under the microscope
By Rodney E . Rohde , PhD , MS , SM ( ASCP ) CMSV CM , MBCM , FACSc
Investigating the U . S . Case of Human Avian Influenza A ( H5 ) Virus
Viral respiratory agents are at the forefront of concern to healthcare and public health . As the SARS-CoV2 pandemic continues , efforts to detect and respond to index cases of ongoing and novel microbial agents is critical in our efforts to curtail outbreaks .
In an April 28 , 2022 Centers for Disease Control and Prevention ( CDC ) news release , it was reported that a person tested positive for avian influenza A ( H5 ) virus ( H5 bird flu ) in the U . S ., as reported by Colorado and confirmed by CDC . The individual was involved in a direct exposure to poultry via depopulation ( culling ) of poultry with presumptive H5N1 bird flu . The case patient presented fatigue as their sole symptom and has recovered . Out of precaution , the patient was isolated and treated for influenza with oseltamivir ( antiviral drug ). Surface contamination of the nasal nares / membranes is possible in the detection of H5 bird flu in this case ; however , it can ’ t be determined so the positive test result meets the H5 case criteria . The CDC must assume this case in an infection and take necessary actions to contain and treat .
The CDC reported that this case does not change the low human risk assessment for the general public . However , people who have job-related or recreational exposures to infected birds are at higher risk of infection should take appropriate precautions outlined in
CDC guidance .
As part of our nationals ( and global ) efforts to understand the circulation and introduction viral ( and other ) agents , the CDC monitors surveillance data . Since late 2021 and into 2022 , the CDC has been monitoring illness detection for anyone who may have been exposed to H5N1 virus-infected birds . As of the writing of this column , H5N1 viruses have been reported in 29 U . S . states of commercial and backyard birds , as well as in wild birds in 34 states . With more than 2,500 people having been exposed to H5N1 virus-infected birds , this is the only case detected to date . Others in the Colorado culling operation have tested negative but are being retested out of caution .
The first case was in the United Kingdom which occurred in December 2021 . In that international case , the person had no symptoms and raised birds that became infected with H5N1 virus . The U . S . case in Colorado is the second human case associated with this specific group of H5 viruses that are currently predominant , and the first case in the United States . Since 2003 , more than 880 human infections with earlier H5N1 viruses have been reported globally , however , the predominant H5N1 viruses now circulating among birds globally are different from earlier H5N1 viruses .
The CDC has published “ Prevention and Control of Seasonal Influenza with Vaccines : Recommendations of the Advisory Committee on Immunization Practices — United States , 2021-2022 Influenza Season .” This report updates the 2020-21 recommendations of the Advisory Committee on Immunization Practices ( ACIP ) regarding the use of seasonal influenza vaccines in the United States ( MMWR Recomm Rep 2020 ; 69 [ No . RR-8 ]). Routine annual
influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications . For each recipient , a licensed and age-appropriate vaccine should be used . ACIP makes no preferential recommendation for a specific vaccine when more than one licensed , recommended , and age-appropriate vaccine is available . During the 2021-22 influenza season , the following types of vaccines are expected to be available : inactivated influenza vaccines ( IIV4s ), recombinant influenza vaccine ( RIV4 ), and live attenuated influenza vaccine ( LAIV4 ).
In the November 2020 issue of this publication , I asked the question “ Why is it so important to receive the flu vaccine during the ongoing pandemic ?” The answer remains the same ! Global efforts to lower the transmission of SARS-CoV2 which is responsible for the COVID-19 illness , such as reduced travel , staying
During the 2021-22 influenza season , the following types of vaccines are expected to be available : inactivated influenza vaccines ( IIV4s ), recombinant influenza vaccine ( RIV4 ), and live attenuated influenza vaccine ( LAIV4 ).
home , telecommuting for work and online education , have led to a reduction in the number of people taking advantage of routine physician visits for a number of services , including getting one ’ s vaccines up to date . Overall , healthcare is already under dangerous workloads and shortages in both healthcare professionals and healthcare PPE , as well as other essential medical items due to the pandemic . It is vital that everyone get their routine vaccinations during the COVID-19 pandemic to protect people and communities from vaccine-preventable diseases and outbreaks , including flu .
We can never perfectly predict how bad an upcoming flu season will be for a particular year . It is always critical to prepare for the upcoming flu season since we know that it can lead to high morbidity and mortality for certain populations . It will be even more important this year to reduce flu because it can help reduce the overall impact of respiratory illnesses on the population and thus lessen the resulting burden on the healthcare system during the COVID-19 pandemic . A flu vaccine may also provide several individual health benefits , including preventing one from getting flu , lowering the severity of a flu illness and reducing one ’ s chances of having to go to the hospital .
Rodney E . Rohde , PhD , MS , SM ( ASCP ) CM SVCM , MBCM , FACSc , serves as chair and professor of the Clinical Laboratory Science Program at Texas State University . Follow him on Twitter @ RodneyRohde / @ TXST _ CLS , or on his website : http :// rodneyerohde . wp . txstate . edu /