A child who fell ill earlier this month may become San Francisco’s first confirmed case of bird flu — almost exactly five years after the first COVID-19 case was detected in the SF Bay Area.
California was the first state to take statewide precautions against H5N1 bird flu in December of 2024 when it declared a state of emergency around the disease. The proclamation immediately allowed the State to side-step legislative red tape and allocate additional funds to departments responsible for safeguarding the public against an infectious disease outbreak. As a result, multiple State government branches, like the California Department of Public Health (CDPH), and the California Department of Food and Agriculture (CDFA), now have streamlined communication and resource distribution to ensure those in high-risk areas and occupations receive access to medical education around H5N1, suitable amounts of personal protective equipment (PPE) requirement, and resources to keep any outbreaks within livestock contained.
Past viral outbreaks — monkeypox, COVID-19, swine flu, etc. — have taught us Mother Nature will always outsmart (and outmaneuver) humankind. It’s more a matter of how we can mitigate the worst of those deadly outcomes. While human-to-human transmission (HHT) hasn’t been observed in this current strain of HPAI H5N1 as of publishing, it’s simply a matter of time; unlike COVID-19, there are developed vaccines available to combat disease spread and its mortality.
San Francisco might’ve just documented its first case of H5N1. And just like with COVID-19, the case initially went undetected.
“The [infected individual]l is a child who experienced symptoms of fever and conjunctivitis but did not need to be hospitalized and has since fully recovered,” the San Francisco Department of Health (SFDPH) said in a press release Friday, January 10th. The child is the first presumptive case of H5N1 documented in the San Francisco Bay Area after they tested positive for H5N1 at the SFDPH Public Health Laboratory — “which performed this testing as part of enhanced surveillance efforts,” per the release, those efforts being supported by California’s state of emergency.
The child, who was not hospitalized during the symptomatic infection and has since fully recovered, was first tested for COVID-19, influenza, and RSV “based on symptoms,” but later tested positive for influenza A … the most dangerous flu type and one responsible for bird flu. Confirmatory testing will be performed at the Centers for Disease Control and Prevention (CDC) soon; should the center’s testing verify the infection, it will be the first confirmed case of H5N1 documented in the San Francisco Bay Area, though the exact transmission vector of the yet-confirmed infection still remains unknown.
The first case of COVID-19 in the San Francisco Bay Area was confirmed in Santa Clara County on January 31, 2020, a week after a resident returned from Wuhan, China. The individual reported flu-like symptoms the week of January 24th and was not hospitalized for the infection. Because of the patient’s travels to Wuhan, ground zero for SARS-CoV-2 — the virus responsible for causing COVID-19 — the Santa Clara County Public Health Department ran samples from the patient through preliminary coronavirus tests. The CDC later confirmed the case, making it the first of what became of 200 confirmed COVID-19 cases documented in Santa Clara County by the center between January 31st and March 31st of that year.
Make no mistake, the coronavirus and this current strain of bird flu are behaving in considerably different ways. (HPAI H5N1 is evolving slower than COVID-19 and has yet to become airborne among humans and primates; as of publishing, the bird flu variant, which was first documented in March 2024 remains mostly a “pandemic among animals.”) Unlike COVID-19, vaccines —albeit ones that aren’t explicitly engineered for this current strain — exist for H5N1 and have proven efficacious against the virus. We, too, now have modernized public health protocols on how to contend with a pandemic.
And yet, the uncanny sentiments of déjà vu to this exact time nearly five years ago feel unshakable. Those emotions are only flamed when considering the United States recorded its first death from H5N1 last week.
“I want to assure everyone in our city that the risk to the general public is low, and there is no current evidence that the virus can be transmitted between people,” said Dr. Grant Colfax, Director of Health for SFDPH. “We will continue to investigate this presumptive case, and I am urging all San Franciscans to avoid direct contact with sick or dead birds, especially wild birds and poultry. Also, please avoid unpasteurized dairy products.”
