Since the highly pathogenic avian influenza (H5N1 bird flu) was first detected among dairy cows in late March, a total of 132 herds across 12 states have now officially been impacted. In the last 30 days, an additional 65 infected herds have been confirmed across eight states. Despite repeated assurances given by the federal government that every resource is being utilized to eliminate the threat, scientists are increasingly concerned that far too little is actually being done to protect humanity from another pandemic.
Number of dairy cow herds infected with H5N1 weekly in the US (Source: USDA) [Photo: USDA/WSWS]
To date, the Centers for Disease Control and Prevention (CDC) has only tested 51 people potentially exposed to H5N1, a figure which has remained essentially static since the outbreak was detected. This only confirms in the negative that little has been done to conduct surveillance, testing, and serological studies of communities where people and livestock live in close proximity, which are necessary for epidemiologists to comprehend the scope of the ongoing threat.
More recently, a Michigan initiative is underway with the support of the US Food and Drug Administration (FDA) to begin testing a wider range of dairy products and a human serology study to assess the impact on workers after exposure to sick cows. The CDC stated that the objective of these efforts is to determine the efficacy of antivirals on the circulating clade of the bird flu, understanding infection in people, estimating the incubation period and potential mechanisms to mitigate the possibility of an H5N1 pandemic.
In a recent social media post on Twitter/X, molecular biologist and social science journalist Kai Kupferschmidt commented on research being conducted in a high security lab in Germany where cows were infected with the H5N1 strain circulating in US dairy cows and strains from H5N1-infected wild birds. He wrote, “In both cases they infected the udders directly through the teats and in both cases the animals got sick. They showed clear signs of disease such as a sharp drop in milk production, changes in milk consistency and fever.”
A dairy cow. [Photo: Keith Weller/USDA]
Kupferschmidt noted that the preliminary results imply that wherever H5N1 is circulating, the virus can spill over into cows. The researchers also indicated that transmission among cows may be a result of human activity, in which contaminated equipment is causing transmission through direct contact. However, he said that more research is needed on the potential for cow-to-cow transmission, and he is awaiting the results of the research to be published soon.
In a special report published in STAT News, based on interviews with numerous experts and federal representatives, the authors concluded,
The country still does not have a sufficient testing infrastructure in place, nor a full understanding of how the virus is moving within herds and to new herds, experts say. Government officials also have not secured the cooperation from farmers and dairy workers that would be required to rein in the outbreak.
In another interview, former CDC director in the Trump administration Dr. Robert Redfield said, “I really do think it’s very likely that we will, at some time, it’s not a question of if, it’s more of a question of when we will have a bird flu pandemic.” He added that a bird flu pandemic would have considerably greater mortality than COVID-19, placing the figure at “somewhere between 25 and 50 percent mortality,” while the death rate for COVID-19 has been estimated at 0.6 percent.
As CDC director under Trump, Redfield botched the initial rollout of mass testing and contact tracing and was instrumental in the dismantling of public health infrastructure. He discouraged COVID-19 testing, advocated the deadly reopening of schools in the fall of 2020, lied about the airborne nature of the virus and denigrated masking. One must ask, when the next pandemic ignites, will Redfield call for an elimination strategy or endorse a “forever bird flu” policy?
Redfield’s decades of experience in public health and discussions with experts on flu viruses and the evolution of H5N1 over nearly three decades underscore the significance of his warnings. That this particular virus has insinuated itself into livestock and animals, such as cats and mice, known to habitate homes and farms, indicates the potential ability for the virus to mutate further and potentially evolve to easily infect people via respiratory pathways.
The case of SARS-CoV-2, the virus that causes COVID-19, and its emergence from the wild animal market in Wuhan, underscores these concerns. According to the EcoHealth Alliance’s 2022 study published in Nature, the authors found an abundance of SARS-and SARS-CoV-2-related bat coronaviruses across a broad geographic region in Southern China, home to 300 million people. Their estimates indicated approximately 66,000 people were exposed to these viruses annually.
Given that 16 million people were engaged in the wild animal trade industry in China at that time, estimated at $73 billion by the Chinese Academy of Engineering, brings to the fore the connection between economics, human activity, the need for sources of alternative proteins given the prohibitive cost of basic foods and the threat of pandemics.
That SARS-CoV-2 has the ability to infect a wide array of animals besides humans suggests that the virus had already been well established in intermediary hosts before it had erupted in a self-sustaining outbreak in December 2019. Such is the case with H5N1 clade 2.3.4.4b, which emerged in 2020 when the virus reassorted between wild birds and poultry and has led to the mass killing of hundreds of millions of birds, as well as dozens of animal species.
As the STAT News report highlights, private dairy farms and agricultural businesses see the need for a thorough public health investigation into the outbreak of H5N1 as an intrusion into their profit-making. That is why the statement by the USDA—“The actions we have taken to limit movements, improve biosecurity and encourage testing are expected to establish the foundation for eliminating this virus from the dairy herd”—must be taken with a massive grain of salt. While the USDA advocates for a sound scientific approach, it is ultimately invested in the corporate structure.
It is precisely because the US cattle industry is struggling to break even that the call to investigate H5N1 on their farms and among their workers and livestock is met with trepidation. According to the Federal Reserve Bank of Kansas City, cattle inventories are at historic lows. A March 29, 2024 report notes:
Cattle producers may face challenges maintaining or restocking herds, as higher interest expenses on cattle and input purchases in 2022-23 have constrained profit margins. Although feed costs have decreased slightly, higher costs for financing and other operating expenses could continue to put pressure on cattle production and profitability.
The STAT News piece indicates the cool response from farmers to public health measures that might cut into their profits, noting:
But the government’s own data indicate the efforts have holes large enough for the virus to run through. In one USDA survey, 60 percent of farms acknowledged moving cows within a state even after the animals had started showing symptoms of infection. Federal officials have acknowledged they’re not getting much cooperation from dairy producers and workers.
Despite the clear and growing dangers of a bird flu pandemic, there is now a repeated refrain that the threat posed thus far remains low. However, one should recall a report from 2010 by influenza virologist Professor Yoshihiro Kawaoka and colleagues from the School of Veterinary Medicine at the University of Wisconsin-Madison, studying potential reassortments between co-circulating H5N1 and human H3N2 influenza viruses, which noted:
Our data demonstrate that the gene segments of these two viruses are largely compatible, resulting in 184 reassortant viruses with different replicative abilities. Pathogenicity experiments performed with 75 H5 reassortant viruses showed that 22 viruses were more pathogenic for mice than the parental SK06 virus. Strikingly, three viruses exhibited substantial lethality for mice.
As H5N1 continues to spread deeper into US dairy farms, one can ask how might the flu season evolve if these two flu viruses co-circulate, thereby allowing H5N1 to gain respiratory transmission potential with its pathogenicity intact? Are such possibilities being considered, and what preparations should US and World Health Organization (WHO) authorities undertake to prevent such a catastrophic development?
To suggest, as many political mouthpieces have, that the US and the world will somehow be prepared to vaccinate their way out of a pandemic scenario is utterly depraved and dangerous. As Rick Bright, former director of the Biomedical Advanced R&D Authority, recently told Fortune, “A head-in-the-sand approach to influenza readiness will not serve the public well when there is a need to respond to an influenza pandemic. The time to commence serious action is now, not when the country is staring down the barrel of a full pandemic.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
