As of last Friday afternoon, a total of 13 people in the United States had been officially infected with H5 avian influenza, also known as bird flu, this year. A variant of the virus, known as H5N1, which could cause a pandemic, has been circulating among U.S. dairy cows for months and has already killed tens of millions of birds. The 13 confirmed cases by last Friday were generally mild, and more importantly, all were linked to apparently sick cows or poultry. When I consulted with a bird flu expert in July, he told me this fact was crucial. Experts say the only time we’ll see signs of a crisis is when the virus starts to show signs of human-to-human transmission.
And then came case 14. update At least one other person has been infected with the H5 virus, this time in Missouri, and it’s unclear whether the patient had contact with sick livestock, according to the CDC. In other words, the harbinger of a more widespread and deadly crisis may just be waving its flag a little higher.
Whatever the danger this means, the CDC report didn’t get much coverage. The story was covered by major media outlets, but it competed for attention all weekend with a host of other urgent matters, including the war in Gaza, another horrific high school shooting, and tonight’s presidential debate. When I told my husband, a historian, about this new infection, he was stumped. When I explained the implications (possible human-to-human transmission?!), he admitted, “That doesn’t seem right,” and carried on with his dinner. The next night, at our wedding reception in a crowded bar in Brooklyn, I asked again: “Is anyone else scared?” No one had the latest updates from Missouri, and they didn’t seem too bothered when I explained the details. This is where we are with bird flu at the moment: the awkward gap between watchful waiting and all-out panic mode. The risk may still be minimal, but the stakes are so high, and with every new bit of information the situation seems a little more precarious than before. But it’s hard to get a firm grasp on what it means, and whether it matters.
For most people, it may be perfectly appropriate to ignore bird flu altogether, at least for now. Plus, bringing up a new respiratory virus at someone’s wedding party is a great way to spoil the atmosphere. (Sorry, Max and Daphne!) According to the CDC, the risk posed by bird flu to the general public is “Remains lowThe Missouri case, discovered through seasonal influenza surveillance, remains puzzling. So far there is no evidence that the disease was transmitted from another person, and it could have been transmitted from a contaminated bird feeder, an infected cat, or even a glass of raw milk. Little is known about the patient, even his specific age, other than the fact that he is an adult with “underlying health conditions” and was hospitalized and treated with antiviral drugs. In fact, it is not even clear if bird flu was the primary reason for his hospitalization. The most reassuring finding so far is that this person does not appear to have transmitted the disease to others.
This puts public health researchers and science journalists in a tricky spot. Given all these unknowns, it’s both premature and immoral to sound the alarm about the next pandemic. At the same time, bird flu is a real and looming concern, and it’s unsettling that while experts are on high alert, much of the public is almost completely ignorant. The very fact that the H5N1 virus is now circulating on farms across the country, infecting chickens, cows, and pigs alike, means that there are plenty of opportunities for the virus to recombine or mutate in dangerous ways in the coming months and years. “It’s like buying a lottery,” one flu expert told me this summer. “We’re giving this virus a lot of tickets.”
The public should understand this risk and take it seriously, but how do we communicate that awkward middle ground? Corona fatigue is still there, and few people want to think about another virus, let alone the possibility of further mask-wearing or quarantine, unless it is truly necessary. “I only want to know if I have to tell my elderly parents how to stay safe,” a friend told me. By that standard, bird flu is safe to ignore. Even considering the Missouri case, all available information indicates that a pandemic is not imminent. Still, the facts could change at any time, and experts are waiting for more data. If the CDC identifies the exact subtype of the virus involved in the Missouri case, it will tell us whether the person was indeed infected with the same H5N1 avian flu virus that is circulating on farms.
Even if this case turns out to be a false alarm, people tracking bird flu seem to be more nervous than ever. The fact that a dozen people have already been infected this year is worrying in itself. At any moment, a new disease could emerge globally with just a few mutations. The general public doesn’t need to worry for now, but the gap between the current situation of bird flu and how we perceive the news seems to be getting stranger by the day.
