People Are Worried About Bird Flu — Should They Be?

After the second person in the United States was infected with avian flu, also known as bird flu, many are left wondering if we are heading for another pandemic.

A patient in Texas tested positive for avian flu following contact with dairy cows presumed to be infected, Texas health officials announced Monday. The patient had a mild disease, with conjunctivitis as their only symptom, and is now being treated with antiviral medication.

The Centers for Disease Control and Prevention (CDC) says the risk of avian flu for the U.S. general public remains low.

However, as it is the second human infection in recent years, and people are still living with the consequences of the COVID-19 pandemic, unsurprisingly, many are concerned about the possible outbreak.

People also wonder how to handle eggs and dairy products to minimize the risks of contracting avian flu since the virus now appears in poultry and dairy cows.

While headlines claiming that the virus could be “100 times worse than COVID” continue fueling fear, we ask experts how worried we should be about contracting bird flu.

Can avian flu spread between people?

Raina MacIntyre, a professor of global biosecurity at the Kirby Institute at the University of New South Wales, says the risk of avian flu for the general population is low at this stage because the virus is not easily transmitted from human to human.

"If the virus mutates and adapts to humans, it could become easily transmitted between people. That is what we worry about," MacIntyre tells Healthnews.

Sequencing of the H5N1 virus in a Texas patient identified "minor changes, " making it better adapted to infect mammals. One mutation has been previously detected in other human cases, but with no evidence of onward spread among people, according to the CDC report.

Historically, human-to-human transmission of H5N1 has been low and has not led to sustained outbreaks among humans, says Dr. Darin Detwiler, a food policy safety expert at Northeastern University.

From January 2003 to February 2024, 887 cases of human infection with the avian flu A(H5N1) virus were reported from 23 countries globally.

However, Detwiler cites the World Health Organization data and says the H5N1 strain has caused severe disease and fatalities in humans who have been infected, with about a 50% fatality rate among confirmed cases.

The cases in the U.S. have been mild thus far. The first patient who tested for avian flu in 2022 in Colorado experienced fatigue lasting for a few days as their only symptom and has since recovered.

Dr. Angela Rasmussen, a virologist at the University of Saskatchewan, finds it particularly worrisome that this human case was limited to mild conjunctivitis. Although it is good news for avian flu patients, mild cases are difficult to recognize and isolate.

"If human cases are mild and not detected, the virus will have more opportunities to spread to other humans. It will have more opportunities to adapt to human hosts. So far, there's no evidence that this is happening, but the absence of evidence doesn't mean evidence of absence," Rasmussen wrote on X, a social network.

She underlined the importance of identifying avian flu cases in cows and humans and preventing new ones from occurring.

We don't want to give H5N1 the opportunity to adapt to efficient growth in humans. It can be deadly. To prevent the public health crisis of tomorrow, solve the problem of today.

Rasmussen

Dr. Mandy Cohen, the CDC director, told NPR that the U.S. has been preparing for avian flu outbreaks for more than 20 years. She emphasized that the situation is very different from the beginning of the COVID pandemic when tests, treatments, and vaccines were not available.

Currently, people most at risk for avian flu are those with regular unprotected contact with poultry or wild birds and those who work with raw milk, including in milking parlors.

Can I get bird flu from eggs?

Since January 2022, more than 1,100 avian flu outbreaks among wild aquatic birds, commercial poultry, and backyard or hobbyist flocks across 48 states have been reported, according to CDC data.

Cal-Maine Foods, Inc., the largest producer and distributor of fresh eggs in the U.S., announced Tuesday that it would halt production after its location in Parmer County, Texas, tested positive for avian flu.

The CDC recommends cooking poultry and eggs to an internal temperature of 165°F (74°C) to kill bacteria and viruses, including bird flu viruses.

However, the risk arises with improperly cooked eggs or poultry meat, Detwiler says. He recommends taking the following precautions when handling eggs:

• Purchase eggs from reputable sources that follow strict biosecurity measures.
• Store eggs in the refrigerator at 40°F (4°C) or colder immediately upon returning home.
• Avoid using eggs that are cracked or dirty.
• Always wash your hands, utensils, and surfaces with soap and water after they come into contact with raw eggs.
• Cook eggs until both the white and yolk are firm.

Detwiler says the level of risk associated with consuming runny eggs can vary depending on the status of avian flu in poultry populations and specific health advisories in place.

For instance, the most vulnerable populations, such as the elderly and pregnant individuals, should adhere to local health department advisories regarding egg consumption.

Can I get bird flu from milk?

The H5N1 virus has now been emerging among dairy cows, raising concerns about its transmission through milk. Pasteurization kills bacteria and viruses, including H5N1, meaning that pasteurized milk is safe to consume.

However, the demand for raw milk has been increasing in the U.S., and its sales are now legal to some degree in all but four states and Washington, D.C., an analysis shows.

Advocates and consumers compare raw milk to human breast milk, saying that's why it is well-digested and compatible with humans. Some increasingly popular diets, like the carnivore diet, include raw milk.

Generally, avian influenza viruses, including H5N1, are not known to be transmitted through cow's milk, Detwiler says. Risks to humans from consumption of raw milk would depend on whether the virus could survive in milk and remain infectious to humans.

Consuming raw milk carries risks of exposure to other harmful pathogens, such as Salmonella, E. coli, and Listeria. These risks are well-documented and unrelated to avian influenza.

Detwiler

Detwiler adds, "Consuming raw milk carries risks of exposure to other harmful pathogens, such as Salmonella, E. coli, and Listeria. These risks are well-documented and unrelated to avian influenza."

Evidence suggests that avian flu currently doesn’t pose major risks to the general population. Meanwhile, extra carefulness when consuming poultry and dairy products can protect against harmful bacteria and viruses, including the H5N1 virus.