The Spread and Detection of H5N1 in Dairy Herds

Since the detection of H5N1 in dairy herds In March and April of 2024, H5N1 has been identified in 720 dairy herds in 15 states. A comprehensive investigation into the spread of H5N1 among Michigan farms identified significant biosecurity concerns related to shared equipment and personnel and highlighted challenges in controlling the spread of H5N1 between farms.

Despite this, the United States has not moved to limit these practices. In contrast, Australia, which has other strains of highly pathogenic avian influenza (HPAI) but not H5N1, implements comprehensive movement restrictions that apply to animals and equipment, a practice that has helped limit the geographic spread of HPAI.

Due to the limited preventative measures and expanded testing, PHC Global expects that H5N1 will be identified in additional states and dairy herds in the coming days and months.

Detection of H5N1 in humans

As H5N1 has expanded geographically, human cases have also increased. Initially, H5N1 cases in humans were limited to people who had known close contact with dairy cattle or poultry. More recently, cases have been reported in Missouri and California among individuals with no known animal exposure.

This strongly suggests the virus’s spread is much more extensive than surveillance data indicate. Like the early days of the COVID-19 pandemic, limited surveillance testing for H5N1 has allowed the virus to establish a substantial presence in the agricultural sector.

PHC expects additional cases to be identified in people with no known animal exposure in the coming weeks.

Detection of H5N1 in raw milk

In recent years, consuming raw milk has gained popularity in some online wellness communities and has even been endorsed by prominent public figures despite well-documented evidence of its risks. While drinking raw milk has always carried significant health risks, the possibility of the live H5N1 virus being present is new.

On April 1, PHC issued an alert advising people to avoid drinking raw milk. As predicted, the live H5N1 virus was detected in raw milk and subsequently some products were recalled in November. Additionally, on December 10, health officials announced they are investigating a possible link between a suspected avian flu case and raw milk consumption in Marin County, California. PHC expects that live H5N1 will continue to be detected in raw milk and strongly advises against consuming it.

Announcement of Bulk Milk Testing

The USDA has announced that it will begin widespread bulk milk testing across the United States to help track the virus’s spread among dairy herds. Scientists can map the virus’s geographical distribution and mutation patterns by testing milk samples from multiple farms and regions.

Prior to the USDA-led testing, independent scientists were already monitoring H5N1 spread through the testing of grocery store milk. While these localized studies provided proof of concept, large-scale surveillance remains a critical government function.

While the USDA’s testing initiative may be coming late in the H5N1 outbreak, this new initiative is a welcome development.

“One Mutation Away”

A widely shared scientific paper suggested that H5N1 could be “one mutation away” from becoming highly transmissible among humans. This does not mean imminent human-to-human transmission is inevitable, but it highlights the virus’s potential adaptability as influenza viruses rapidly mutate. The “one mutation” scenario suggests a specific genetic modification could enable more efficient human-to-human transmission.

Currently, this specific mutation scenario remains a theoretical possibility. The overall risk of H5N1 infection is low for the general population. Heightened precautions, such as appropriate personal protective equipment, are warranted for people with direct or indirect contact with dairy herds or poultry.

However, this paper is a stark reminder, much like the symbolic Doomsday Clock, that we are inching closer to another flu pandemic.

Continued Vigilance Necessary

While the current situation doesn’t warrant panic, it demands careful attention. The research community is closely monitoring H5N1 viral samples and tracking potential mutations. The business community needs to be just as engaged in developing and testing preparedness strategies to get through another pandemic.

Early warning helps your business prepare and respond to threats, including pandemic influenza. Don’t let the next biological threat compromise your business continuity. Sign up for a free trial of PHC Pharos today and equip your business with the tools needed to protect your people, assets, and revenue in our ever-changing world.

H5N1 avian influenza-related trade restrictions evoke memories of supply chain meltdowns during early COVID-19, but Hong Kong’s ban on poultry imports from some countries does not reflect a change in the threat posed by food. The actions are a reminder that restrictions can be issued for both safety and political reasons.

On May 27, the Centre for Food Safety in Hong Kong announced a ban on poultry meat and egg imports from several countries, including the US, citing the risk posed by H5N1 avian influenza. Within hours, Macau, another special administrative region of China, issued a similar announcement, which, while not as direct as Hong Kong’s announcement, also implied an immediate ban on US poultry imports.

Context matters at the intersection of public health, trade, and politics

Historical context is important to understand the current situation. In 2015, following a similar period of heightened global awareness of avian influenza, Hong Kong announced a comparable ban on US poultry products, which was part of a broader Chinese ban on US poultry products. The restrictions lasted nearly five years, far exceeding the period of heightened bird flu activity used to justify the ban. Since then, China has issued numerous shorter bans on poultry imports during periods of US avian influenza outbreaks. While Chinese imports of US poultry products account for less than 1% of US to China export value, it does equate to over $1 billion annually for US farmers.

While long-term public health risks from avian influenza are real and growing, the immediate risk from the food supply is small. When outbreaks in poultry facilities are handled properly, the risk of avian influenza entering the food chain is negligible. Additionally, import bans are sometimes used for political reasons. In addition to protectionism, import bans can frame a disease as a foreign threat to the domestic audience. Given that Hong Kong’s 1997 H5N1 cases represent the first example of a purely avian virus causing respiratory disease and death in humans, the new ban is inconsistent with the known ecology of avian influenza viruses.

Don’t let hype or politics distort your risk assessments

Media attention and dramatic headlines can bring attention to the wrong risks, and threaten your bottom line. PHC Global understands businesses need expert-grounded assessments. We combine expertise, data, and technology to give you the insight you need to focus on the real threats to business continuity.

Sign up for a free trial of PHC Pharos today and equip your business with the tools needed for an ever-changing world to protect your people, assets and revenue.

Disease surveillance is multi-purpose and fundamental to public safety

Disease surveillance systems provide ongoing monitoring of health-related data that can be used to understand baselines and to prevent and control disease. Since 1799, when Paul Revere monitored incoming ships for disease as the nation’s first health officer and board of health chair, data on disease has been collected to protect the public. However, for many people, the COVID-19 pandemic intertwined surveillance with restrictions and lockdowns. Erosion of trust in public institutions presents a challenging environment for setting up new surveillance systems to address emerging threats.

Gaps require surveillance innovation

Businesses embracing data-driven decision-making may feel a sense of COVID-inspired deja vu from this lack of data. In the absence of traditional data through testing or health records, alternative or proxy data can be used. Recently, scientists from the University of Washington and the Fred Hutchinson Cancer Center constructed the complete H5N1 viral genetic sequence from two positive samples of grocery store milk. If we can’t go to the source, we can still look at something further downstream.

Proxy data analysis is not self-serve

Analyzing grocery store milk protects the identity of the infected farms, therefore obscuring the location and timing of infections. Downstream and proxy data are useful flashlights when the power goes out, but their illumination is poorer than your ceiling lights. Making sense of these data sources requires more expertise. For example, a positive grocery store milk sample could represent one or more herds’ infections, including multiple versions of the virus, and it could represent the coinfection of multiple H5HN versions in one cow or several cows, each with one version. Similarly, wastewater surveillance data can be heavily impacted by mass gatherings or travel events. Additional data is required to interpret these proxy signals, helpful as they are.

The good news is that grocery store milk may be a more achievable surveillance approach than on-farm testing. The even better news for businesses is that they don’t need to expand their workforce to understand these more nuanced data sources. PHC Pharos evaluates and contextualizes proxy and traditional data through expert analyses and customizable dashboards.

Sign up for a free trial of PHC Pharos today and equip your business with the tools needed for an ever-changing world so that you can protect your people, assets and revenue.

H5N1 in dairy cattle is a wake-up call to CSOs. COVID may feel over, but new disruptive biosecurity threats are constantly emerging. Last week, we told you the milk isn’t the threat—it’s the warning. If H5N1 evolves dangerously, the CSO role will once again be responsible for the company response plan, but the knock-on effects of biosecurity threats can be hard to anticipate. This week, we walk you through three possible and highly disruptive H5N1 scenarios: the agricultural disaster, the moderate pandemic, and the severe pandemic. These scenarios are valuable for shaping preparedness strategies and highlighting biologically possible outcomes but are not intended as near-term predictions.

Scenario #1 Massive Agricultural Disruption

In Scenario #1, H5N1 evolves to massively disrupt agriculture by causing severe disease in dairy or beef cattle or by asymptomatically infecting humans who could unintentionally spread the virus throughout commodity operations (cattle or poultry). The consequences of an H5N1-driven catastrophic agricultural disease would be extensive. Initially, commodity prices would rise dramatically; those costs would then ripple through the US economy. The food industry, grocery stores, restaurants, and anywhere serving food (including public schools and hospitals) would feel the brunt of food scarcity and high prices. How would your food services team adapt? Will there be cost overruns?

A devastating agricultural H5N1 would trigger an international response. Although World Trade Organization member countries are required to justify trade restrictions due to disease, fear could trigger highly reactive import bans. Even if the World Organization for Animal Health (the designated adjudicator of animal disease-related embargos) eventually found import restrictions could not be justified, the impact on U.S. markets would be massive. Agriculture, food, and related industries contribute 5.6% of the US GDP and employ 10.4% of US workers. 2023 US export values included $9.97B (beef), $8.01B (dairy), $5.49B (poultry), and $760M (eggs).

Scenario #2 A Moderate Pandemic – H1N1 Redux

In Scenario #2, H5N1 acquires the ability to be transmitted between people. Influenza viruses have two protein spikes on their outer layer: the H in H5 and the N in N1. Pandemic influenza viruses have novel spike proteins that our immune systems haven’t seen before. That universal lack of past exposure through infection and vaccine means essentially all people are susceptible to the new virus. Current seasonal influenza vaccines cover an H3N2 and an H1N1 (along with two influenza B viruses); the H5 would be entirely new.

Pandemic severity reflects the transmissibility and severity of illness. In Scenario #2, H5N1 would echo the 2009-2010 H1N1 swine flu pandemic, which was moderately infectious and moderately severe. To imagine the company impacts of this scenario, CSOs can review the impacts that moderate biosecurity threats (e.g., H1N1 or Zika) had on their operations and assess what new options exist today. Key questions include:

• What departments or roles had the greatest excess absenteeism or reduced productivity? What were the challenges faced in 2009-2010, and were they fully addressed during COVID-19, or do you need to find solutions? Where hybrid isn’t an option, did reduced customer demand match absenteeism impacts?
• Did your business host flu vaccine clinics onsite to lower barriers to employees getting the extra flu shot? H1N1 got a separate vaccine from seasonal flu that year. The same thing could happen if H5N1 evolves. Reducing infections can limit productivity losses, reduce absenteeism, and save on health insurance premiums.
• Are your business continuity plans up to date, to include lessons learned? Do they reflect the current organizational structure and identify the correct decision makers?

Scenario #3 A Severe Pandemic – H5N1 Goes Person-to-Person and Regains Previous Severity

In this darkest scenario, a severe H5N1 pandemic spreads easily between people and regularly causes severe disease. An earlier strain of H5N1 killed about 50% of identified human cases. Even if H5N1 didn’t kill half of the people infected, a plausible worst-case scenario could see rates much higher than the 8.7% case fatality rate that COVID averaged in studies conducted during the first year of the pandemic. This severe influenza pandemic would be COVID on steroids.

No pandemic looks exactly like the previous pandemic, but the experience of decision makers can be invaluable in tackling a new crisis. Before staff turnover cements a complete loss of institutional knowledge, CSOs should document not just the decisions made during past pandemics but also the challenges and the considerations. A playbook that dictates if X then Y will rapidly fall short. Instead, CSOs should record the decision-making processes, criteria, considerations, and ripple effects. Lessons learned should not focus on the specific tactical solution selected but rather on how leaders successfully understood the problem and strategically planned for it.

Waiting to develop a plan is too risky for today’s conditions. These scenarios require thoughtful consideration and planning to ensure your business weathers any possible disruption. PHC Global understands businesses need early warning on both tactical and strategic intelligence. We combine expertise, data, and technology to give you the insight you need now to ensure business continuity.

Sign up for a free trial of PHC Pharos today and equip your business with the tools needed for an ever-changing world, so you can protect your people, assets and revenue.

Influenza is particularly good at traveling the globe.

Genomic sequencing indicates that an initial H5N1 spillover from birds to several dairy cattle herds. Movement of cattle with undetected infections spread H5N1 to other farms. After this introduction into dairy cows, spillback into migratory birds—or wild mammals—could cause the dairy cattle H5N1 strain to spread further within the United States or beyond its borders. 

These concerns aren’t overblown. Migratory birds have spread earlier versions of H5N1 along their flyways, allowing new viruses to travel the world within two years.

Movement of dairy cattle can introduce the virus to new farms, even with the new Federal testing requirements for cattle. Once the infection is introduced to a farm, H5N1 can quickly spread among dairy cows, likely through contaminated milking equipment. H5N1 infection in cows is mild; the most pronounced symptom is a temporary reduction in milk production. However, H5N1 has caused significant illness–and high rates of mortality–in other mammals. An earlier version of H5N1 had a ~50% mortality rate in humans.

What happens on the farm doesn’t stay on the farm. Agriculture impacts ripple globally.

Given the potential economic impact of H5N1 on milk production and operational costs, it’s only natural that it is top of mind for agricultural businesses.

However, enterprise businesses outside the agricultural sector are also exposed to risks. Most immediately, enterprise businesses—including those outside the United States—purchasing poultry or cattle products (eggs, dairy, beef, etc.) should prepare for price fluctuations. 
Influenza viruses constantly evolve, and these shifts can happen quickly. In an ever-changing—and mutating—landscape, staying ahead of risks is more important than ever. PHC Global’s Pharos early warning system empowers subscribers to stay ahead of the curve and effectively manage risks before a significant disruption occurs.

Don’t let the next biological threat compromise your business continuity. Sign up for a free trial of PHC Pharos today and equip your business with the tools needed for an ever-changing world, so you can protect your people, assets and revenue.

Before COVID-19, when pandemic experts imagined the next great threat, we always started with a novel influenza virus. Other diseases have also caused pandemics, but influenza is a constantly evolving and ever-present threat. Seasonal influenza viruses have slight changes that let them infect people year after year, but pandemics come from significant shifts in the virus. The 2009-2010 H1N1 pandemic was most recent, but the Great Influenza pandemic of 1918 is what we feared most – one-fifth of the world infected and 50 million dead, far more than the 16 million lives lost in World War I.

The Current State of H5N1 and Its Potential Risks

Flu viruses are excellent at picking up mutations. When two different viruses infect the same person or animal, they can exchange genetic material. The current H5N1 strain (H5N1 2.3.4.4b) can now infect a surprisingly wide variety of birds and mammals. While it is no longer as deadly in humans (the 50% fatality rate was seen earlier in different H5N1 strains), it has caused mass die-offs in sea lions and seals. The more it spreads in mammals, the more opportunities for a mutation that could enable it to cause severe disease in humans or allow for person-to-person transmission. The detection of H5N1 viral fragments in 1 out of 5 grocery store milk samples in many states indicates the virus is far more widespread than initially thought. As expected, gold-standard egg-inoculation tests have shown that pasteurization inactivates the virus. The milk isn’t the threat; it’s the early warning of what could happen.

For most enterprise businesses, the current situation is a straightforward, early signal of a potential disruptive threat. The virus may never evolve to transmit between people, but it has regularly surprised us. With COVID in the rear-view mirror for many, the current situation is a reminder that biosecurity threats will continue to emerge.

Businesses can take several actions now:

• Review your pandemic plan NOW, before an emergency: update personnel information and ensure designated decision-makers know their roles and decision criteria.
• Evaluate planning for flu vaccine clinics on site in the fall. If H5N1 evolves to spread easily between humans, an additional flu vaccine may be developed (as happened in the 2009-2010 H1N1 pandemic). On-site flu clinics could provide both seasonal and H5N1 vaccines if warranted.
• Encourage employees to stay home when sick and to work from home as appropriate. This practice prepares employees and IT teams for widespread remote or hybrid work, if necessary maintain or establish a work culture that supports employees’ choices to wear masks. An open environment makes it easier for other employees to add this layer of protection if the risk rises. Reducing infections protects workers’ health, reduces absenteeism, and can reduce employer health insurance costs.
• Maintain or increase the budget for cleaning supplies and hand sanitizer to avoid unexpected costs. Increase the cadence for reviewing purchasing schedules. An unpredictable future is not the time for “set it and forget it.”
• Prepare for milk and egg price volatility when developing food service budgets. Mandatory testing or other interventions may add costs to milk production that are eventually passed down to the consumer.

Strategic Organizational Pandemic Planning

Staying ahead of potential risks is more critical now than ever; that’s where PHC Pharos comes in. As a dedicated early warning system, PHC Pharos empowers subscribers with real-time intelligence and expert recommendations to navigate the complex biosecurity landscape effectively. It’s not simply managing potential risks; it’s about solutions and staying ahead of them.

Don’t wait for the next biological threat to disrupt your business continuity.

Sign up for PHC Pharos today and equip your business with the tools to stay one step ahead in an ever-changing world.