IIf H5N1 turns into a full-blown pandemic, we are currently in the first chapter. To prevent chapter two from becoming a reality, the most important tool in our arsenal will be widespread testing. Testing is not just about diagnosing people with the virus. Containing the spread of this highly pathogenic strain of bird flu in livestock depends on our ability to detect and track it.
The H5N1 outbreak in dairy cows is widespread and spans several US states. Although only one If human infection with the virus has been documented, it is likely that more infections will go unnoticed. Most importantly, uncontrolled transmission between cattle means the virus is increasingly attacking humans. Each human exposure, in turn, provides an opportunity for new mutations that could allow human-to-human transmission.
The US Centers for Disease Control and Prevention (CDC) keeps that as of now, the risk of H5N1 to the general public remains low. And, in fact, it is entirely possible that H5N1 will never become a human pandemic.
However, being wrong would be incredibly expensive.
We find ourselves in a situation reminiscent of early 2020, when the US was on the brink of the COVID-19 pandemic and hesitated to take decisive action, restricting testing only to those with epidemiological links to China. Scientists I estimated that in early March 2020, less than 1% of SARS-CoV-2 infections in the US were detected by testing. We effectively flew blind straight through chapters one and two of the COVID-19 pandemic.
Today, genomic analyzes tell us that bird flu had been circulating in dairy cows for at least four months before it was detected in March 2024. The delay came despite early warning signs of infections on dairy farms in February. The U.S. government cannot afford to repeat the mistakes made at the start of the COVID-19 pandemic. Although the risk of an H5N1 pandemic may currently be low, the consequences of inaction could be catastrophic and the benefits of proactive testing far outweigh the short-term costs.
see more information: Why experts are concerned about bird flu in cows
Despite the high risks, government action has initially been slow and uncoordinated. Until mid-April, testing was not just voluntary, but restricted to symptomatic animals, with limits on the number of tests per farm. One complicating factor is that responsibility for controlling the outbreak is divided among three federal agencies: the U.S. Department of Agriculture (USDA) for livestock, the U.S. Food and Drug Administration (FDA) for food safety, and the CDC for human health and surveillance. However, in May, the CDC was only aware of about 30 people that were tested for bird flu. The CDC was monitoring data from emergency departments in areas where H5N1 has been found in cattle and has found nothing unusual so far. But if and when infected people show up in the emergency room, it will be too late to contain the outbreak at its source.
We must stop flying blind. Regular, widespread testing is our only way to detect H5N1 and stop the virus from spreading.
The recent federal order Requiring mandatory testing of dairy cows before they cross state lines is a step in the right direction. But we could be doing more: we should be encouraging testing, rather than restricting it. A layered testing strategy that combines surveillance of residues or wastewater on farms, routine testing of accumulated milk from cows, and active surveillance testing of animals and humans – including those without symptoms – is our best hope of stopping the spread. of the virus.
The tools and infrastructure for this testing regime are already within our reach. During the pandemic, the US government spent billions support testing and creating an extensive biosurveillance infrastructure. Monitoring Influenza Through Wastewater Surveillance already shown increases in subtype H5 – the viral group to which H5N1 belongs. In 2024, labs in the US now have PCR machines sitting idle, waiting to be turned back on. And U.S. test manufacturers have efficient automated production lines capable of producing millions of rapid tests per day.
see more information: Is it safe to eat eggs and chicken during the bird flu outbreak?
For animal testing, we must accelerate evaluations of both laboratory tests and spot tests. Tests are expected to include cows, but also pigs, which are known “mixing containers”For viruses in host species. We must also evaluate different samples, such as swabs and cow’s milk, including grouping samples to test more efficiently.
If existing rapid influenza A tests could detect the virus from a drop of contaminated milk, that would be a game changer. Given the very high virus loads detected in the milk of infected dairy cows, it is possible that a single drop is sufficient. But if the tests need to be adjusted, the USDA and FDA should fund studies to do so now. With H5N1 circulating in herds across the country, we can quickly assess the effectiveness of these tests and refine our strategies accordingly.
When it comes to human testing, it is commendable that the CDC is now engaging with test manufacturers to develop a widely available H5N1 test. However, existing authorized rapid tests for influenza A will likely detect H5N1. To confirm, the CDC, FDA, and the National Institutes of Health’s Rapid Acceleration of Diagnostics (RADx) program must support assessments that close this knowledge gap. If these rapid influenza tests detect H5N1, we may send any positive influenza A tests to a laboratory for confirmation and evaluation of H5N1 or another virus. This surveillance testing algorithm, which uses comprehensive flu testing for initial screening and reserves more specific H5N1 testing for confirmation, followed by rapid sequencing of positive results, would allow us to allocate our public health resources with the maximum efficiency. Rapid testing turnaround times at points of need would allow infected people to immediately isolate and receive flu antivirals, minimizing the risk of transmission.
The federal government maintains the influenza antiviral drug Tamiflu and personal protective equipment (PPE) in its collection. Strategic National Stock. To ensure that tests are similarly available, the government must send a clear demand signal to manufacturers by committing to purchasing a substantial quantity of tests, just as they do with antivirals and PPE. This would give manufacturers the confidence to increase production and create a robust national stockpile. Congress should appropriate funding to support these efforts, with the new White House Office of Pandemic Preparedness and Response coordinating a unified response between the CDC, USDA and FDA.
The government must also address the stigma associated with positive test results and provide financial aid and resources to help affected farmers and their workers. Many of the individuals who work on dairy farms are undocumented, for example. The current administration must provide safeguards that offer protection to undocumented workers who agree to be tested as part of public health surveillance testing programs.
Success in public health prevention is difficult to detect, and success in preventing a pandemic can be misinterpreted as failure or a misappropriation of funds. It is almost impossible to recognize the absence of a pandemic that never happens, but would happen if not for aggressive and early efforts. However, tracking detections and documenting actions taken will help. The cost of inaction far outweighs the cost of prevention. We risk losing all the lessons learned from COVID-19 if we don’t apply them now.
The good news is that we have the tools at hand to prevent an H5N1 pandemic. But we must be willing to use them, and quickly.
This story originally appeared on Time.com read the full story
