The current strain of H5N1 is a few mutations away from posing concerns about it becoming the next pandemic-causing virus — but California was the first state to highlight that concern.
The avian flu has been recorded in at least 108 countries — a number that’s expected to only grow in the coming weeks and months. 70 mammalian species and at least 530 bird species have been infected by H5N1, the most current strain of bird flu circulating the globe. Among those species affected is the endangered California condor, which has prompted zoological intuitions like the Oakland Zoo to start vaccinating their housed condors against the disease. It’s a move that came just a week after California became the first state in the country to enact a state of emergency around the bird flu.
The motion by Governor Newsom was initially met with hostility and notions of fear-mongering; the far-right took it as another instance of the “woke left” infringing on public health freedom (never mind the said cohort’s general viewpoint on female reproductive autonomy). Now, it’s a move that’s panning out to be right and might lay the foundation for other such edicts in the coming months or years.
As of publishing, the current H5N1 has produced symptomatic infections in at least 66 people — one severe case occurring in California. The infection vectors have been animals, either caused by repeated and long contact with infected birds or, recently, dairy cattle. We still don’t have any evidence of a human-to-human infection occurring … but it is only a matter of time. The question is when rather than if. And, as important, is how we’ll respond.
Unlike SARS-CoV-2, the “coronavirus,” H5N1 is by no means a novel disease.
The first record of the disease came out of southern China in 1996 after farmers began noticing entire flocks were nearly wiped out by a yet-identified illness — the disease later described at A/H5N1. The ensuing decades have seen the bird flu evolve, becoming more infectious and lethal in affected bird populations. HPAI A, the most pathogenic subtype of H5N1, has become the dominant strain detected in bird flu outbreaks since 2018 and is the heavily mutated strain that’s garnered both the media and the public’s attention for its multifaceted virality.
For all intents and purposes: H5N1 is synonymous with HPAI A in respect to the current avian influenza outbreak. 2024 saw everything from wild Asiatic bird species to a polar bear in the Antarctic region contract the virus; the polar bear, believed to be the first documented wild case of an avian flu infection among the species, died from the disease. New Year’s Day brought more troubling, cross-speciation news: Domesticated house cats are becoming infected by H5N1 after eating certain types of raw food.
Outside of exposure to birds, no human contracted this current strain of H5N1 from another human, making the means of exposure still relatively slim for the average person. But it’s a fact — peer-reviewed and academically published — that H5N1 can adapt to an ape or human host with relatively few protein modifications. And there’s striking, glaring, worrisome evidence that H5N1 is just a “few small mutations” away from possibly being spread from human to human, effectively putting the entire world on the edge for another pandemic.
That said: Remember, H5N1 is not a novel disease. The coronavirus entered our collective lexicons with no clear vaccine, no understood antiviral medication, and little to no knowledge of how the virus behaved, sans just two outbreaks — one in 2002, another in 2012 — involving a highly lethal SARS-CoV pathogen that collectively infected less than 17,000 people. (By contrast, over 705 million people have contracted COVID-19.) The bird flu has been around for decades. We have efficacious vaccines for the avian flu; there’s a roaster of antiviral medication that mitigates influenza infections; the vectors and pathways to infection are clearly known for the bird flu.
It’s now predicated on how we allocate resources to help prevent the spread (and further mutation) of H5N1. California’s state of emergency declaration around the avian flu allows local and state governments to easily access funds that might otherwise be kept behind red tape and bureaucratic hoops.
“This proclamation is a targeted action to ensure government agencies have the resources and flexibility they need to respond quickly to this outbreak,” reads a press release from the California Governor’s Office. “California’s testing and monitoring system — the largest in the nation — we are committed to further protecting public health, supporting our agriculture industry, and ensuring that Californians have access to accurate, up-to-date information. While the risk to the public remains low, we will continue to take all necessary steps to prevent the spread of this virus.”
The proclamation will also help streamline communication and action items from multiple State government branches, like the California Department of Public Health (CDPH), and the California Department of Food and Agriculture (CDFA), 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. The current edict does not include vaccination against bird flu, solely because no H5N1 vaccine has been authorized by the FDA for rollout to the general public.
Former Baltimore Health Commissioner and public health professor Leana Wen found herself in a sea of backlash from MAGA die-hards after declaring on the CBS News Face the Nation broadcast that the U.S. government should be working fast to streamline a bird flu vaccine — “we should have learned our lesson from COVID.” There are presently three H5N1 vaccines licensed in the United States, two of which are approved for children. The FDA has approved the use of them in past outbreaks, most recently in 2020, but notes that these edifications are “outdated.” (Clinical research, however, suggests that even these stockpiled vaccines prove moderately effective in preventing serious complications from H5N1 and could well exist as a bridge of sorts until newer, more updated vaccines are developed.)
“We need to know if there are new mutations that are being developed and other countries also need to know so that they can prepare as well,” Wen said toward the tail end of her appearance on CBS News in December. “And I think it’s a major problem that in the US, we have been holding back on testing and also holding back on getting the vaccines deployed that are already developed.”
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