US Faces Potential Pandemic Risk as H5N1 Virus Mutates, Experts Warn

Avian Influenza in the US has escalated to a Critical Point

United States: Health experts have warned that there is a high possibility that avian flu can quickly spread among humans as it has been showing mutations, and the virus is just two mutations away from becoming a pandemic for humans. They have also outlined that new flu symptoms among high-risk individuals are expected to emerge within health systems starting this summer.

Director of the flu department at US Centers for Disease Control and Prevention (CDC) – Vivien Dugan addressed, “There is a broad range of symptoms to be watching for,” adding, “Some of this will not be obvious or at the forefront of our minds.”

Since 2022, Dugan has been heading a CDC team collaborating with the US Department of Agriculture, the FDA, and state and local health departments to monitor and combat the widespread H5N1 avian flu outbreak across the United States. The virus has been identified in over 9300 wild birds across all 50 states and territories, as well as in commercial and backyard poultry, as reported by

Besides this, professor of vaccinology at Icahn School of Medicine at Mount Sinai in New York – Florian Krammer said, “It’s a bad situation.” Further the expert mentioned, “Globally, we’ve seen tons of exposure in cities around the world and even in the birds here in New York City where I am.”

According to the experts, the birds excrete the virus through saliva, mucus, and feces, making close, unprotected contact with infected birds or their contaminated surroundings a potential route of infection for both humans and other animals.

In a notable development in March 2024, H5N1 bird flu was detected for the first time in dairy cows. According to the US Department of Agriculture, as of the latest update, 101 dairy herds across 12 states had been affected, with several cases also reported among dairy workers.

Transitioning from avian species to cattle and agricultural workers, the National Veterinary Services Laboratories confirmed these infections as the highly pathogenic avian influenza H5N1 clade of Eurasian lineage, also recognized as the Guangdong clade from China. Phylogenetic analysis and epidemiological studies indicate a single introduction into cows, followed by subsequent transmission.

The concern was also addressed by Dugan during an interview. He was quoted saying, “I was surprised when H5 was introduced to dairy cattle in this way. Influenza viruses are always surprising us and it reminds me to stay humble and keep an open mind when dealing with them,” according to the reports by

According to Dugan, inhaling or coming into direct contact with the virus through the eyes or mouth is uncommonly sufficient to cause illness in people. However, those in close proximity to animals remain at risk, potentially experiencing upper respiratory symptoms such as shortness of breath, cough, sore throat, or nasal congestion.

Similar to other viral infections, individuals may also suffer from muscle or body aches, headaches, fatigue, fever, and, as observed in farm workers, conjunctivitis. Additionally, less frequent symptoms such as diarrhea, nausea, vomiting, and occasionally seizures can occur.

Despite the low risk to the general public, Dugan emphasized the importance of preventive measures. Authorities recommend that individuals working closely with animals practice thorough handwashing with soap and water and use personal protective equipment, including fluid-resistant coveralls, waterproof aprons, approved respirators, properly fitted goggles or face shields, head coverings, gloves, and boots.

Dugan noted that healthcare providers often overlook inquiring about occupational exposures when diagnosing flu cases. With the increasing prevalence of bird flu in new animal hosts, he stressed the necessity of integrating such inquiries into routine medical assessments as a crucial step forward.

New Cases Linked to the Infection!

The health authorities of the United States have reported as many as three (3) human cases linked to avian influenza in humans since April 2024. The infection has been reported among dairy farmers who were in close contact with dairy cows. Krammer stated, “And what we don’t want to see this summer is an unusual human cluster of influenza. It’s important we keep a close, watchful eye for this,” as per

He was further quoted saying, “Influenza viruses do very interesting things, and as we head into fall and winter flu season, we don’t want new human co-infections that could cause major problems for us.”

Additionally, Krammer stated, “It wasn’t all that long ago that we were asking China difficult questions about the steps Chinese authorities took to protect human lives from SARS-CoV-2 in the COVID pandemic. Now, we must ask ourselves many of these questions. We are at a crucial crossroads where we will either elude a new pandemic or see one take off, risking 10 to 20 million lives.”

Krammer also noted that there’s a precedent for effectively avoiding further issues. He highlighted ongoing collaboration between government agencies and the poultry industry over the past few years. “We’ve successfully halted H5N1 through new regulations and policies.”

However, Dugan pointed out that transitioning from poultry farms to cattle has been challenging. Cattle farms lack experience with bird flu and strategies to manage it under regulations. Officials are navigating unfamiliar territory.

Krammer emphasized, “Our current challenge isn’t scientific, but rather a policy issue and leadership responsibilities haven’t always been clear.”

Dugan added, “Government agencies are coordinating at local, national, and international levels. We’re enhancing transparency and sharing information promptly,” as reported by

Dugan mentioned that the infrastructure developed during the COVID-19 pandemic has prepared teams for this new crisis. There’s year-round monitoring in place, including clinical labs reporting cases of seasonal flu and new strains.

“Laboratories are equipped and ready to assist with testing,” Dugan confirmed.

Regarding specimen collection, it’s advised that samples be gathered promptly from patients showing flu symptoms. This typically involves a nasopharyngeal swab, and in cases of conjunctivitis with or without respiratory symptoms, both a conjunctival and nasopharyngeal swab should be collected. Patients with severe respiratory illness should have lower respiratory tract specimens taken.

For patients presenting symptoms consistent with influenza and recent exposure to birds or animals, standard precautions, contact precautions, and airborne precautions are recommended during medical care.

Regarding antiviral treatment, four drugs are FDA-approved for influenza: Oseltamivir phosphate (Tamiflu), Zanamivir (Relenza), Peramivir (Rapivab), and Baloxavir (Xofluza). Early treatment is recommended for suspected or confirmed cases of avian influenza. Although there are no clinical trials specifically measuring the outcomes of antiviral treatment in people infected with avian influenza, evidence from animal models and observational human studies suggests potential benefits.

“We can’t afford to wait this summer,” Krammer said, adding, “We have an opportunity right now to stop this in cows before we risk infecting more people. I hope we do.”

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