At least 42 dairy cattle farms have been infected in at least nine states. But infectious disease experts highly suspect there are more since testing is voluntary, unless they are being moved between state lines. The USDA also reported this week more confirmed cases of H5N1 in poultry and wild birds, including pigeons at a Michigan dairy where an outbreak has occurred.
After public health officials confirmed H5N1, the virus also known
as bird flu, jumped from poultry to cows and recently infected an
American, they’ve warned that if the virus strain made its way to
pigs, it could be time to press the panic button. That’s because
swine are closer to humans in genetic terms, acting as a prime
reservoir for viruses to mutate into something that could turn into
a far-reaching pandemic in people.
But now, a new study suggests that dairy cows might have the same
potential as pigs, which could improve the bird flu’s capability of
being more human-to-human transmissive.
As reported by Nature, preliminary data shows that the flu virus can
jump back and forth between cows and birds thanks to a specific
receptor. This specific trait might allow the virus to spread more
widely and develop more mutations along the way. If a single cow can
be a host to multiple types of influenza over time, it could evolve
to more readily infect humans.
“The biggest question is whether cows are mixing vessels like pigs;
pigs are well-known mixing vessels for influenza because they have
both avian and human receptors and that allows a virus to mutate
pretty easily and to make it more susceptible to humans,” Katelyn
Jetelina, an epidemiologist and author of the newsletter Your Local
Epidemiologist, told Salon. “And this preprint said that cows have
both avian and human receptors in the mammary glands as well as
other areas of the cow, which may suggest that they’re a mixing
vessel.”
Jetelina emphasized that “may” is a key word.
“Because although they have the receptor it doesn’t necessarily mean
it’s active, it doesn’t necessarily mean it’s exactly how we see the
dynamics playing in pigs,” she said. “So it really opens up more
questions and answers at this point.”
Dr. Rajendram Rajnarayanan of the New York Institute of Technology
campus in Jonesboro, Ark., told Salon this preliminary report
“changes things a lot.”
“That means that if you let the virus collect in cows a lot, then
soon you’re going to see an adaptation that’s going to pick it up in
humans and other mammals,” he said. Pigs can get infected with
multiple viruses at a time. This could make it easier for the virus
to mutate into a new one that could more easily jump from mammal to
mammal, like say, from one human to another. If that’s the case with
cows, as Rajnarayanan said, “that’s going to be a problem.”
According to data from the U.S. Department of Agriculture (USDA), at
least 42 dairy cattle farms have been infected in at least nine
states. But infectious disease experts highly suspect there are more
since testing is voluntary, unless they are being moved between
state lines. The USDA also reported this week more confirmed cases
of H5N1 in poultry and wild birds, including pigeons at a Michigan
dairy where an outbreak has occurred. Meanwhile, the Centers for
Disease Control and Prevention (CDC) has also urged state health
officials to provide personal protective equipment for livestock
workers.
On Thursday, the CDC announced the launch of a dashboard to track
wastewater samples of the virus and confirmed the presence of
influenza A in wastewater samples. But as Reuters reports, “The
wastewater tests are capable of detecting many types of influenza A,
including the H5N1 subtype, but the findings do not indicate the
source of the virus or whether it came from a bird, cow, milk or
from farm runoff or humans.”
Notably, bird flu is not a new virus like SARS-CoV-2, which causes
COVID-19 and first began spreading in late 2019. H5N1 has been
spreading in birds since at least 2021, killing hundreds of millions
of them around the world. It has also infected other mammals,
including seals and bears. However, this outbreak is the first time
officials have confirmed that the virus has jumped from a cow to a
human, and the line of transmission suggests it’s easily passed
between cows.
The last time a human tested positive for H5N1 was in April 2022 in
Colorado, when an individual got infected from poultry. Recently, a
report published in the New England Journal of Medicine shed more
light on the one confirmed human case where someone got infected
from an infected cow. A photo in the journal showed the patient with
conjunctivitis in both eyes, also known as pink eye, with a
subconjunctival hemorrhage, which is like a bruise, making them
appear bloody. The patient was treated with an antiviral right away,
and close contacts were given post-exposure prophylaxis. Notably,
the patient didn’t have any respiratory symptoms, and household
contacts remained in good health, according to the report.
“I think they acted quickly on that person, and that was good,”
Rajnarayanan said. “But the only thing is, we haven’t really heard
about anything else.” He added it’s likely that there have been more
cases that haven’t been recorded. Jetelina agreed she wouldn’t be
surprised to hear of more human cases either. As noted in Nature,
there have been anecdotal reports of farm workers being infected.
One expert told the publication that they suspect the exposure is
widespread.
Jetelina said it’s important to note “the social context” in which
this situation is unfolding. Primarily, a majority of farmer workers
are undocumented, Spanish-speaking immigrants.
“There’s not really an incentive for them to test,” Jetelina said.
“If they test positive that means they’re out of work for two weeks,
which has huge implications to their family and there’s a lot of
language barriers as well.”
In order to move forward, Jetelina said there needs to be better
data transparency and communication.
“And this isn’t just disease-based, this is working with humans and
all the behaviors and values that those humans possess,” she said.
“And I think all we can do is try to explain why we want them to be
tested, protect them with incentives for example, paid time-off
would be great.”
Rajnarayanan said at the moment, he’s at his “highest level of
concern.”
“We don’t really have a lot of data,” he said. “The data is coming
here and there, but it’s [difficult] to connect the dots sometimes
when you have dots that are so far from each other.”