Highly Pathogenic Avian Influenza (HPAI) H5N1: Early Warning

PHC is tracking the evolution of highly pathogenic avian influenza (HPAI) H5N1 2.3.4.4b strain to provide early warning to PHC’s partners. Currently, the risk of person-to-person transmission of H5N1 is low, although as H5N1 expands into new animal reservoirs, this may change quickly.
As time passes, the risk of mutations that increase its severity or allow transmission between people increases — as does the risk of a pandemic.

Expert Insights

advisory
H5N1 identified in 3 Idaho alpacaIdaho05/28/24

Enterprise businesses are not directly affected, but detection of H5N1 in alpacas illustrates that the disease is spreading to new animal groups and to more areas. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26. ...SEE MORE

Enterprise businesses are not directly affected, but detection of H5N1 in alpacas illustrates that the disease is spreading to new animal groups and to more areas. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26.

Alpaca have not previously tested positive for H5N1, but given the many other mammals that have been infected, this finding is not completely unexpected. The strain in the alpaca was the same as in poultry that had been culled on the premises; it is also the same as the strain found in US dairy cattle. [Confidence: Very High]

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advisory
H5N1 detected in muscle tissue in one cow diverted from food chainUnited States of America05/24/24

Prior studies have found H5N1 is inactivated when proper food safety cooking recommendations are followed. Businesses should continue to follow food safety protocols when handling and cooking beef. See PHC analysis on 4/26 for more information and guidance on this outbreak....SEE MORE

Prior studies have found H5N1 is inactivated when proper food safety cooking recommendations are followed. Businesses should continue to follow food safety protocols when handling and cooking beef. See PHC analysis on 4/26 for more information and guidance on this outbreak.

Diverted cows are not allowed to enter the food chain. To date, one cow of the 96 cows tested has been positive for H5N1. No meat from these dairy cattle entered the food supply. [Confidence: Very High]

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watch
Study finds H5N1 positive raw milk sickens mice, poses risk to humansUnited States of America05/24/24

Businesses should not stock raw milk to avoid liability due to numerous diseases that can be transmitted in unpasteurized milk....SEE MORE

Businesses should not stock raw milk to avoid liability due to numerous diseases that can be transmitted in unpasteurized milk.

A laboratory study found mice that consumed raw milk positive for H5N1 contained high virus titers, indicating infection. Prior studies have confirmed that pasteurization inactivates the H5N1 virus, making it safe to drink. [Confidence: Very High]

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advisory
H5N1 detected in 7 new US dairy herds this week in Michigan, Idaho, and TexasMichigan05/24/24

The detection of H5N1 in additional dairy herds is not unexpected and does not indicate an immediate change in overall risk. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26. ...SEE MORE

The detection of H5N1 in additional dairy herds is not unexpected and does not indicate an immediate change in overall risk. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26.

H5N1 was detected in 7 new US dairy herds this week in Michigan (4 herds), Idaho (1), and Texas (1). See PHC alerts 4/1, 4/29, and 5/21 for more info. [Confidence: Very High]

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advisory
Michigan's first human case of influenza A (H5) detected in a farm workerMichigan05/22/24

The detection of a second positive farm worker is not unexpected and does not indicate an immediate change in overall risk. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26. ...SEE MORE

The detection of a second positive farm worker is not unexpected and does not indicate an immediate change in overall risk. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26.

Michigan reported its first human case of H5N1 avian influenza in a farmworker who worked with livestock infected with H5N1. This is the first human case of H5N1 since March 29. See PHC alerts 4/1 and 4/29 for more info. [Confidence: Very High]

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advisory
Australia reports a human case of H5N1, the first time H5N1 has been identified in a person or animal in AustraliaVictoria05/22/24

Human cases of H5N1 are rare; the risk of an outbreak is extremely low. Employees in or traveling to countries where human H5N1 cases have been identified, such as Vietnam or India, should avoid live-animal markets and not have contact with or consume diseased poultry....SEE MORE

Human cases of H5N1 are rare; the risk of an outbreak is extremely low. Employees in or traveling to countries where human H5N1 cases have been identified, such as Vietnam or India, should avoid live-animal markets and not have contact with or consume diseased poultry.

Australia reported a human case of H5N1, the first time H5N1 has been identified in a person or animal in Australia. The case is a child with a history of travel to India. Close contacts were monitored, but have not tested positive. [Confidence: Very High]

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advisory
Three more Michigan dairy herds test positive for H5N1Michigan05/21/24

Informational update only....SEE MORE

Informational update only.

Michigan reported that 3 more dairy herds have tested positive for H5N1, affected counties include Clinton, Gratiot, and Ionia. 18 dairy herds in MI have now had positive tests among their cows. [Confidence: Very High]

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advisory
USDA study finds H5N1 can be inactivated by fully cooking beef United States of America05/17/24

H5N1 in eggs and poultry is killed by cooking; a new study results find the same for cooked beef. USDA recommends cooking beef to 160 degrees (well done). See PHC analysis on 4/26 for more information and guidance on this outbreak....SEE MORE

H5N1 in eggs and poultry is killed by cooking; a new study results find the same for cooked beef. USDA recommends cooking beef to 160 degrees (well done). See PHC analysis on 4/26 for more information and guidance on this outbreak.

A USDA study found that fully cooking beef inactivates the H5N1 virus, making it safe to eat. The study involved inoculating beef patties with an H5N1 virus surrogate, cooking it to different temperatures, and then checking for live virus. Results indicate that cooking the beef to medium or well done fully inactivated the virus. The study was conducted after H5N1 was found to infect dairy cows; there were concerns about beef cows becoming infected or posing a risk to the commercial beef supply. [Confidence: Very High]

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advisory
Michigan’s largest commercial egg producer lays off 40% of its workers amidst H5N1 outbreakIonia County05/17/24

Businesses with eggs sourced from Michigan should assess their supply chains and expect price fluctuations in response to production shortfall....SEE MORE

Businesses with eggs sourced from Michigan should assess their supply chains and expect price fluctuations in response to production shortfall.

Herbruck’s Poultry Ranch, Michigan's largest commercial egg producer, reported laying off 400 workers across 5 facilities. Due to H5N1, many commercial bird flocks are being culled--reducing the need for labor--and facilities decontaminated to prevent the spreading of H5N1, the first time this has been done in MI. Avian flu has affected the poultry industry since 2022, but this is the first time the commercial egg industry has been affected. Herbruck’s reported that they intend for the layoffs to be temporary. [Confidence: Very High]

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advisory
USDA detects H5N1 in 3 new dairy herds in Michigan and IdahoMichigan05/16/24

Informational update only....SEE MORE

Informational update only.

The USDA reported that H5N1 has been detected in 3 new dairy herds, 2 in Michigan and 1 in Idaho. 9 states have detected H5N1 in dairy herds, with Michigan having the most outbreaks (14). [Confidence: Very High]

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advisory
H5N1 detected in 6 wild birds in New York CityNew York05/16/24

Detecting H5N1 in urban wild birds in NYC is not surprising since migratory birds interact with urban bird populations, but this has not been well documented. The current risk of human disease is low, but individuals should not interact with wild birds. ...SEE MORE

Detecting H5N1 in urban wild birds in NYC is not surprising since migratory birds interact with urban bird populations, but this has not been well documented. The current risk of human disease is low, but individuals should not interact with wild birds.

Researchers reported that 6 of 1,792 samples collected from wild birds in New York City tested positive for H5N1. The positive samples were found in a red tail hawk, Canadian geese, a Peregrine falcon, and a chicken. The H5N1 strains were a mix of Eurasian and North American avian flu viruses. [Confidence: Very High]

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advisory
Highly pathogenic avian influenza (HPAI) identified in sewage samples of 9 Texas cities Texas05/15/24

Informational update only....SEE MORE

Informational update only.

19 of 23 sewage samples collected in 9 Texas cities tested positive for highly pathogenic avian influenza (HPAI). Samples were collected from 10 cities over two months, with 9 cities having at least one positive sample. Tests cannot identify the virus source as coming from animals, humans, or milk. [Confidence: Very High]

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advisory
Canada's commercial milk supply samples all tested negative for H5N1 Canada05/15/24

These test results indicate that H5N1 has not entered the Canadian dairy cattle population....SEE MORE

These test results indicate that H5N1 has not entered the Canadian dairy cattle population.

The Canadian Food Inspection Agency reported that tests conducted on 142 samples of their commercial milk supply have all tested negative for H5N1. Tests conducted on Canadian dairy cows have also been negative. [Confidence: Very High]

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advisory
Raw milk sales rise amidst H5N1 misinformationUnited States of America05/14/24

Raw milk sales are rising due to misinformation on H5N1. Businesses should not stock raw milk to avoid liability due to numerous diseases that can be transmitted in unpasteurized milk....SEE MORE

Raw milk sales are rising due to misinformation on H5N1. Businesses should not stock raw milk to avoid liability due to numerous diseases that can be transmitted in unpasteurized milk.

Market research reports weekly sales of raw cow’s milk have increased 21% to 65% compared with the same period a year ago. Some social media influencers are promoting raw milk and making false statements about its safety and health benefits. [Confidence: Very High]

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advisory
Michigan's "Extraordinary Emergency" H5N1 mitigation strategies go into effect todayMichigan05/08/24

Businesses operating in Michigan should be aware of the new biosecurity protocols and have a plan for implementing them when applicable....SEE MORE

Businesses operating in Michigan should be aware of the new biosecurity protocols and have a plan for implementing them when applicable.

Michigan's biosecurity mitigation strategies aimed at preventing spread of H5N1 among cattle and poultry go into effect today. These practices must be implemented at all dairy farms and commercial poultry operations in Michigan until further notice. [Confidence: Very High]

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advisory
USDA's tests on beef products found no H5N1 influenza United States of America05/02/24

These test results confirm that the commercial beef supply does not contain H5N1 virus. Businesses should continue to follow food safety protocols when handling and cooking beef. See PHC analysis on 4/26 for more information and guidance on this outbreak....SEE MORE

These test results confirm that the commercial beef supply does not contain H5N1 virus. Businesses should continue to follow food safety protocols when handling and cooking beef. See PHC analysis on 4/26 for more information and guidance on this outbreak.

Tests conducted on beef products by the USDA found no H5N1 avian influenza. The tests were conducted on ground beef sold in grocery stores in areas where dairy cows have tested positive for H5N1. [Confidence: Very High]

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advisory
Lack of early surveillance may have missed other human H5N1 cases, but person-to-person risk remains lowUnited States of America05/02/24

Despite widespread media coverage, no new information has emerged. See PHC analysis on 4/26 for earlier assessment. Increased surveillance is likely to identify more human H5N1 cases among dairy workers, but the risk of human-to-human spread still remains low. ...SEE MORE

Despite widespread media coverage, no new information has emerged. See PHC analysis on 4/26 for earlier assessment. Increased surveillance is likely to identify more human H5N1 cases among dairy workers, but the risk of human-to-human spread still remains low.

The first human case of H5N1 tied to cow-to-human interaction was identified on March 29, soon after H5N1 was found to have infected dairy cows in multiple states. Since then, surveillance of poultry, cows, dairy products, and humans has increased. Investigation has found that multiple dairy workers had illnesses that may have been H5N1 around the time that dairy cows were testing positive, but before human surveillance activities had begun. [Confidence: Very High]

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advisory
On one farm, over half of the cats who drank raw milk from cows infected with H5N1 diedTexas05/01/24

Informational update only. Businesses may want to remind their employees to avoid consuming raw milk or feeding it to their pets as it may contain harmful pathogens....SEE MORE

Informational update only. Businesses may want to remind their employees to avoid consuming raw milk or feeding it to their pets as it may contain harmful pathogens.

Over half of the domestic cats on a Texas dairy farm who drank raw milk from cows infected with H5N1 died. The cats became sick one day after symptoms were noted in the cows (March 16/17). Several cats died between March 19–20. Two cats who died were tested for H5N1; both were positive. Cats are known to be susceptible to severe illness from H5N1. [Confidence: Very High]

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advisory
FDA reports that pasteurization inactivated H5N1 in cottage cheese, milk, and sour creamUnited States of America05/02/24

These test results confirm that the commercial milk supply is safe. ...SEE MORE

These test results confirm that the commercial milk supply is safe.

Today, the FDA released the anticipated results from the egg inoculation studies that confirmed pasteurization inactivates H5N1 in dairy products. [Confidence: Very High]

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advisory
Travel advisory to Cambodia raised following 4 human cases and 1 death from H5N1 avian influenza Cambodia02/21/24

Taiwan's elevation of the travel advisory around H5N1 in Cambodia does not require businesses operating in Taiwan to make any changes, but employees on work travel to Cambodia may have additional questions. As previously noted, employees should avoid live-animal markets and not have contact with or consume diseased poultry. ...SEE MORE

Taiwan's elevation of the travel advisory around H5N1 in Cambodia does not require businesses operating in Taiwan to make any changes, but employees on work travel to Cambodia may have additional questions. As previously noted, employees should avoid live-animal markets and not have contact with or consume diseased poultry.

Cambodia has reported 4 human cases and 1 death related to H5N1 avian influenza A since mid-Jan 2024. All cases had contact with infected poultry. The Ministry of Health & Welfare issued a travel advisory to Cambodia, cautioning against interacting with poultry when visiting the area. H5N1 influenza is typically spread between birds (both domestic and wild) and can occasionally spread from birds to humans, but human-to-human transmission is extremely rare. Viral mutations could increase the potential for human-to-human transmission. [Confidence: Very High]

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advisory
Ohio dairy cattle test positive for H5N1 avian influenzaOhio04/04/24

Informational update only. Businesses may want to remind their employees to avoid consuming raw milk as it may contain harmful pathogens....SEE MORE

Informational update only. Businesses may want to remind their employees to avoid consuming raw milk as it may contain harmful pathogens.

Ohio reported that highly pathogenic H5N1 avian influenza (HPAI) was detected in a herd of dairy cattle, the first in this state. The infected cows were from Texas, a state which recently reported HPAI in some livestock, raw milk, and one farmer. The type of H5N1 identified in the cattle is the same that has been causing mass die-offs of birds around the world; it is different from the H5N1 that has caused human fatalities in the past. [Confidence: Very High]

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advisory
Cal-Maine Foods temporarily halts egg production after detection of H5N1 avian influenza in Texas flockUnited States of America04/05/24

Information update only. Standard industry practice is to cull all birds when Highly Pathogenic Avian Influenza is identified in a commercial flock. The risk of human disease remains low, but avian flu outbreaks in poultry can have a financial impact on businesses in the food industry and can also increase the price of consumer eggs and chicken. ...SEE MORE

Information update only. Standard industry practice is to cull all birds when Highly Pathogenic Avian Influenza is identified in a commercial flock. The risk of human disease remains low, but avian flu outbreaks in poultry can have a financial impact on businesses in the food industry and can also increase the price of consumer eggs and chicken.

Cal-Maine Foods reported detection of H5N1 avian influenza in a Texas flock, necessitating a temporary halting of egg production. The culled birds represent 3.6% of the company's birds. Eggs that are handled and cooked appropriately are safe to eat. [Confidence: Very High]

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advisory
Texas poultry flock tests positive for H5N1 avian influenzaTexas04/02/24

Informational update included due to recent H5N1 cases in cattle and a human in Texas. The risk of human disease remains low, but avian flu outbreaks in poultry can have a financial impact on businesses in the food industry and can also increase the price of consumer chicken. ...SEE MORE

Informational update included due to recent H5N1 cases in cattle and a human in Texas. The risk of human disease remains low, but avian flu outbreaks in poultry can have a financial impact on businesses in the food industry and can also increase the price of consumer chicken.

Texas reported avian influenza H5N1 in a commercial poultry flock in a facility owned by the largest US egg producer. This comes just one day after H5N1 was identified in a farmer with exposure to infected cows. H5N1 influenza is typically spread between birds (both domestic and wild) and can occasionally spread from birds to other animals and humans, but human-to-human transmission is extremely rare. The type of H5N1 identified in the Texas poultry is the same that has been causing mass die-offs of birds around the world; it is different from the H5N1 that has caused human fatalities in the past. [Confidence: Very High]

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advisory
USDA to test beef products for H5N1 avian influenzaUnited States of America04/30/24

Informational update only. H5N1 has only been identified in dairy cows; beef cows are now being tested. Additionally, H5N1 has been proven to be killed by the cooking process with eggs and poultry; cooking beef is expected to be the same. See PHC analysis on 4/26 for more information and guidance on this outbreak....SEE MORE

Informational update only. H5N1 has only been identified in dairy cows; beef cows are now being tested. Additionally, H5N1 has been proven to be killed by the cooking process with eggs and poultry; cooking beef is expected to be the same. See PHC analysis on 4/26 for more information and guidance on this outbreak.

The USDA reported that they will conduct tests on beef to identify H5N1 avian influenza. 3 types of tests will be conducted: 1) sampling ground beef in grocery stores, 2) testing muscle tissue from sick cows culled from affected herds, and 3) testing cooked beef inoculated with a virus surrogate to see if it survives. [Confidence: Very High]

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advisory
Florida identifies dolphin with highly pathogenic avian influenza H5N1, first cetacean with H5N1 in North AmericaDixie County04/30/24

Informational update only. Enterprise businesses are not directly affected, but detection of H5N1 in dolphins in North America illustrates that the disease is spreading to new animal groups and to more areas. See PHC analysis on 4/26 for more information and guidance on this outbreak....SEE MORE

Informational update only. Enterprise businesses are not directly affected, but detection of H5N1 in dolphins in North America illustrates that the disease is spreading to new animal groups and to more areas. See PHC analysis on 4/26 for more information and guidance on this outbreak.

Dixie County, Florida reported identification of a dolphin infected with highly pathogenic avian influenza H5N1, the first cetacean with H5N1 in North America. It is not known how the dolphin became infected. Researchers are investigating. Many other species of marine mammals have experienced H5N1-related die-offs. [Confidence: Very High]

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advisory
Vietnam reports first human death from H5N1 avian influenza since 2022 Vietnam03/25/24

Businesses with employees in or traveling to Vietnam should advise them to avoid live-animal markets and not have contact with or consume diseased poultry....SEE MORE

Businesses with employees in or traveling to Vietnam should advise them to avoid live-animal markets and not have contact with or consume diseased poultry.

Vietnam has reported a human death from H5N1 avian influenza; this is only Vietnam's second case since 2014. The individual had a history of exposure to wild birds. H5N1 influenza is typically spread between birds (both domestic and wild) and can occasionally spread from birds to humans, but human-to-human transmission is extremely rare. Viral mutations could increase the potential for human-to-human transmission. [Confidence: Very High]

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advisory
USDA requirement of H5N1 testing of cows prior to interstate travel starts todayUnited States of America04/29/24

For awareness only. USDA's policy requiring a negative H5N1 test to transport lactating cows goes into effect today. This requirement may detect additional outbreaks outside those in the 9 known impacted states....SEE MORE

For awareness only. USDA's policy requiring a negative H5N1 test to transport lactating cows goes into effect today. This requirement may detect additional outbreaks outside those in the 9 known impacted states.

The USDA now requires H5N1 testing of all lactating cows being transported across states. All lactating cows must be tested prior to travel, up to 30 cows per herd being transported. [Confidence: Very High]

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advisory
H5N1 detected in cows in Colorado, the 9th state with confirmed H5N1Colorado04/29/24

Informational update only. Enterprise businesses outside the dairy supply chain are not directly affected, but detection in a 9th state demonstrates that the outbreak might be more widespread than is currently known. See PHC analysis on 4/26 for more information and guidance on this outbreak....SEE MORE

Informational update only. Enterprise businesses outside the dairy supply chain are not directly affected, but detection in a 9th state demonstrates that the outbreak might be more widespread than is currently known. See PHC analysis on 4/26 for more information and guidance on this outbreak.

The USDA announced that highly pathogenic avian influenza (HPAI) H5N1 has been detected in dairy cows in Colorado, making it the 9th state to identify H5N1 in cows. No additional human H5N1 cases have been identified since the dairy farmer earlier this year; however, H5N1 is not included on standard respiratory panels. [Confidence: Very High]

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advisory
First human death from H5N1 avian influenza in Cambodia, 2024Kratie02/12/24

Businesses in Cambodia should inform their employees to avoid live-animal markets and not have contact with or consume diseased poultry. ...SEE MORE

Businesses in Cambodia should inform their employees to avoid live-animal markets and not have contact with or consume diseased poultry.

A 9 year boy died of H5N1 avian influenza in Kratie province, Cambodia, the first death from avian influenza in Cambodia in 2024. Days later, his brother tested positive, but has been asymptomatic. The boys were exposed by infected poultry at their house; 5 chickens and 3 ducks had died and were cooked for food. Cambodia has been experiencing a resurgence of H5N1 human cases after a decade-long absence of cases. These brothers bring the number of human H5N1 cases in Cambodia in 2024 to four. Risk to the general population from H5N1 remains low, but sporadic cases will likely continue. [Confidence: Very High]

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advisory
Texas reports a case of human avian influenza H5N1; second case in the United States since 2022Texas04/01/24

Informational update only. Businesses may want to remind their employees to avoid consuming raw milk as it may contain harmful pathogens....SEE MORE

Informational update only. Businesses may want to remind their employees to avoid consuming raw milk as it may contain harmful pathogens.

Texas reported a human case of avian influenza H5N1, the second case in the US since 2022. The case developed conjunctivitis after contact with dairy cows presumed to be infected with avian influenza. H5N1 influenza is typically spread between birds (both domestic and wild) and can occasionally spread from birds to other animals and humans, but human-to-human transmission is extremely rare. The type of H5N1 identified in the cattle is the same that has been causing mass die-offs of birds around the world; it is different from the H5N1 that has caused human fatalities in the past. [Confidence: Very High]

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advisory
Cambodia records second H5N1 case of 2024Cambodia01/29/24

This newly reported case of avian influenza (H5N1) in Cambodia does not require increased respiratory precautions for the general public. Individuals in close contact with poultry should use personal protective equipment....SEE MORE

This newly reported case of avian influenza (H5N1) in Cambodia does not require increased respiratory precautions for the general public. Individuals in close contact with poultry should use personal protective equipment.

A Cambodian man who kept backyard chickens has contracted H5N1 influenza. H5N1 influenza is typically spread between birds (both domestic and wild) and can occasionally spread from birds to humans, but human-to-human transmission is extremely rare. Viral mutations could increase the potential for human-to-human transmission.

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ANALYSIS
H5N1 is another reason to avoid rare beefUnited States of America05/22/24

As grilling season heats up in the Northern Hemisphere, it is crucial to ensure meat is cooked to safe temperatures to prevent foodborne illness....SEE MORE

As grilling season heats up in the Northern Hemisphere, it is crucial to ensure meat is cooked to safe temperatures to prevent foodborne illness.

While H5N1 has not been identified in retail beef, the current H5N1 outbreak among dairy cows warrants taking additional precautions to ensure food safety. In a question-and-answer session with reporters, USDA scientists disclosed that existing safe cooking temperature recommendations for ground beef and steaks are adequate to prevent H5N1 exposure through food.

The USDA reported that hamburgers cooked to 120° Fahrenheit–the temperature of a rare steak–still contained traces of an H5N1 surrogate virus. The H5N1 surrogate virus was killed in hamburgers cooked to 145° F (medium) and 160° F (well done).1 While steaks are safe from other microbial contamination when cooked to 145° F, the USDA considers ground beef safe only when cooked to 160° F (well done). A complete list of safe minimum temperatures is available on the USDA website.

In addition to preventing possible H5N1 transmission, cooking meat to recommended temperatures helps prevent other foodborne illnesses caused by other viruses, bacteria, and parasites. An estimated 9.4 million cases of foodborne illness occur in the United States each year, and approximately 55,000 cases require hospitalization. Foodborne illnesses result in more than 1,300 deaths each year.2

For your safety, PHC strongly recommends using a food thermometer to ensure meats reach safe internal temperatures. This inexpensive and easy-to-use tool can significantly reduce the incidence of foodborne illnesses.

References

  • 1. https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/livestock/h5n1-beef-safety-studies
  • 2. https://wwwnc.cdc.gov/eid/article/17/1/p1-1101_article

Confidential and Proprietary

PHC Global provides this material for informational purposes only. It does not constitute, and is not a substitute for, medical services or advice and should not be construed as such.

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ANALYSIS
H5N1 Preprint Study Findings May Hold Good News for Cattle and Beef IndustryUnited States of America05/10/24

A recent preprint study of cow tissue may bode well for the beef industry and explain the unusual way that H5N1 appears to spread among dairy cows in the United States....SEE MORE

A recent preprint study of cow tissue may bode well for the beef industry and explain the unusual way that H5N1 appears to spread among dairy cows in the United States.1

Researchers studied various tissues present in dairy cows and identified that memory gland tissue–such as that found in a cow udder–contained a large number of the cell receptors that H5N1 binds to. Equally important, the study found low numbers of these H5N1 binding sites in respiratory and brain tissue.

These biological findings support the hypothesis that H5N1 is transmitted among cows by infected milk – likely small amounts of infected milk remaining on milking equipment. These findings also help explain why the most significant symptoms of H5N1 infection in dairy cows –mastitis and a drop in milk production–are unrelated to the respiratory and neurological systems, where H5N1 has previously been documented.

The beef industry should take notice of these findings. The 2.3.4.4b strain of the virus–in the absence of commercial milking equipment–may be hard to transmit between dairy cows and beef cattle or among beef cattle due to the low numbers of H5N1 receptor sites in the respiratory tract.

References

  • https://www.biorxiv.org/content/10.1101/2024.05.03.592326v1

Confidential and Proprietary

PHC Global provides this material for informational purposes only. It does not constitute, and is not a substitute for, medical services or advice and should not be construed as such.

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ANALYSIS
H5N1 in Dairy Cattle: What You Need to KnowUnited States of America 05/08/24

The detection of highly pathogenic avian influenza H5N1 in dairy cattle is a rapidly evolving multi-state outbreak. In this analysis, PHC assesses the current situation and describes low-effort actions to take now. Details for each bullet are available at the end of the analysis....SEE MORE

The detection of highly pathogenic avian influenza H5N1 indairy cattle is a rapidly evolving multi-state outbreak. In this analysis, PHC assesses the current situation and describes low-effort actions to take now. Details for each bullet are available at the end of the analysis.

Brief Overview:

In March 2024, highly pathogenic avian influenza (HPAI) H5N1 was detected in adairy herd in Texas. In the following weeks, 33 herds in 8 states tested positive for H5N1.1 This week, viral fragments were found in grocery store milk. HPAI H5N1 has been devastating to poultry operations for several years. Before the current strain emerged, H5N1 had a roughly 50% mortality rate in humans, but the current strain (H5N1 2.3.4.4b) typically causes mild disease in people. The current outbreaks in cattle do not pose an immediate threat to employee safety or work continuity for enterprise businesses, but the situation is rapidly evolving. PHC details low-effort actions businesses can take now to prepare for potential shifts in the virus behavior.

PHC's assessment:

  • H5N1 has been circulating in cows for many months. [Strong evidence]
  • H5N1 genetic material is present in grocery store milk. [Strong evidence]
  • Infectious H5N1 is not present in grocery store milk. [More evidence needed]
  • Human infection with this H5N1 is often but not always mild. [More evidence needed]
  • Person-to-person transmission of H5N1 is currently rare. [Strong evidence]
  • Human infection with this strain of H5N1 is rare. [Not well investigated]
  • H5N1 is susceptible to commercially available antiviral medicines used to treat seasonal influenza. [Strong evidence]
  • Existing processes and manufacturing platforms can be used to jump start the development of a human vaccine against H5N1 if needed. [Strong evidence]
  • PHC predicts restrictions on and testing requirements for dairy cattle movement will continue to evolve. [High confidence]

Unanswered questions:

  • How did the first infection in a cow occur?
  • How is H5N1 transmitted between cows and from cows to humans?
  • How widespread is the outbreak?
  • How feasible is it to control H5N1 transmission within commercial farms?

Actions your business can take now:

  • Review your pandemic plan NOW, before there is an emergency.
  • Evaluate planning for flu vaccine clinics on site in the fall.
  • Maintain or establish a work culture that supports employees’ decisions to wear masks.
  • Maintain or increase the budget for cleaning supplies and hand sanitizer to avoid unexpected costs.
  • Businesses that provide food services should plan for the price of milk and eggs to fluctuate when developing budgets.

Evidence evaluation:

Strong evidence:The statement is well supported by publicly available data and established scientific knowledge. More evidence needed:The statement is supported by evidence, but additional data is still needed (e.g., more testing required). Not well investigated:The statement has some evidence to support it, but significant gaps exist. Conflicting evidence:The statement has conflicting evidence, so more evidence is needed before drawing conclusions.

Additional details for items above:

H5N1 has been circulating in cows for many months. [Strong evidence]

On April 21, USDA released 249 genomic sequences2 to GISAID (the Global Initiative on Sharing Avian Influenza Data). Michael Worobey is a world-renowned expert inviral genomics who uses molecular and computational biology to understand how pandemics emerge and spread. Worobey’s team immediately analyzed the published sequences. Their analysis indicates the time of the most recent common ancestor (TMRCA) of the US cattle flu clade was late December,3 meaning this version of H5N1 has been circulating for months. Louise Moncla's labat the University of Pennsylvania found similar results.4

H5N1 genetic material is present in grocery store milk. [Strong evidence]

On April 23, the FDA reported that tests on grocery store milk had found genetic material from the same H5N1 virus identified in the sick dairy cattle.5 Quantitative polymerase chain reaction (qPCR) is a molecular biology technique used to determine the presence or absence of an organism’s DNA in a sample. The tests can identify pieces of the virus, which can be present even if the virus has been inactivated.

Andrew Bowman, a veterinary epidemiologist at Ohio State University, collected 150 commercial milk from 10 states. Using PCR, his team found 58 tested positive samples.6

The discovery of H5N1 genetic material raises two questions. First, how widespread is the outbreak? The presence of H5N1 genetic material in milk may indicate that many more herds are impacted than known herds suggest. Secondly, are some infected cows not developing symptoms? If the cow appears well, dairy farms may not suspect infection and continue to milk the cow as usual.

Infectious H5N1 is NOT present in grocery store milk. [More evidence needed]

Although tests have detected the presence of viral H5N1 fragments in milk, that isnot necessarily a cause for alarm. Pasteurization 7 is likely to inactivate (kill) the virus but is not expected to remove inactive viral fragments from the milk.

Studies of pasteurization and virus inactivation 8 indicate pasteurization should inactivate H5N1. Pasteurization was developed primarily to address the threat of infectious bacteria. Bacteria are typically much hardier than viruses. Additionally, influenza viruses are enveloped viruses and are more susceptible to heat and changes in pH.

Additional tests are being performed to confirm that these viral fragments are not capable of causing infection. Laboratory tests in which viral fragments are transferred to eggs to see if they can infect the eggs are currently in progress; the results of these tests are expected over the next few days.

Human infection with this H5N1 is often but not always mild [More evidence needed]

The US has identified two human cases of H5N1 in the past two years. The most recent case is a worker on the Texas dairy farm where H5N1 was identified; their only symptom was conjunctivitis. The other US case occurred in April 2022 in a person culling infected commercial poultry; they reported fatigue. Both cases recovered.

Internationally, several people have been infected with this H5N1 strain, including 5 asymptomatic cases in the UK and 2 asymptomatic cases in Spain. Chile, China,and Ecuador have reported a total of 4 severely ill cases with 1 death. Historically, other H5N1 strains have caused severe illness and high death rates in humans. Notably, H5N1 2.3.2.1c caused 4 illnesses (3 of them fatal) in Cambodia last year.9

Person-to-person transmission of H5N1 is currently rare. [Strong evidence]

H5N1 does not have mutations that support easy person-to-person transmission. Between 2004 and 2007, there were rare non-sustained instances of human-to-human transmissions that most likely occurred between family members with prolonged close exposure to a sick individual. Those cases involved earlier strains. The current H5N1 2.3.4.4b strain did not emerge until 2020.

Over time, the virus may acquire mutations that make person-to-person transmission more efficient, reinforcing the need for effective interventions to control and monitor transmission in livestock, commercial flocks, and wild birds.

Human infection with this H5N1 is rare. [Not well investigated]

As of April 25, the CDC has tested 23 people for H5N1, is actively monitoring 44 people, and is passively monitoring additional people. Only one case has been detected. Anecdotally,10 people in the bovine industry have observed sick people where there have been sick cows; however, it is also winter respiratory illness season, which may explain the illnesses. Because people are not regularly tested for H5N1, mild cases may have gone undetected.

H5N1 is susceptible to commercially available antiviral medicines used to treat seasonal influenza. [Strong evidence]

This week, the CDC concluded tests indicating that two classes of antiviral medications used to treat seasonal influenza are effective against H5N1. Neuraminidase inhibitors (e.g., oseltamivir (Tamiflu®), zanamivir, and peramivir) and polymerase inhibitors (e.g., baloxavir (Xofluza®)) can be used against H5N1. [Study results were shared at a symposium with PHC staff in attendance.]

The US maintains a Strategic National Stockpile (SNS)11 of several medications, including all the antivirals discussed above. These tens of millions of courses of antivirals can be used to supplement commercial sources and alleviate supplychain issues should they arise. No supply chain issues have been noted so far for these antiviral medications. During the 2022-2023 flu season, the early peak caused spot shortages, and the SNS remedied the deficit. If needed for H5N1, the SNS could follow the same operational plan used for that shortage.

Existing processes and manufacturing platforms can be used to jumpstart the development of a vaccine for H5N1 if needed. [Strong evidence]

Vaccination of humans against H5N1 is not a tool that is required at this time, but the preparedness steps are in place to develop vaccines and plans for administration. The CDC constantly monitors for emerging types of influenza. When they identify viruses that are sufficiently new or concerning in any way, they create candidate vaccine viruses. These are blueprints for a potential vaccine target. The National Pre-pandemic Influenza Vaccine Stockpile (NPIVS)12 program takes these candidates and completes the initial manufacturing of a potential vaccine. Completing this process before the vaccine is needed allows them to address manufacturing issues and build an initial vaccine supply. NPIVS also stockpiles other components of the vaccines to allow for rapid manufacturing.

Two H5N1 candidate vaccine viruses are well matched to the H5N1 in dairy cattle. NPIVS has completed an initial fill of some vaccine doses and is evaluating the appropriate regulatory pathway for use if they are needed for response. These hundreds of thousands of doses would be the initial rollout. A second wave woulduse stockpiled components to create up to 10 million doses. If more doses are needed, existing US government contracts with manufacturers would be leveraged for large-scale manufacturing. The current preparedness is covered as normal activities in the US budget; switching to a response posture would require additional funding from Congress.

PHC predicts restrictions on and testing requirements for dairy cattle movement will continue to evolve. [High confidence]

Numerous US states 13 have restricted cattle imports from states with H5N1 outbreaks. USDA will require dairy cattle to have a negative Influenza A result for interstate travel.14 As of April 5, The World Organisation for Animal Health (WOAH) did not recommend import restrictions on cattle or dairy products.15 WOAH recommendations have wide-reaching impacts. All countries that are members of the World Trade Organization agree to abide by WOAH assessments regarding import restrictions. 16An import risk analysis must be conducted according to WOAH Terrestrial Animal Health Code Chapter 2.1. Despite this requirement, on April 25, Colombia became the first country to restrict US beef exports.17

Actions your business can take now:

Review your pandemic plan NOW, before there is an emergency.

The outbreak of H5N1 in dairy cattle serves as a reminder that new infectious disease outbreaks are inevitable. Companies should plan to review their pandemic plans yearly and when potential threats emerge. Ensure that personnel information reflects changes due to staff turnover or contact information changes. Be clear on how decisions will be made regarding office closures,changes to remote work policies, cleaning schedules, and provision of supplieslike hand sanitizer and masks.

Evaluate planning for flu vaccine clinics on site in the fall.

On-site flu shot clinics reduce barriers to employees getting annual vaccinations for seasonal flu. Last year, some employers reported difficulty securing practitioners for on-site flu clinics. Early contracting with these clinics can help ensure your employees are protected against seasonal influenza. If H5N1 evolves to spread easily between humans, an additional flu vaccine may be developed (as happened in 2010 during the H1N1 pandemic). On-site flu clinics could be used to provide both seasonal and H5N1 vaccines if warranted.

Maintain or establish a work culture that supports employees’ decisions to wear masks.

Masks can be effective at preventing influenza and other infections. Individuals who are vulnerable or who have vulnerable family members may prefer to wear masks to reduce the risk of numerous airborne infections. A work culture that supports those decisions can make 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.

Assess the budget for items like cleaning supplies and hand sanitizer to avoid unexpected costs. Plan to restock early to avoid any shortages that develop.

The current situation is not a crisis; businesses should not over invest in stockpiling. Nevertheless, the current outbreak introduces uncertainty around the demand forthese products, and businesses should consider the cost of additional storage versus potential future order delays. Increasing the cadence for reviewing purchasing schedules may suffice during this early stage.

Businesses that provide food services should plan for the price of milk and eggs to fluctuate when developing budgets.

H5N1 outbreaks in US poultry have repeatedly resulted in significant losses of commercial poultry. The culling of egg-laying flocks has previously driven egg prices to record highs. The spring avian influenza season is starting, and egg prices are currently up 16% from January. Numerous industry publications predicted egg prices would not climb above 2023 prices, but avian influenza impacts remain unpredictable.

By comparison, infected dairy cattle appear to fully recover after about two weeks, a limited period of the cow’s overall milking days. Currently, the outbreaks are too limited to impact the availability of milk in the US. Cattle live longer and are far more expensive than poultry. Therefore, culling will not be an initial step in control. Mandatory testing or other interventions may add costs to milk production that are eventually passed down to the consumer (although USDAAPHIS will compensate farmers for the cost of H5N1 testing for diagnostics or travel if performed at a National Animal Health Laboratory Network lab). Consumer reaction to the discovery of H5N1 genetic material in grocery store milk may have a larger impact on the industry.

References

1. https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/livestock 2. https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/usda-publishes-h5n1-influenza-virus-genetic 3. https://twitter.com/MichaelWorobey/status/1782756133402509587 4. https://twitter.com/LouiseHMoncla/status/1783555179180356093 5. https://www.fda.gov/food/alerts-advisories-safety-information/updates-highly-pathogenic-avian-influenza-hpai 6. https://www.science.org/content/article/u-s-government-taking-action-stop-cow-flu-it-too-little-too-late 7. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=131.3 8. https://pubmed.ncbi.nlm.nih.gov/32650645/ 9. https://www.cdc.gov/flu/avianflu/spotlights/2022-2023/h5n1-technical-report_october.htm 10. https://www.bovinevetonline.com/news/industry/message-ag-industry-about-h5n1 11. https://aspr.hhs.gov/SNS/Pages/Access-to-Influenza-Countermeasure.aspx 12. https://medicalcountermeasures.gov/barda/influenza-and-emerging-infectious-diseases/pandemic-vaccines-adjuvants/ 13. https://www.avma.org/news/states-begin-restrict-cattle-imports-those-influenza-cases 14. https://www.usda.gov/media/press-releases/2024/04/24/usda-actions-protect-livestock-health-highly-pathogenic-h5n1-avian 15. https://www.woah.org/en/high-pathogenicity-avian-influenza-in-cattle/ 16. https://www.wto.org/english/thewto_e/coher_e/wto_oie_e.htm 17. https://www.reuters.com/markets/commodities/colombia-becomes-first-country-restrict-us-beef-due-bird-flu-dairy-cows-2024-04-25/

Confidential and Proprietary

PHC Global provides this material for informational purposes only. It does not constitute, and is not a substitute for, medical services or advice and should not be construed as such.

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ANALYSIS
H5N1: Global Risk to CattleUnited States of America 05/01/24

Although the United States is the only country that has detected H5N1 in cows, the discovery can still have global impacts.1 ...SEE MORE

Examination of genomic sequences points to a single viral introduction from birds to dairy cows.2This specific H5N1 has mutations that allowed researchers to identify its reintroduction into wild migratory birds. Spillback into migratory birds–or wild mammals–introduces the possibility of the dairy cattle H5N1 strain spreading throughout the United States and to additional countries. Migratory birds have spread earlier versions of H5N1 along their flyways, allowing new viruses to travel the world within two years.3

Contaminated milking equipment is suspected of transmitting H5N1 between dairy cows, and the movement of dairy cattle can introduce the virus to new farms.4 Because dairy and beef operations are separate, dairy cows are unlikely to spread H5N1 to beef cattle directly. However, the fact that H5N1 was introduced to dairy cows does not eliminate the possibility of a future introduction to beef cattle. Understanding more about the mechanism by which H5N1 spreads between dairy cows is critical to understanding the possible impacts of H5N1 to beef cattle. Dairy cattle appear to recover fully after infection, with limited lost milking days. For beef cattle, a similar impact could be less efficient weight gain.

Agricultural businesses and businesses sensitive to the cost of poultry and cattle products should prepare for the possibility of H5N1 spreading to cattle beyond the United States. While pasteurization of dairy products and proper cooking of meat can ensure food safety, testing or treatment could increase production costs that may be passed to consumers.

The overall risk from H5N1 to the public is currently low. Because this strain of H5N1 does not spread readily from person-to-person, individuals working closely with birds and cows remain at the highest risk of infection. However, more research is needed to determine how transmissible this strain is from cows to humans. Ongoing genomic surveillance of H5N1 in cattle will be necessary to detect changes with implications for human health.

PHC will update this assessment as conditions change.

References

  • 1. https://media.un.org/unifeed/en/asset/d320/d3202385
  • 2. https://twitter.com/MichaelWorobey/status/1782756133402509587/photo/1
  • 3. https://www.sciencedirect.com/science/article/pii/S0006320723001428#f0005
  • 4. https://www.science.org/content/article/bird-flu-may-be-spreading-cows-milking-and-herd-transport

Confidential and Proprietary

PHC Global provides this material for informational purposes only. It does not constitute, and is not asubstitute for, medical services or advice and should not be construed as such.

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BLOG POST
H5N1 and the risks to enterprise businesses globallyUnited States of America05/08/24

Influenza viruses, including H5N1, are notorious for their constant evolution. Although the H5N1 2.3.4.4b strain currently poses little risk of person-to-person transmission, that could rapidly change....SEE MORE

Influenza viruses, including H5N1, are notorious for their constant evolution. Although the H5N1 2.3.4.4b strain currently poses little risk of person-to-person transmission, that could rapidly change. It would only take the wrong cow to meet the wrong bird for the virus to morph into one that could cause more severe disease symptoms or become more transmissible. That ability to easily pick up new genetic characteristics is why influenza constantly ranks as having the highest pandemic potential and why businesses need H5N1 on their radar.

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.

Agriculture impacts ripple globally

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.

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BLOG POST
To Prepare Against the Worst, CSOs Need High-Impact H5N1 ScenariosUnited States of America05/07/24

What is the Milk Warning Us About? 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....SEE MORE

What is the Milk Warning Us About?

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?

Massive-Agricultural-Disruption

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?
H5N1 Goes Person-to-Person and Regains Previous Severity

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.

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BLOG POST
If the grocery store milk is safe, why are experts worried about H5N1?United States of America05/02/24

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....SEE MORE

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.

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.

Milk at store

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.

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.

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Dave Komendat retired as the Vice President and Chief Security Officer for The Boeing Company, a role he held for 14 years of his 36 years within the security profession. Komendat was responsible for the company’s global security and fire protection policy and procedures, site security, executive protection, supply chain and aviation security, structural and aircraft fire protection, government and proprietary information security, classified cyber security, strategic intelligence, international security, business continuity and disaster preparedness, Global Security Operations Center, and security background investigations.

 

Komendat was also the lead Boeing interface for both national and international security policy engagement with numerous government and industry advisory groups. He represented Boeing as past co-chairman and current board member on the Domestic Security Alliance Council, past President of The International Security Management Association and served as a member of the Threats and Information Committee for the Overseas Security Advisory Council.  

 

Komendat is the founder and President of DSKomendat Risk Management Services, he also serves on several company advisory boards and holds board leadership roles with several non-profit organizations whose missions are to protect people globally, including Hostage U.S. and The International Security Foundation. Dave is also a Strategic Engagement Advisor for the Office of Private Sector within the FBI. In 2018, Dave was awarded the Director’s Award for Exceptional Public Service by FBI Director Christopher Wray.

 

Komendat graduated from California State University at Long Beach and also attended and completed the executive development program at the Kellogg School of Management at Northwestern University.

Dr. Carter Mecher serves as the Medical Advisor for the Public Health Company. 

 

Prior to joining PHC, Carter served as a Senior Medical Advisor for the Office of Public Health in the U.S. Department of Veterans Affairs. In this position, Dr. Mecher played a key role in the COVID-19 outbreak response. 

 

From 2005 to 2011, he served as the Director of Medical Preparedness Policy at the White House Homeland Security Council and National Security Staff. He was a principal author of the National Strategy for Pandemic Influenza Implementation Plan. In this capacity, he helped set policy and devise strategies to mitigate the consequences of a pandemic and promote pandemic preparedness. 

 

Before serving at the White House, Dr. Mecher was the Chief Medical Officer for the Southeast VA Network in Atlanta from 1996 to 2005. In this role he oversaw the healthcare delivery for veterans in Alabama, Georgia and South Carolina. 

 

Dr. Mecher is a co-author of Lessons from the COVID War, an in-depth examination of the U.S. response to the pandemic. In addition, he is featured in Michael Lewis’ book The Premonition.

 

Dr. Mecher received his medical degree from Chicago Medical School and completed a residency in internal medicine and a fellowship in critical care medicine at Los Angeles County/USC Medical Center.

Dr. Joe DeRisi is a Scientific Advisor to PHC. He is one of the early pioneers of DNA microarray technology and whole genome expression profiling; he is nationally recognized in the field of genomic epidemiology for designing a first-of-its-kind initiative for COVID-19. Joe currently serves as Co-President of Chan Zuckerberg BioHub and is a professor of Biochemistry and Biophysics at University of California, San Francisco. He has a Bachelor of Arts in Biochemistry and Molecular Biology from University of California, Santa Cruz, and a Ph.D. in Biochemistry from Stanford University.

Dr. Sumiko Mekaru is the Vice President of Research and Innovation at The Public Health Company. Dr. Mekaru is an epidemiologist operating at the intersection of traditional epidemiology and technology and leading cross-disciplinary teams to solve challenges in public health. Prior to joining PHC, Dr. Mekaru was a Life Sciences Strategy, Policy, and Operations Expert at Booz Allen Hamilton where she recently led the development of COVID-19 forecasting models for disease transmission, resource utilization, and critical events for the Department of Defense. Dr. Mekaru has also led health technology teams at Epidemico and Boston Children’s Hospital, creating innovative health surveillance tools. She has published extensively on infectious disease outbreak monitoring, modeling, and surveillance. Dr. Mekaru holds a Doctor of Veterinary Medicine from Tufts University and a PhD in epidemiology from Boston University.

Justin McIntosh is an experienced professional with 10+ years in management and 8+ years in software engineering. Currently, he is the Vice President of Operations at The Public Health Company. His journey began in college when he co-founded Safe Site, a utility services company, which expanded to operations in three states with over 300 employees. After a successful exit, he founded Docusite, a construction risk management application, diving into software engineering. Despite challenges with Docusite, Justin’s passion for technology led him to various roles before landing at The Public Health Company.

 

In his current role, Justin is tackling the challenging task of improving operations in a remote environment. He is dedicated to his role and is always open to sharing experiences and insights. He is committed to nurturing effective teams, improving operations, and shaping innovative solutions. His focus is on creating a positive, growth-oriented environment and mentoring emerging leaders, reflecting his commitment to collective success.

Lori Sutton is the Vice President of Marketing at The Public Health Company. She is a strategic marketing visionary and global brand leader with 20+ years of progressive experience in B2B/B2C SaaS software marketing in large enterprise and SMB markets. She has expertise in leading strategy development, overhauling brands, launching products and driving growth in target verticals. Prior to joining PHC, Lori was the Vice President of Marketing and Growth at SMS-Magic, where she led the global GTM strategy, orchestrated a brand overhaul, developed new messaging and positioning and launched revenue generating campaigns. Lori held marketing and management roles at Model N, Bullet Point Network, Saba and other SaaS software companies where she focused on marketing strategy, business objectives and analytics to drive revenue.

Lori holds an MFA from California Institute of the Arts, a BFA from Virginia Commonwealth University, an Executive Education in Corporate Strategy at Harvard Business School and continues coursework at Massachusetts Institute of Technology.

Craig Katsuyama is the Vice President of Administrative Services at PHC. He brings extensive experience building companies from the ground up and was instrumental to the launch of IEX Group in 2012, which challenged the status quo of financial markets and created an entirely new stock exchange that works for all investors. Craig spent the last eight years at IEX where he built and oversaw the accounting and finance teams before transitioning to help establish IEX’s Event Stream business, a data messaging platform that applies IEX’s core technology to areas outside of finance. Craig graduated from Mount Allison University in New Brunswick, Canada with a Bachelor of Commerce in Accounting and Economics.

Dr. David Fisk is the Chief Medical Officer at The Public Health Company. Prior to joining PHC, Dr. Fisk served as an Infectious Disease Specialist at Sansum Clinic.  He serves as the Medical Director of Infection Prevention and Control at Cottage Health, leading the infection control team at Cottage, working with physicians and hospital leaders on the COVID Incident Command Center to ensure the highest level of preparation and care for patients. In early March 2020, before the first confirmed COVID-19 case in Santa Barbara County, Dr. Fisk advised that the virus was already spreading locally before community members were observing symptoms.

 

Dr. Fisk completed his medical degree from Johns Hopkins University School of Medicine and his Internal Medicine residency and Infectious Diseases fellowship at University of Michigan Medical Center. He is board certified in Infectious Diseases and a Fellow of the Infectious Diseases Society of America.

Chris Latko is the Chief Technology Officer at PHC. He joined as a Principal Software Architect where he played a key role in building out the platform. He has over 25 years experience in the technology sector holding positions at companies he started, Fortune 500 companies, and a multitude of startups both in the United States and Japan. He has spent the last decade designing, refining, and reimplementing architectures for hypergrowth startups such as Boxfish, Paxata (acquired by DataRobot), Banjo, and Globality. Chris earned two patents for designing a streaming data ingestion/data normalization platform.

Kendall Burman serves as PHC’s General Counsel and Chief Operating Officer. Prior to joining PHC, Burman held leadership roles at Alloy, a data and technology start-up for the progressive political market. Burman previously served as the Deputy General Counsel for Strategic Initiatives at the Department of Commerce and as Associate White House Counsel and Special Assistant to the President in the Obama Administration. She was also a counsel in the cybersecurity and data privacy practice at Mayer Brown and served as Chief Staff Counsel for President Obama’s 2008 campaign.

 

Burman is a graduate of Bowdoin College and received her J.D. from the University of Chicago where she was an editor of the law review. She was also was a fellow at both the New America Foundation and the Center for Democracy and Technology.

Dr. Charity Dean is the CEO, Founder and Chairman of The Public Health Company, a venture-backed Silicon Valley technology startup. 

 

In August 2020 Dr. Dean founded PHC, envisioning a commercial-grade global biosecurity platform to empower enterprises to manage biorisk at scale. Dr. Dean’s obsession with building a new solution was born out of 24 years in public health and the recognition that Silicon Valley innovations in artificial intelligence and machine learning could birth this entirely new capability. Two years later PHC PharosTM is a game-changer for numerous businesses providing real-time, dynamic risk management across their global footprint and assets. 

 

Dr. Dean founded PHC having served as the Assistant Director for the California Department of Public Health where she was part of the executive team under Governor Newsom running the COVID-19 pandemic response. She co-founded and co-chaired California’s COVID-19 Testing Task Force and under her leadership, California went from ranking last in the nation for testing to first in three months. In 2019, Dr. Dean served as Acting State Public Health Officer overseeing 4,300 staff with an annual operating budget of $3.5 billion. 

 

Before her move to statewide office, she served as the Public Health Officer for Santa Barbara County and oversaw a myriad of disease outbreaks and biological threats; she also served as attending physician for TB, HIV, and homeless medicine at the Santa Barbara Health Care Centers. 

 

Dr. Dean was awarded Physician of the Year in 2018 by the Central Coast Medical Association and honored as one of the Women of the Year by the California State Legislature.

 

Dr. Dean is a co-author of Lessons from the COVID War. Her work during the pandemic is the focus of Michael Lewis’ book The Premonition. Dr. Dean has shared her insights about the danger of biological threats and the changes we must make before the next crisis in a number of interviews and podcasts.

 

Dr. Dean holds a Doctor of Medicine and Master of Public Health and Tropical Medicine from Tulane University and a Bachelor of Science in Microbiology from Oregon State University.

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