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CDC Promote H5 Screening of Influenza Patients

01/19/2025

Dr. Nirav Shah, Principal Deputy Director of the Centers for Disease Control and Prevention is promoting routine screening for H5N1 virus in patients diagnosed with influenza A. In a press conference on January 16th Dr. Shah noted that “time is of the essence” in confirming a diagnosis in order that additional protective measures can be taken to prevent transmission to hospital staff or other contacts. Funding for the initiative will be supplied by the Department of Health and Human Services as part of a $200 million program to enhance detection and response to emerging infectious diseases.

 

It is noted that despite confirmation of H5N1 infection in approximately 70 workers involved in either depopulation of infected flocks or in close contact with affected dairy cows, there has been no evidence of contagion based on surveillance of family and residential contacts. Dr. Shah is justified in stating “Although the risk to the general public remains low, there remains a moderate risk of a pandemic as the result of the current H5 virus.”

 

Although the probability of a zoonotic strain of H5N1 emerging with evident contagion is considered to be exceptionally low at present, this is only one side of the equation.  The consequences of an emergent H5N1 strain demonstrating person-to-person transmission would be catastrophic. There is potential to eclipse the mortality and the direct and indirect costs of the 2020-2022 COVID pandemic.

 

Public health agencies worldwide and especially in the U.S. should intensify surveillance programs against H5N1 infection in human patients, domestic livestock and free-living mammals.  Planning for a response to an H5N1 outbreak with appropriate designation of responsibilities among state and federal agencies is considered critical to minimizing losses in the event of emergence of a zoonotic infection.

 

It is axiomatic that suppression of avian influenza, especially among large concentrations of egg production, complexes should be a priority.  Since structural and operational biosecurity does not provide absolute protection, vaccination should be considered for egg-production and turkey flocks at risk based on location and a history of recurrent infections associated with proximity to migrating waterfowl.

 

In accordance with the One Health principle, coordination among veterinary and human health regulators is considered to be critical with international cooperation.  This includes posting of gene sequences on recognized data bases, harmonization of regulations for the movement of livestock and animal products in the event of outbreaks and control measures applicable to trade and travel.

 

The lessons from COVID should be applied to planning for a potential localized epidemic or pandemic H5N1 infection.