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H5N1 SPOTREP

April 12, 2024  /  TLP:GREEN

 Healthcare Ready is currently MONITORING the evolving situation surrounding Avian Influenza  

We are monitoring supply chain needs and community impacts with the assistance of our private and public sector partners. We are committed to ensuring rapid access to accurate and comprehensive data to facilitate informed decision-making and effective response.

Situation Overview

• Key Highlights
  • H5N1 is a type of influenza virus that causes highly infectious respiratory disease in birds. The virus does not easily transmit to humans and has limited potential for person-to-person transmission.
  • Earlier this month, a person in Texas tested positive for H5N1 after exposure from infected dairy cows. This would be the first instance of cow-to-human spread of bird flu. Additionally, this is only the second case of H5N1 in the US.
  • Currently there is no available vaccine to prevent H5N1 infection.
  • An outbreak of H5N1 could lead to increased prices for poultry, egg, and beef products. Cal-Maine Foods, the largest egg producer in the US, had culled over 1.5 million hens after they tested positive for HPAI at one facility in Texas. If similar actions take place nationwide, there could be significant price increases if producers struggle to meet demand in the coming months.
• Background
  • Commonly referred to as H5N1 bird flu or Highly Pathogenic Avian Influenza (HPAI), avian flu is highly contagious among birds, with near 100% case fatality rate among birds.
  • In rare cases, transmission from animals to humans has occurred through close contact with infected living or deceased birds. Even rarer, human infection has occurred through an intermediary animal, such as a cow or cat.
  • The primary concern regarding H5N1 is its potential to achieve high transmissibility, as mortality rates in past outbreaks have been reported to be as high as 60%.
  • Over the past 20 years, there have only been two reported human cases of H5N1 in the US. The initial case occurred in 2022, involving direct contact with infected poultry. The second case, reported in April 2024 in Texas (mentioned above), with symptoms limited to redness in the eyes.

Treatments

• Oseltamivir (Tamiflu), an antiviral medicine, can reduce the severity of the illness and prevent death. Additionally, zanamivir, peramivir, and baloxavir are all antivirals that can be used to treat influenza symptoms.
  • Oseltamivir oral suspension and capsules is listed on the ASHP Drug Shortage list as of February 11, 2024. Per FDA, they have contacted several suppliers and have determined that the shortage is more local stock outs due to increased demand versus upstream manufacturing challenges.
  • Zanamivir, peramivir, and baloxavir are not listed on ASHP’s Drug Shortage list so there are substitute medications in the event that oseltamivir is in short supply.
• The seasonal flu vaccine does not provide protection against avian influenza viruses.
  • Candidate vaccine viruses have been formulated; however, there are currently no H5N1 vaccines available for widespread use. A candidate vaccine virus is an influenza virus prepared by the CDC (or another public health entity) that can be used to produce a flu vaccine.
• The most effective mitigation strategy is for poultry farmers, livestock handlers, and any other individuals in occupations involving exposure to potentially infected animals to be wearing person protective equipment (PPE) when working with them; such as N95 masks, eye protection, and gloves.
• Additional recommendations, posted by the CDC, for worker protection to reduce exposure from influenza viruses can be found here.

Populations of Concern

• Poultry farmers, livestock handlers, veterinarians, and individuals in occupations with high exposure to or contact with sick or deceased animals are at greatest risk of potential exposure and subsequent infection.
• Immigrant and migrant workers who predominantly comprise the meat- and poultry-processing workforce are also at greater risk of exposure. Healthcare providers, especially those providing care in rural areas where workers with direct contact with animals are most likely to seek care, should be equipped to monitor for rising cases, and to provide culturally sensitive education and care in multiple languages.
• As noted during outbreaks in previous years, workers’ physical and mental health may be impacted from impacts related to the economic and emotional impacts associated with the culling of animals to stop the spread of disease.

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