Health authorities in Louisiana confirmed on Monday a first fatality in the United States caused by avian influenza (H5N1). The deceased, a man over the age of 65 with pre-existing medical conditions, was hospitalized approximately three weeks ago after contracting the virus through contact with birds and poultry in his backyard.
The Centers for Disease Control and Prevention (CDC) stated that, at present, there is no evidence of human-to-human transmission within the United States, and the risk to the general population remains low. However, virologists and infectious disease experts caution that mutations in the virus could potentially enhance its ability to infect human hosts more effectively, raising concerns about future outbreaks.
Emerging mutations and concerns
One such mutation was identified about a month ago in a 13-year-old girl from Canada, who contracted the virus but recovered following intensive medical care. The CDC reported that viral samples taken from the Louisiana patient contained mutations that improve the virus' ability to bind to human cellular receptors. Notably, these mutations were absent in samples taken from the birds in the patient’s yard, suggesting that the genetic changes occurred within the patient’s body during the course of the infection.
This case is particularly unusual, as the majority of documented H5N1 infections in the United States have been among individuals working in poultry farms or animal agriculture. Most cases have presented with conjunctivitis and mild respiratory symptoms. The Louisiana case raises additional concerns because the patient was not a farm worker, broadening the potential risk group.
In 2023, at least 66 cases of H5N1 infection were reported across the United States, with most involving poultry workers exposed to the virus in occupational settings. Globally, avian influenza has claimed approximately 500 lives over the past two decades, primarily in Southeast Asia.
Louisiana health officials have declined to release further details about the deceased patient to protect the privacy of the individual and their family. Despite this, public health experts emphasize the importance of avoiding direct contact with sick or dead animals, ensuring the thorough cooking of poultry and meat products to neutralize pathogens, and refraining from consuming unpasteurized milk.
Interestingly, Robert Kennedy Jr., Trump's nominee for Health Secretary, is a vocal advocate of unpasteurized milk consumption. He has publicly stated that he exclusively drinks raw milk and intends to advocate for its introduction into American schools, a position that has drawn criticism from public health professionals.
Ongoing outbreaks in the United States
In addition to the Louisiana case, multiple states are battling ongoing outbreaks of avian influenza. The virus has affected over 900 commercial and backyard poultry flocks in 16 states and has also been detected in wild bird populations. California has been hit particularly hard, with the state declaring a public health emergency in December due to the extensive spread of the virus.
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Experts underscore that as long as the virus lacks the ability to transmit efficiently from person to person, the risk of a widespread human outbreak remains low. Nevertheless, health officials in the United States are continuing to recommend the seasonal influenza vaccine, which does not protect against H5N1 but can reduce complications in cases of co-infection. The U.S. is currently experiencing an especially severe influenza season, further emphasizing the importance of vaccination to safeguard public health.