labs so far did not identify live virus from any of its sampling. Additionally, several previous studies have found that pasteurization of eggs—which is done at a lower temperature than it is for milk—was effective at destroying H5N1.

While experts are largely unconcerned with the safety of commercial milk, the potential for wide, unrecognized spread of bird flu in dairy herds is alarming. To date, the US Department of Agriculture has only confirmed infections in 33 herds in eight states. The FDA acknowledged that of its positive samples, “a greater proportion of positive results [are] coming from milk in areas with infected herds.” But with tens of thousands of dairy herds in the US, the finding suggests that infections are being missed. It does not necessarily suggest that 20 percent of all cows are affected, since milk is pooled for commercial distribution. But 33 herds alone are unlikely to explain the high prevalence.

Last week, The New York Times reported that the one dairy herd that tested positive for bird flu in North Carolina did not show any symptoms of the infection. The possibility of asymptomatic spread of the virus among cows will make containment and monitoring far more difficult—and could explain why infections may be easily missed. On Wednesday, the USDA issued a federal order requiring dairy cattle to have a negative H5N1 test before being moved across state lines.

For now, the risk to the public is still considered low by the Centers for Disease Control and Prevention. But the more the bird flu virus spreads among mammals—and mammals with close contact with humans—the more opportunities it has to evolve to jump to and among people, experts warn.

20% of grocery store milk has traces of bird flu, suggesting wider outbreak Read More »

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Concern grows as bird flu spreads further in US cows: 32 herds in 8 states

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Rapidly evolving —

Experts say the US is not sharing as much data on the outbreak as it should.

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Greylag geese sit on a field and rest while a cow passes by in the background.

Enlarge / Greylag geese sit on a field and rest while a cow passes by in the background.

Researchers around the world are growing more uneasy with the spread of highly pathogenic avian influenza (H5N1) in US dairy cows as the virus continues to make its way into new herds and states. Several experts say the US is not sharing enough information from the federal investigation into the unexpected and growing outbreak, including genetic information from isolated viruses.

To date, the US Department of Agriculture has tallied 32 affected herds in eight states: Idaho, Kansas, Michigan, New Mexico, North Carolina, Ohio, South Dakota, and Texas. In some cases, the movement of cattle between herds can explain the spread of the virus. But the USDA has not publicly clarified if all the herds are linked in a single outbreak chain or if there is evidence that the virus has spilled over to cows multiple times. Early infections in Texas were linked to dead wild birds (pigeons, blackbirds, and grackles) found on dairy farms. But the USDA reportedly indicated to Stat News that the infections do not appear to be all linked to the Texas cases.

Spread of the virus via cattle movements indicates that there is cow-to-cow transmission occurring, the USDA said. But it’s unclear how the virus is spreading between cows. Given that even the most symptomatic cows show few respiratory symptoms, the USDA speculates that the most likely way it is spreading is via contaminated milking equipment.

Adding to the uncertainty of the virus’s spread, The New York Times on Friday reported that the one herd found infected with H5N1 in North Carolina showed no symptoms of the virus. This raises the possibility that the virus could be silently spreading in unknown numbers of other asymptomatic herds and states. In its most recent FAQ document, the USDA encouraged testing for H5N1 if herds show clinical symptoms, such as lethargy, fever, low milk production, and loose stools. But the Times noted that the agency has begun reimbursing farms for testing asymptomatic cows.

Meanwhile, the USDA also reported that it has evidence that H5N1 from dairy farms has spread back into birds in nearby poultry farms, but how this is happening is also unknown.

Data gaps

All the uncertainty and widespread transmission raises concern about how the virus is evolving to infect mammals and whether it is heading for humans. Last week, the chief scientist for the World Health Organization, Jeremy Farrar, told reporters in Geneva that the spread of the virus in US dairy cows is an “enormous concern,” according to CNN.  “The great concern, of course, is that in doing so and infecting ducks and chickens—but now increasingly mammals—that that virus now evolves and develops the ability to infect humans. And then critically, the ability to go from human-to-human transmission.”

In particular, experts are wary that the dairy cow outbreaks could spill over to nearby pig farms as it’s doing with nearby poultry farms. Pigs can be infected with both bird flu viruses and human flu viruses, making them potential melting pots for new recombinant flu strains.

So far, the USDA says that genetic sequences of H5N1 viruses infecting cows has not revealed any mutations that “would make it more transmissible to humans and between people.” But last Thursday, Stat reported that international experts have faulted the USDA for not sharing more genetic data from its investigation, among other information. Until this weekend, the agency had only shared a few genetic sequences in an international database of viral genome sequences (GISAID).

“A country with capacity like the United States should be able to generate this information within days,” Marion Koopmans, head of the department of viroscience at Erasmus Medical Center in the Dutch city of Rotterdam told Stat last week. “I would expect very fast, very transparent updates, and it’s somewhat amazing not to see that happening.”

On Sunday, facing mounting criticism, the USDA announced the release of 239 genetic sequences to GISAID. It noted it is also adding raw data to a US federal database “in the interest of public transparency and ensuring the scientific community has access to this information as quickly as possible.” The agency said it will continue to make such data available on a rolling basis.

Dr. Rosemary Sifford, the USDA’s chief veterinarian, told the Times, “Please recall that we’ve been engaged in this for less than a month. We are working very hard to generate more information,” she said.

Overall, the USDA and the US Centers for Disease Control and Prevention continue to consider the risk to the public to be low. Farmworkers and others who have direct contact with infected animals are encouraged to take precautions, however.

While deadly to birds, H5N1 in cows is relatively mild, rarely if ever causing deaths. Milk from sick animals contains high levels of virus, but it is being destroyed. Even if some infected milk makes its way into the milk supply, the Food and Drug Administration is confident that the virus would be killed in the pasteurization process. “Pasteurization has continually proven to inactivate bacteria and viruses, like influenza, in milk,” the agency said in an FAQ Friday. Some experts have called for data confirming this, though.

Concern grows as bird flu spreads further in US cows: 32 herds in 8 states Read More »

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The urban-rural death divide is getting alarmingly wider for working-age Americans

deaths, disease, health care, mortality, natural cause mortality, rural, rural health care, Science, urban, USDA / /

Growing divide —

The cause is unclear, but poverty and worsening health care access are likely factors.

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Dental students, working as volunteers, attend to patients at a Remote Area Medical (RAM) mobile dental and medical clinic on October 7, 2023 in Grundy, Virginia. More than a thousand people were expected to seek free dental, medical and vision care at the two-day event in the rural and financially struggling area of western Virginia.

Enlarge / Dental students, working as volunteers, attend to patients at a Remote Area Medical (RAM) mobile dental and medical clinic on October 7, 2023 in Grundy, Virginia. More than a thousand people were expected to seek free dental, medical and vision care at the two-day event in the rural and financially struggling area of western Virginia.

In the 1960s and 1970s, people who lived in rural America fared a little better than their urban counterparts. The rate of deaths from all causes was a tad lower outside of metropolitan areas. In the 1980s, though, things evened out, and in the early 1990s, a gap emerged, with rural areas seeing higher death rates—and the gap has been growing ever since. By 1999, the gap was 6 percent. In 2019, just before the pandemic struck, the gap was over 20 percent.

While this news might not be surprising to anyone following mortality trends, a recent analysis by the Department of Agriculture’s Economic Research Service drilled down further, finding a yet more alarming chasm in the urban-rural divide. The report focused in on a key indicator of population health: mortality among prime working-age adults (people ages 25 to 54) and only their natural-cause mortality (NCM) rates—deaths among 100,000 residents from chronic and acute diseases—clearing away external causes of death, including suicides, drug overdoses, violence, and accidents. On this metric, rural areas saw dramatically worsening trends compared with urban populations.

Change in age-adjusted, prime working-age, external- and natural-cause mortality rates for metro and nonmetro areas, 1999–2001 to 2017–2019.

Enlarge / Change in age-adjusted, prime working-age, external- and natural-cause mortality rates for metro and nonmetro areas, 1999–2001 to 2017–2019.

The federal researchers compared NCM rates of prime working-age adults in two three-year periods: 1999 to 2001, and 2017 to 2019. In 1999, the NCM rate in 25- to 54-year-olds in rural areas was 6 percent higher than the NCM rate of this age group in urban areas. In 2019, the gap had grown to a whopping 43 percent. In fact, prime working-age adults in rural areas was the only age group in the US that saw an increased NCM rate in this time period. In urban areas, working-age adults’ NCM rate declined.

Broken down further, the researchers found that non-Hispanic White people in rural areas had the largest NCM rate increases when compared to their urban counterparts. Among just rural residents, American Indian and Alaska Native (AIAN) and non-Hispanic White people registered the largest increases between the two time periods. In both groups, women had the largest increases. Regionally, rural residents in the South had the highest NCM rate, with the rural residents in the Northeast maintaining the lowest rate. But again, across all regions, women saw larger increases than men.

  • Age-adjusted prime working-age natural-cause mortality rates, metro and nonmetro areas, 1999–2019.

  • Change in natural-cause, crude mortality rates by 5-year age cohorts for metro and nonmetro areas, 1999–2001 to 2017–2019.

Among all rural working-age residents, the leading natural causes of death were cancer and heart disease—which was true among urban residents as well. But, in rural residents, these conditions had significantly higher mortality rates than what was seen in urban residents. In 2019, women in rural areas had a mortality rate from heart disease that was 69 percent higher than their urban counterparts, for example. Otherwise, lung disease- and hepatitis-related mortality saw the largest increases in prevalence in rural residents compared with urban peers. Breaking causes down by gender, rural working-age women saw a 313 percent increase in mortality from pregnancy-related conditions between the study’s two time periods, the largest increase of the mortality causes. For rural working-age men, the largest increase was seen from hypertension-related deaths, with a 132 percent increase between the two time periods.

Nonmetro age-adjusted, prime working-age mortality rates by sex for 15 leading natural causes of death, 1999–2001 and 2017–2019, as percent above or below corresponding metro rates.

Enlarge / Nonmetro age-adjusted, prime working-age mortality rates by sex for 15 leading natural causes of death, 1999–2001 and 2017–2019, as percent above or below corresponding metro rates.

The study, which drew from CDC death certificate and epidemiological data, did not explore the reasons for the increases. But, there are a number of plausible factors, the authors note. Rural areas have higher rates of poverty, which contributes to poor health outcomes and higher probabilities of death from chronic diseases. Rural areas also have differences in health behaviors compared with urban areas, including higher incidences of smoking and obesity. Further, rural areas have less access to health care and fewer health care resources. Both rural hospital closures and physician shortages in rural areas have been of growing concern among health experts, the researchers note. Last, some of the states with higher rural mortality rates, particularly those in the South, have failed to implement Medicaid expansions under the 2010 Affordable Care Act, which could help improve health care access and, thus, mortality rates among rural residents.

The urban-rural death divide is getting alarmingly wider for working-age Americans Read More »

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Bird flu flare: Cattle in 5 states now positive as Texas egg farm shuts down

bird flu, CDC, Chickens, dairy cows, eggs, health, hens, Highly pathogenic avian influenza, influenza, Science, USDA / /

flare-up —

The risk to the general public remains low, federal officials say.

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Chicken eggs are disposed of at a quarantined farm with bird flu in Israel's northern village of Margaliot on January 3, 2022.

Enlarge / Chicken eggs are disposed of at a quarantined farm with bird flu in Israel’s northern village of Margaliot on January 3, 2022.

The flare-up of highly pathogenic bird flu continues to widen in US livestock after federal officials confirmed last week that the virus has spread to US cows for the first time. The virus has now been detected in dairy cows in at least five states, a single person in Texas exposed to infected cows, and an egg farm in Texas, all spurring yet more intense monitoring and biosecurity vigilance as the situation continues to evolve.

As of Tuesday, seven dairy herds in Texas, two in Kansas, and one each in Idaho, Michigan, and New Mexico had tested positive for the virus. The affected dairy herd in Michigan had recently received cows from one of the infected herds in Texas. It remains unclear if there is cow-to-cow transmission of the flu virus.

The virus—a highly pathogenic H5N1 avian influenza or HPAI—has been devastating wild birds worldwide for the past several years. Throughout the devastating outbreak, the flu virus has spilled over to various species, including big cats in zoos, river otters, bears, dolphins, seals, squirrels, and foxes. While cows were an unexpected addition to the list, federal officials noted last week that affected dairy farms had found dead wild birds on their farms, suggesting that wild birds introduced the virus to the cows, not an intermediate host.

On Monday, the Centers for Disease Control and Protection reported that a person in Texas who had contact with infected dairy cows had tested positive for the HPAI. The person’s only symptom was eye redness. The CDC said the person was treated with an antiviral for flu and was recovering. It is the second case of HPAI found in a person in the US. The first case was in a person in Colorado who was directly exposed to poultry infected with the virus. In that case, the person’s only symptom was fatigue over a few days. The person recovered. The CDC considers the risk of HPAI to the general public to be low.

Low risk

Meanwhile, the virus continues to spread to less-surprising animals: chickens. On Tuesday, Cal-Maine Foods, Inc., the country’s largest producer of fresh eggs, reported that HPAI was detected in one of its facilities in Texas. The facility is located in Parmer County, which sits at the border of Texas and New Mexico. It’s unclear if the egg facility is close to any of the affected dairy herds. Cal-Maine, following the US Department of Agriculture biosecurity protocols, immediately shut down the facility. Approximately 1.6 million hens and 337,000 pullets—young hens—were culled. Cal-Maine said the hens represented about 3.6 percent of the company’s total flock.

Since the outbreak began in wild birds, the virus has led to the deaths of over 82 million commercial and backyard birds in the US, with 48 states affected and over 1,000 outbreaks reported. The infections have spurred increases in egg and poultry prices.

It’s unclear if the virus will have the same effect on milk or beef, but so far, it appears that it will not. In the infected herds, the virus appears to only be affecting a small percentage of animals, particularly older animals, and they generally recover. As the USDA puts it there’s “little to no associated mortality reported.” Milk from sick cows is always diverted from the milk supply, but even if milk contaminated with HPAI were to make it into the supply, the virus would be destroyed in the pasteurization process.

Still, the continued, widespread outbreak and spillovers of HPAI in various species highlight the ever-present risk that influenza viruses could mix together, combining genetic fragments of different strains (genetic reassortment) to create a new strain that could spark outbreaks or even a pandemic in humans. In the current outbreak among dairy cattle, federal researchers were quick to check the genetic sequence of the HPAI, finding that, so far, the strain lacks mutations in key genetic regions that would signal the virus has become more infectious to humans. For now, the USDA and the CDC report that the risk to the public is low.

Bird flu flare: Cattle in 5 states now positive as Texas egg farm shuts down Read More »

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Cows in Texas and Kansas test positive for highly pathogenic bird flu

avian influenza, bird flu, cows, dairy cows, H5N1, health, kansas, milk, Science, texas, USDA / /

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The risk to the public is low, and the milk supply is safe.

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Image of cows

Wild migratory birds likely spread a deadly strain of bird flu to dairy cows in Texas and Kansas, state and federal officials announced this week.

It is believed to be the first time the virus, a highly pathogenic avian influenza (HPAI), has been found in cows in the US. Last week, officials in Minnesota confirmed finding an HPAI case in a young goat, marking the first time the virus has been found in a domestic ruminant in the US.

According to the Associated Press, officials with the Texas Animal Health Commission confirmed the flu virus is the Type A H5N1 strain, which has been ravaging bird populations around the globe for several years. The explosive, ongoing spread of the virus has led to many spillover events into mammals, making epidemiologists anxious that the virus could adapt to spread widely in humans.

For now, the risk to the public is low. According to a release from the US Department of Agriculture (USDA), genetic testing by the National Veterinary Services Laboratories indicated that H5N1 strain that spread to the cows doesn’t appear to contain any mutations that would make it more transmissible to humans. Though the flu strain was found in some milk samples from the infected cows, the USDA emphasized that all the milk from affected animals is being diverted and destroyed. Dairy farms are required to send only milk from healthy animals to be processed for human consumption. Still, even if some flu-contaminated milk was processed for human consumption, the standard pasteurization process inactivates viruses, including influenza, as well as bacteria.

So far, officials believe the virus is primarily affecting older cows. The virus was detected in milk from sick cows on two farms in Kansas and one in Texas, as well as in a throat swab from a cow on a second Texas farm. The USDA noted that farmers have found dead birds on their properties, indicating exposure to infected birds. Sick cows have also been reported in New Mexico. Symptoms of the bird flu in cows appear to include decreased milk production and low appetite.

But so far, the USDA believes the spread of H5N1 will not significantly affect milk production or the herds. Milk loss has been limited; only about 10 percent of affected herds have shown signs of the infection, and there has been “little to no associated mortality.” The USDA suggested it will remain vigilant, calling the infections a “rapidly evolving situation.”

While federal and state officials continue to track the virus, Texas officials aim to assure consumers. “There is no threat to the public and there will be no supply shortages,” Texas Agriculture Commissioner Sid Miller said in a statement. “No contaminated milk is known to have entered the food chain; it has all been dumped. In the rare event that some affected milk enters the food chain, the pasteurization process will kill the virus.”

Cows in Texas and Kansas test positive for highly pathogenic bird flu Read More »