First human death from avian flu sparks calls for stricter hygiene, more testing

After the first U.S. avian flu death was reported this week, Wisconsin health researchers say people with backyard chickens and other poultry should be proactive in guarding against the virus.

The Louisiana Department of Health reported Monday that a patient who was infected with avian flu in December had died. Officials say the person was over the age of 65 and had underlying medical conditions. 

The patient was the first in the country to experience severe illness related to the virus and is the first infected person to die in the U.S. The case is also the first to be tied to a backyard poultry flock instead of a commercial farm.

Tom Friedrich, professor of virology at the University of Wisconsin-Madison’s School of Veterinary Medicine, said more details are needed to understand what led to the patient’s death. But he pointed out that other countries have already seen deaths caused by similar H5N1 viruses, especially in people who are sick enough to be hospitalized.

“There’s over 50 percent case fatality when people have these severe infections,” Friedrich said. “So it’s not unheard of in other parts of the world, even though this is the first time it’s happened in the United States.”

There have been 66 confirmed human cases of avian flu in the U.S., including one in a Wisconsin poultry farm worker in December. More than half of the infections have been in farm workers exposed by infected dairy cows in California. 

Public health officials say the virus is still a low risk to the general public. There has been no evidence of human to human spread.

Friedrich, who studies how viruses can cross from animals to humans, said the receptors on the surface of human cells are different from those in birds, making it harder for the virus to infect people. But he said the case in Louisiana shows some concerning signs.

“They found a few mutations in that virus that likely make it easier for that virus to grab on to human type cells,” he said, adding that there is no sign the virus was transmitted to another person.

Influenza expert urges hygiene, flu shots among people with poultry 

UW-Madison researcher Peter Halfmann has been studying avian influenza for years. He said the nation’s first death is not a reason for panic about the virus. But it is a sign that people with backyard flocks need to take the same biosecurity measures that are recommended to commercial farms.

“People should be vigilant if they have backyard birds,” Halfmann said. “If their birds are looking sick, if their birds are dying, contact the DNR here in Wisconsin or the USDA nationally to let them know.”

He said people should avoid touching sick birds and should practice good hand washing if contact is unavoidable. He also urged people to avoid touching their eyes. Eye infection, or conjunctivitis, has been a  symptom among people with avian flu infections.

Halfmann said people who let their cats spend time outdoors should also take action to prevent possible exposure to the virus. Wild hawks have been infected by eating sick birds and mice, and Halfmann said cats could be exposed in the same way.

He also encouraged anyone working with poultry or dairy cattle to get their seasonal flu shot. He said doing so could prevent H5N1 from swapping genes with human influenza strains.

More testing, data needed to prevent an avian flu pandemic

Halfmann is one of many health experts in Wisconsin and across the U.S. who say the country should be doing more surveillance testing for the virus in humans.

He pointed to a case in Missouri last year where a sick person had no known contact with infected animals.

“We did a lot of surveillance and a lot of sequencing for SARS-CoV-2 during the (COVID-19) pandemic,” Halfmann said. “That has almost stopped, but I think it’s time that we start looking at this again, especially for H5N1.”

An official from the Wisconsin Department of Health Services said last month that the agency offers testing to people who have been in contact with sick poultry and people related to someone who was exposed and become ill.

Dave O’Connor, a professor at UW-Madison’s School of Medicine and Public Health who studies the emergence of new viruses in humans, said public and political backlash to pandemic-era health measures has made it harder to respond to a new virus threat.

“People are deeply exhausted and fatigued, and are also highly skeptical of public health,” O’Connor said. “We’re arguably in a worse position now in terms of mobilizing readiness than we were at the beginning of COVID.”

O’Connor said hindsight shows that the COVID-19 virus was spreading at much higher levels in early 2020 than was believed at the time. But he said the nation’s public health response to avian flu is still relying on reactive testing when there is a large animal die-off or cluster of human infection.

“That increases the potential that, once again, the virus is going to spread explosively, and by the time we recognize the extent of the spread, it’s going to be too late to do something about it,” O’Connor said.

He said it’s possible avian flu could never make a more permanent jump into humans and will remain a minor human disease. But he believes it will take more data to know that for sure as the virus continues to spread in animals.