Massachusetts Urges Caution Against Avian Flu

Highly Pathogenic Avian Influenza is the suspected cause of death in wild and domestic birds across Massachusetts, according to a press release from Massachusetts Department of Agricultural Resources (MDAR). 

The Highly Pathogenic Avian Influenza (HPAI) H5N1 virus rarely infects humans, but health officials are advising the public not to handle dead birds or other animals and to avoid those that appear sick. A group of five or more wild birds deceased in a single location should be reported to local officials through MassWildlife. Sick or dead domestic birds should be reported to the MDAR. 

The guidance follows a January 19 press release that identified HPAI as the culprit in an outbreak in Plymouth, Massachusetts, that included more than 60 deaths among Canada geese, swans, and other birds.

Additional MDAR safety tips for the public include keeping pets away from wildlife, especially cats, which are highly susceptible to HPAI, and for hunters to follow best practices for handling and processing game, according to the press release. 

In a separate press release, the MDAR reported that HPAI H5N1 tests on dairy cows in the state’s 95 licensed herds came up 100% negative. The virus was most recently detected in dairy cows in Texas, according to the release, and dairy cow herds in 14 states to date have been affected. Some dairy farm workers have become infected after contact with unpasteurized milk, according to the release, but pasteurized milk remains safe for human use. 

What Clinicians Need to Know Now

Ongoing vigilance to the activity of avian flu is important, in part because of the potential for virus mutation, said Shirin A. Mazumder, MD, associate professor and infectious disease specialist at The University of Tennessee Health Science Center, Memphis, in an interview. 

“Although the risk to human health is low, there have been 67 human cases and one death due to avian flu in the United States to date according to the CDC,” Mazumder said. Human to human transmission of the avian flu virus in its current form appears not be a concern, but influenza viruses can mutate frequently, she said.

Monitoring the virus activity is important for spotting any signs of mutation, which has the potential to increase transmissibility and cause community spread of infection, she said.

Clinicians should continue to educate patients about prevention measures such as avoiding unpasteurized dairy products, said Mazumder. “Other food safety measures such as cooking eggs, poultry and meat to safe temperatures prior to consumption should be encouraged,” she added. “Frequent and thorough hand washing is important, especially after contact with birds or wild animals, and including visiting a petting zoo or farm, she noted. “Hand hygiene is also important after contact with items that birds or wild animals may have also been in contact with, such as birdfeeders,” she emphasized.

“If an individual must have contact with sick or dead birds, poultry or other animals, personal protective equipment is recommended,” said Mazumder. Remind patients who fall into this category or who work with seemingly healthy birds or domestic poultry that removing shoes before entering a home can help reduce the spread of potentially contaminated bird droppings, she said.

Although there is no available vaccine for H5N1 infection, individuals who have not yet received a flu vaccine can still benefit from reduced risk for any potential coinfection with seasonal flu and avian flu, Mazumder noted. Oseltamivir can be used for chemoprophylaxis and treatment, she added.

In the clinical setting, keep a high level of suspicion for patients with symptoms of avian flu, which include fever, cough, sore throat, runny nose, fatigue, body aches, or eye redness or irritation, Mazumder told MedscapeMedical News. “The timing to the development of symptoms after exposure is typically within 10 days; avian influenza should be considered when individuals develop symptoms with a relevant exposure history,” she said. Individuals with suspected infections should monitor their symptoms and isolate until their infection status is confirmed. 

Mazumder had no financial conflicts to disclose.