Bird Flu spreads to cats, concern for human infections heighten


So far, 43 types of mammals have tested positive for bird flu in the U.S.


Lazy cat
The bird flu cases are rising in cats. A pet from the Champaign-Urbana area was recently diagnosed infected with the virus.
Photo: Annette Meyer/Pixabay

(Urbana) - A growing number of cases of H5N1 avian influenza, commonly known as bird flu, have been detected in domestic cats across the United States, raising concerns about its potential transmission to humans. Veterinary experts and public health officials are warning pet owners to be vigilant as the virus spreads across multiple states and is linked to contaminated food sources.

Dr. Leyi Wang, a virologist and professor of veterinary medicine at the University of Illinois Urbana-Champaign, recently confirmed the presence of H5N1 in a cat at the university’s Veterinary Diagnostic Laboratory. The U.S. Department of Agriculture (USDA) has reported 130 cases of bird flu in domestic cats, spanning 23 states, including Illinois. Since 2022, 126 domestic cats have been infected, with around half of those cases occurring in 2024. Many cats were exposed through contaminated food or raw milk.

Lethality and Transmission Risk
"Bird flu H5N1 infections in cats are usually serious and life-threatening, with a high mortality rate. Infected cats show severe clinical signs such as lethargy, fever, loss of appetite, difficulty breathing, discharge from the eyes and nose, and neurological issues like tremors, seizures, incoordination or blindness," Wang explains. "Domestic cats are companion animals and have close contact with humans, potentially transmitting viruses to owners. A previous report revealed a cat-to-human transmission of influenza A virus, so H5N1 transmission might be possible as well."


Infections have been reported most often after prolonged and unprotected exposure to an infected animal.

Although no confirmed cases of cat-to-human transmission of H5N1 have been recorded in the current outbreak, Wang and other experts warn that as the virus circulates in mammals, the risk of mutation increases. "Previously, H5N1 had limited infection in mammals. However, the new H5N1 involved in outbreaks since 2022 mutated and acquired the capability to infect different mammal species including domestic and wild cats. So far, 43 types of mammals have tested positive for bird flu in the U.S., with domestic cats being the highest number," Wang says.

Pathways of Infection
The Centers for Disease Control and Prevention (CDC) states that people can be infected with avian influenza viruses through contact with infected wild, stray, feral, or domestic animals. Infections have been reported most often after prolonged and unprotected exposure to an infected animal. The CDC has previously documented avian influenza transmission from mammals to humans in the U.S., including a case involving a cat in New York City in 2016 and a cow in 2024.

The virus has been detected in poultry and cattle, allowing it to enter the raw food supply. Concerns over food contamination led the U.S. Food and Drug Administration (FDA) to recall Savage Cat Food Large Chicken Boxes (84 ounces) and Small Chicken Boxes (21 ounces) due to the potential presence of H5N1. These products, with a “better if used by” date of November 15, 2026, were distributed in multiple states, including Arizona, California, Colorado, Maryland, New York, and Pennsylvania.

Pet owners who have fed their cats the recalled products should watch for symptoms of bird flu, including fever, lethargy, loss of appetite, reddened or inflamed eyes, nasal and eye discharge, difficulty breathing, and neurological signs such as tremors, seizures, or blindness. If a cat exhibits these symptoms, immediate veterinary attention is advised.

Public Health Concerns
Public health experts fear that as H5N1 spreads among mammals, the likelihood of a pandemic increases. The New York Times recently reported that domestic cats could serve as a critical pathway for the virus to evolve and potentially become more transmissible to humans. If the virus mutates or swaps genes with another flu virus, it could pose a greater threat to human populations.

"If you work with animals, wash your hands well after interacting with poultry, livestock or animals outside the household. I also would suggest changing clothing and shoes after interacting with animals or birds with unknown health status, before interacting with your own pets," Wang advised.

Prevention and Protection
With no available vaccine or antiviral treatment for H5N1 in cats, prevention is key. Experts recommend keeping cats indoors to limit exposure to infected birds and wildlife. Pet owners should also avoid feeding raw meat or raw milk to their pets and ensure they do not come into contact with potentially contaminated food sources.

Wang stresses the importance of vigilance among pet owners. "Cat owners should contact their veterinarians if they are concerned their pet has contracted bird flu. Tell the veterinarian if your pet has been exposed to raw meat, raw milk, backyard birds or wild waterfowl. Unfortunately, only supportive care is available for cats with bird flu, and no antiviral drugs are yet available."

Beyond pet care, experts urge the public to remain cautious when handling animals and animal products. Personal protective equipment (PPE) is recommended for veterinarians and those working closely with animals at risk of infection.


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IDPH reported bird flu outbreak in Illinois flocks, here's what you should know

by Matt Sheehan
OSF Healthcare

PEORIA - Last month, the Illinois Department of Public Health (IDPH) has reported the state’s first bird flu cases in poultry flocks.

In a health advisory sent to long-term care (LTC) facilities, farm bureaus and local health departments, the IDPH reports large commercial poultry flocks in central and southern Illinois have recently tested positive for the H5N1 virus. Farm owners are now in the process of “de-populating” the birds.

Photo provided

Doug Kasper, M.D.
OSF Infectious Disease Specialist

Several counties in northern Illinois have reported events where many ducks and geese have died, referred to as “die-offs.” The reason LTCs received the notice is because many are located on retention ponds that attract waterfowl and wild birds.

No human cases have been reported in Illinois yet. But health officials continue to warn those who interact with potentially infected animals that if they don’t wear the proper personal protective equipment (PPE), they are at higher risk of developing the novel influenza A virus due to H5N1.

Doug Kasper, MD, an infectious disease specialist with OSF HealthCare, says bird flu has really hurt local American farms.

"Avian flu is a different strain of Influenza A. It's a strain that has been circulating in bird and cattle populations for over two years. It has been devastating to those populations, like poultry and dairy farms across the country," Dr. Kasper says. "What was unique was that in the calendar year 2024, was the first confirmed testing where the spread from an animal to a human occurred of this specific strain of influenza."

In early January, the Louisiana Department of Health reported the first-ever human bird flu death in the United States. The patient was reported to be over 65 years of age and had underlying medical conditions. The patient contracted H5N1 after exposure to sick and dead birds in a backyard flock.

Currently bird flu is only transmitted from animal to animal or animal to person. There have been no reported cases to have transmitted from human to human, but Dr. Kasper says there is always a concern about that possibility.

"Whenever there is an animal strain of infection that's not typically found in humans, we worry about the impact of if it were to cross over," Dr. Kasper says. "We've seen this with other infections throughout history. Even within COVID-19, there was the initial thought that it was an animal strain of infection."

The current flu vaccine does not protect against avian influenza, Dr. Kasper says.

"Each year the influenza vaccine, which is made up of three or four strains of influenza virus, is reexamined and matched up to a variety of factors to try and predict which strains will be most prevalent the next year," Dr. Kasper says. "Right now, avian flu cases in humans are so low that it doesn't warrant a different strain that would be much more likely to be found."

IDPH’s guidance to LTCs is to have residents tested for the flu if they are suspected of having acute respiratory illness. Don’t touch dead or sick birds, only trained staff in appropriate PPE should handle with caution.

"The average person who does not interact with poultry or dairy farms is at very low risk of avian flu," Dr. Kasper says.

There is concern that bird flu could enter the food production and distribution across America. This is why the United States Department of Agriculture (USDA) is closely monitoring dairy and poultry farms, to try and limit any possible contamination of dairy, meat or poultry products.

The bird flu continues to be rarely seen in humans, as only 67 cases (as of January 15) have been reported by the Centers for Disease Control and Prevention. Most cases have been mild, Dr. Kasper says.


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Respiratory illnesses being seen by hospitals, health care providers on the increase

by Matt Sheehan
OSF Healthcare

PEORIA - Respiratory illnesses like influenza, COVID-19 and respiratory syncytial virus (RSV) are leading to many people being seriously ill, overwhelming hospitals and health care providers across Illinois.

Flu remains the dominant virus
“We're seeing a lot of patients be positive with the flu. It makes you feel really bad with headache, body aches, chills, cough and fevers to name a few,” says Sarah Overton, chief nursing officer of OSF Medical Group, Home Care and Employee Health. “But we're also seeing some COVID-19 and RSV. RSV attacks very young children and older adults."

Sarah Overton from OSF Healthcare
Photo provided

Sarah Overton
OSF Medical Group, Home Care and Employee Health


All the viruses spiking at the same time have been "somewhat crippling" for healthcare providers, Overton says OSF HealthCare hospitals are seeing high inpatients counts, with many people coming in sick with respiratory illnesses through the emergency department.

Across Illinois, nearly 20% of emergency department visits were for acute respiratory illness, according to the Illinois Department of Public Health (IDPH). 7.8% of those visits are attributed to patients with the flu.

"From Chicago and Rockford down to Alton, we're seeing a large number of respiratory illnesses. And I think the country is seeing it overall," Overton says. "The SIREN notifications from the IDPH show that other health systems in Illinois, not just OSF, are seeing this."

Illinois’ respiratory activity level, calculated by the Centers for Disease Control and Prevention (CDC) moved up to High in late December, dipped to Moderate in January, and has now returned to High to start February.

“These viruses can kill”
The IDPH has reported five flu deaths this respiratory illness season. Along with three people dying from RSV, and one person dying from RSV and COVID-19.

"There's a little bit of complacency or feeling like the COVID-19 pandemic is done. But these viruses can kill, and they can lead to major medical complications and hospital admissions. I've talked to some of my colleagues who are the nursing leaders in the hospitals, and patients coming in are indeed sick. If you can manage at home, we recommend you do so," Overton says.

For those who are immunocompromised or chronically ill, Overton says you should consult with a medical professional in person if you are sick, but if you’re a fairly healthy individual who is mildly ill, consider staying home and rest. OSF Medical Group and OSF OnCall offer Urgent Care services for many outpatient appointments, including visits with primary care providers and specialists.

For those caring for themselves at home, there are several over-the-counter medications to help alleviate symptoms. Additionally, a health care provider may prescribe antiviral medication.

“Antiviral medication is most effective is initiated less than 48 hours after your symptoms begin,” says IDPH Director Dr. Sameer Vohra.

Flu vaccine rates down
"We've got ample flu vaccine. We are behind our influenza vaccine rates of where we've been in years past," Overton says. "It's not too late to get your flu shot, it's not too late to get your pneumonia shot. If you get it at a retail pharmacy, that's great. You can also get it at OSF or another healthcare provider. We just want you to get vaccinated.”

Flu vaccines are offered at OSF primary care and many medical specialty offices, along with commercial pharmacies. The CDC’s Flu Vaccine Finder allows you to type in your zip code and find options closest to you. Overton also recommends speaking with your healthcare provider about the recently-approved RSV vaccine available for some.

Respiratory illnesses impacting care teams
"Unfortunately, we have had some experiences with respiratory illnesses in our staff," Overton says. "We need to do everything we can to protect them. OSF Mission Partners (employees) have started masking in those areas we know exposure is likely." Respiratory cough stations with hand sanitizer, tissues and masks are available at all OSF facilities.

How health systems being overloaded impacts patients
"When we overwhelm the health system, it could lead to delays in other critical illnesses that need to come to the emergency room or urgent care to receive adequate management," Overton says.

To protect yourself and others, Overton recommends regularly washing and sanitizing your hands. Also make sure to cover your cough to decrease the spread of respiratory droplets, which is a major way the flu and other respiratory illnesses spread.

When to head to the emergency department
“Those hallmark signs of when to see care is when a fever isn't responding to medications after 24-48 hours. Or when you’re extremely uncomfortable and experiencing respiratory impacts like shortness of breath that you are struggling to breathe,” Overton says.

Warning signs look different for kids and adults. The CDC breaks down symptoms to keep a close eye on:

In children
  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert or interacting when awake
  • Seizures
  • Fever above 104 degrees Fahrenheit that is not controlled by fever-reducing medicine
  • In children younger than 12 weeks, any fever
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

In adults
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen


Staying berry healthy; FDA steps up with strategy to address contaminated food imports

SNS - Berries are known as a superfood, essential to healthy living. In addition to being an excellent source of vitamins, minerals, fiber, and antioxidants, they are known to reduce the risk of many age-related conditions, including heart disease, cancer, and arthritis. However, berries, if not harvested and handled correctly, can make you super sick.

The FDA recently advised consumers to exercise caution when eating fresh and frozen imported berries due to concerns about potential links to outbreaks of enteric virus infections, including hepatitis A virus (HAV) and norovirus (NoV). These outbreaks have been associated with fresh and frozen berries exported globally, including to the United States. The Food & Drug Administration has adopted a new strategy to limit consumer exposure to the two viruses.


fresh and frozen berries
Photo provided

Frozen berries are commonly used as ingredients in various foods. While they are often baked into pies and other goods, they are also used raw in fruit salads and smoothies, which have been linked to foodborne illness outbreaks. Between 1997 and 2016, the FDA reported three hepatitis A virus outbreaks and one norovirus outbreak linked to frozen berries.

"While no enteric virus outbreaks associated with domestic berries have been reported in 35 years, there have been outbreaks linked to imported fresh and frozen berries," the FDA said in a statement. The most recent HAV outbreaks in the United States occurred in 2022 and 2023, with imported berries from the same grower identified as the source. "Outbreaks reported since 1997 have been linked to imported fresh and frozen berries. However, hygienic practices and challenges in controlling enteric viruses in berries and other hand-harvested produce apply globally."

Enteric viruses, such as hepatitis A and norovirus, are primarily spread through the fecal-oral route, which occurs when food, water, or surfaces contaminated with fecal (or vomit) matter is consumed. For example, strawberries, raspberries, and blackberries can become contaminated with bacteria or viruses if handled by an infected worker who does not follow proper hygiene after using the toilet. Because berries are often eaten raw and are hand-harvested, they can be particularly vulnerable to contamination if strict hygiene practices are not followed.

Contamination can also occur via water or surfaces during harvesting and packaging. Contrary to popular belief, freezing preserves berries but does not kill viruses, which can survive at low temperatures. Noroviruses, for example, can withstand temperatures as high as 145°F.

According to the Centers for Disease Control and Prevention (CDC), norovirus outbreaks most commonly occur in healthcare facilities, restaurants, catered events, schools, childcare centers, and cruise ships, where food handling procedures maybe suboptimal due lack of training or compliance by workers.

What are Enteric Viruses?
Enteric viruses infect the digestive tract and cause symptoms such as nausea, diarrhea, vomiting, and stomach pain. Typically, a norovirus bout lasts 12 to 60 hours. These viruses are primarily spread through contact with feces or infected animals. People with weakened immune systems or underlying health conditions are at higher risk of severe illness. HAV symptoms can include fatigue, nausea, vomiting, abdominal pain, jaundice, dark urine, and pale stool.

The FDA attributed the contamination of imported berries to lapses in food safety systems and prevention measures by overseas suppliers. "Key factors to consider in preventing outbreaks include proper hygienic practices by field workers, management of sanitary facilities, prevention of cross-contamination during field and processing operations, and monitoring viral carriage among farm and facility workers," the agency stated.

HAV is a vaccine-preventable, short-term infection that does not become chronic. Most infected individuals recover completely within weeks. However, untreated infections can lead to severe complications in older adults, immunocompromised individuals, or those with underlying health issues.

FDA focuses on prevention and spread
To prevent future outbreaks, the FDA announced a strategy to minimize infection risks for the public. The plan includes:
  • Promoting high compliance rates with FDA food safety requirements.
  • Encouraging the berry industry to implement consistent pre- and post-harvest sanitary practices globally and to use root cause analysis when food safety failures occur.
  • Expanding scientific knowledge about detecting and mitigating viruses in fresh and frozen berries, agricultural water, and production environments.
  • Incentivizing public health measures, such as immunization programs, to promote worker health.

The FDA aims to identify sources of contamination using a thorough scientific approach to improve virus detection and prevention before they become consumer health risks.

“Collaboration between regulators, the global berry industry, and other stakeholders has been critical for developing this strategy. We look forward to ongoing collaboration to ensure its success and to prevent foodborne illness,” said Conrad Choiniere, Director of the Office of Microbiological Food Safety at the FDA’s Human Food Program.


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Protecting cherished pets from highly pathogenic avian influenza: A guide for pet owners

Pets, like cats and dogs, are not immune from contracting Highly Pathogenic Avian Influenza, commonly called the Bird Flu. Veterinarians are recommending viligence, keeping a close watch over pets when outside the home to avoid contracting the fatal disease.

Annette Meyer/Pixabay

SNS - As the threat of Highly Pathogenic Avian Influenza (HPAI) looms over both avian and domestic populations, pet owners face an urgent challenge: protecting their beloved companions from a virus that can turn a playful afternoon into a perilous health crisis. HPAI, primarily affecting birds, poses significant risks to pets, particularly those that may come into contact with infected avian species. Understanding the nature of this virus and its transmission is crucial for ensuring the safety and well-being of pets.

HPAI is highly contagious, spreading rapidly among birds and leading to severe illness or death. The virus is shed through the droppings and saliva of infected birds, making close contact with these animals or their waste a potential hazard for pets. While birds such as chickens and ducks are at the highest risk, other pets, including cats and dogs, are not entirely immune to the virus.

Chickens and ducks have the highest risk of contracting Highly Pathogenic Avian Influenza.

Photo: Erik Karits/Pixabay

One of the most effective ways to safeguard pets from HPAI is through diligent biosecurity measures. Pet owners should clean and disinfect areas where their pets spend time, particularly if they have access to outdoor spaces. Limiting contact with wild birds is essential, as these creatures can shed the virus through their droppings and saliva. Additionally, preventing pets from scavenging raw bird remains can further reduce the risk of exposure. By creating a controlled environment, pet owners can significantly diminish the chances of their animals contracting the virus.

Monitoring pets for any signs of illness is another critical step in protecting them from HPAI. Symptoms such as coughing, sneezing, lethargy, and difficulty breathing can indicate a potential infection. If a pet exhibits any of these signs, it is vital to consult a veterinarian promptly. Early diagnosis and treatment can make a significant difference in the outcome for affected animals. Pet owners should remain vigilant, especially during times when HPAI outbreaks are reported in their area.

“Unfortunately, all dead animal carcasses have the potential to transmit HPAI. Waterbirds are the most affected species and they have the potential to transmit the virus without showing clinical signs, but a huge variety of wild and domestic bird and mammal species have died from HPAI,” says Stephany Lewis, a professor of zoological medicine at the University of Illinois Urbana-Champaign and director of the University of Illinois Wildlife Medical Clinic. “It is recommended to always keep cats indoors. Cats, dogs and other pets that do spend some time outdoors should remain leashed and closely monitored to keep them away from wildlife and poultry.”

In the event of suspected exposure to HPAI, immediate action is necessary. Quarantining the affected pet can help prevent the virus from spreading to other animals or humans. Pet owners should also practice thorough hand hygiene after handling their pets to avoid any potential transmission. By staying informed and proactive, pet owners can play a crucial role in protecting their companions from the risks associated with Highly Pathogenic Avian Influenza, ensuring their health and happiness in an uncertain environment.


Infected pets may exhibit a range of symptoms, from flu-like signs to severe respiratory issues. Symptoms can include coughing, sneezing, lethargy, and difficulty breathing.

Lewis said pets may become infected with HPAI if they consume dead infected birds, eat raw meat from infected birds, or drink unpasteurized milk from infected cows. “Some raw pet foods have been linked to HPAI infection and deaths in house cats. Other routes of transmission, such as inhalation or ingestion of aerosolized secretions or feces from infected birds, are also possible but have not yet been confirmed,” she explained in an interview with the University of Illinois News Bureau. “In humans, most HPAI infections have occurred from unprotected direct contact with infected animals — usually poultry or cattle — or surfaces contaminated with feces or respiratory secretions from infected animals. The virus can enter through a person’s eyes, nose, mouth or via inhalation.”

She added that there have not been any reported infections from ingestion of properly cooked poultry or pasteurized milk but pointed out that improper handling of raw poultry products or ingestion of undercooked meat or unpasteurized milk could result in infection in humans as well as pets.

Infected pets may exhibit a range of symptoms, from flu-like signs to severe respiratory issues. Symptoms can include coughing, sneezing, lethargy, and difficulty breathing. In severe cases, HPAI can lead to death, underscoring the importance of vigilance among pet owners.

To mitigate the risks associated with HPAI, biosecurity measures are essential. This involves cleaning and disinfecting pet areas, limiting contact with wild birds, and preventing pets from consuming raw bird remains. Pet owners are advised to supervise any interactions between their pets and birds, ensuring that contact is brief and monitored.

There appears to be a range of susceptibility to this current strain of H5N1 among different species. Besides waterbirds, the next most frequently seen wild birds with HPAI-related morbidity and mortality are crows and raptors, but any bird can become sick with avian influenza.

Lewis said clinical signs in birds observed most frequently are cloudy eyes, a symptom of corneal edema, and neurologic signs like tremors, weakness, incoordination, inability to stand, and seizures. Other vague, non-specific signs of illness can occur, or the animal may die suddenly without observed clinical signs.


Veterinarians can provide expert guidance on treatment options and care for pets affected by HPAI. Their knowledge is invaluable in navigating the complexities of this viral threat.

The symptoms of avian influenza in any species can mimic those of many other diseases, so there’s no way to know for sure an animal has avian influenza without laboratory diagnostics. Wild carnivores, such as foxes, bobcats and other wild felines, skunks, fishers, mink and even marine mammals such as seals have all been documented to get sick and die from avian influenza.

If a pet shows signs of illness, it is crucial for owners to act swiftly. Early diagnosis and treatment can significantly improve outcomes for infected animals. Pet owners should consult their veterinarians immediately if they suspect their pet has contracted HPAI.

In the event of exposure to HPAI, pet owners should implement quarantine measures to prevent the potential spread of the virus. Isolating the affected pet and practicing thorough hand hygiene after handling them can help reduce the risk of transmission to other animals or humans.

Veterinarians can provide expert guidance on treatment options and care for pets affected by HPAI. Their knowledge is invaluable in navigating the complexities of this viral threat.

Animal doctors recommend staying informed and start implementing preventive measures to protect pets from the risks associated with HPAI. By following recommended guidelines above and remaining vigilant, pet owners can help ensure the health and well-being of their cherished companions. Proactive measures and prompt responses to potential threats can make a significant difference in safeguarding pets against this serious viral infection.


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Another pandemic? hMPV may be spreading in China, here’s why we don't need to worry about it



Five years after the first news of COVID, recent reports of an obscure respiratory virus in China may understandably raise concerns.

Chinese authorities first issued warnings about human metapneumovirus (hMPV) in 2023, but media reports indicate cases may be increasing again during China’s winter season.


Photo: Luisella Planeta/from Pixabay

For most people, hMPV will cause symptoms similar to a cold or the flu. In rare cases, hMPV can lead to severe infections. But it isn’t likely to cause the next pandemic.

What is hMPV?

hMPV was first discovered in 2001 by scientists from the Netherlands in a group of children where tests for other known respiratory viruses were negative.

But it was probably around long before that. Testing of samples from the 1950s demonstrated antibodies against this virus, suggesting infections have been common for at least several decades. Studies since have found hMPV in almost all regions in the world.

Australian data prior to the COVID pandemic found hMPV to be the third most common virus detected in adults and children with respiratory infections. In adults, the two most common were influenza and RSV (respiratory syncytial virus), while in children they were RSV and parainfluenza.

Like influenza, hMPV is a more significant illness for younger and older people.

Studies suggest most children are exposed early in life, with the majority of children by age five having antibodies indicating prior infection. In general, this reduces the severity of subsequent infections for older children and adults.

In young children, hMPV most commonly causes infections of the upper respiratory tract, with symptoms including runny nose, sore throat, fever as well as ear infections. These symptoms usually resolve over a few days to a week in children, and 1–2 weeks in adults.

Although most infections with hMPV are relatively mild, it can cause more severe disease in people with underlying medical conditions, such as heart disease. Complications can include pneumonia, with shortness of breath, fever and wheezing. hMPV can also worsen pre-existing lung diseases such as asthma or emphysema. Additionally, infection can be serious in people with weakened immune systems, particularly those who have had bone marrow or lung transplants.

But the generally mild nature of the illness, the widespread detection of antibodies reflecting broad population exposure and immunity, combined with a lack of any known major pandemics in the past due to hMPV, suggests there’s no cause for alarm.

Are there any vaccines or treatments?

It is presumed that hMPV is transmitted by contact with respiratory secretions, either through the air or on contaminated surfaces. Therefore, personal hygiene measures and avoiding close contact with other people while unwell should reduce the risk of transmission.

The virus is a distant cousin of RSV for which immunisation products have recently become available, including vaccines and monoclonal antibodies. This has led to the hope that similar products may be developed for hMPV, and Moderna has recently started trials into a mRNA hMPV vaccine.

There are no treatments that have been clearly demonstrated to be effective. But for severely unwell patients certain antivirals may offer some benefit.

Why are we hearing so many reports of respiratory viruses now?

Since the COVID pandemic, the pattern of many respiratory infections has changed. For example, in Australia, influenza seasons have started earlier (peaking in June–July rather than August–September).

Many countries, including Australia, are reporting an increased number of cases of whooping cough (pertussis).

In China, there have been reports of increased cases of mycoplasma, a bacterial cause of pneumonia, as well as influenza and hMPV.

There are many factors that may have impacted the epidemiology of respiratory pathogens. These include the interruption to respiratory virus transmission due to public health measures taken during the COVID pandemic, environmental factors such as climate change, and for some diseases, post-pandemic changes in vaccine coverage. It may also be the usual variation we see with respiratory infections – for example, pertussis outbreaks are known to occur every 3–4 years.

For hMPV in Australia, we don’t yet have stable surveillance systems to form a good picture of what a “usual” hMPV season looks like. So with international reports of outbreaks, it will be important to monitor the available data for hMPV and other respiratory viruses to inform local public health policy.

The Conversation

Allen Cheng, Professor of Infectious Diseases, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.


Few states are tracking dairy farmer worker health protections amid current Bird Flu outbreak

Records from 15 states with confirmed cases of bird flu in dairy cattle in the USA. Nearly 700 dairy cattle have been found infected.
Photo: Kylee Alons/Unsplash

by John McCracken
Investigate Midwest

In May, the Centers for Disease Control recommended that state public health departments, veterinarians and epidemiologists provide personal protective equipment, or PPE, for workers in direct contact with animals and their fluids, such as raw milk, that could be exposed to bird flu.

As of early December, almost 60 people have been infected with the virus, with the majority of cases stemming from human contact with dairy cattle. Nearly 700 dairy cattle herds have been infected.

The most effective way to protect workers is with face shields, latex gloves and respirators, the CDC advised.

However, records from 15 states with confirmed cases of bird flu in dairy cattle reveal inconsistent responses by agencies when it comes to providing farmworkers with personal protective equipment. Most state health agencies, which are often responsible for the human impacts of communicable diseases, have left PPE distribution to local county health officials.

The documents, which Investigate Midwest obtained through multiple public records requests, found:

  • At least a third of state health departments in states with confirmed dairy cattle outbreaks do not track the distribution of PPE.
  • Ohio, Wyoming and New Mexico, which have had active bird flu cases in dairy cattle, have either not tracked requests for farmworker PPE or are currently not accepting requests.
  • Only one dairy farm in Wisconsin, a major dairy state that has not had a confirmed cattle outbreak, has requested PPE from the state’s health department.
  • Minnesota has had few cases of bird flu in dairy cattle, but more than 200 agriculture businesses have received PPE from the state.
  • Michigan and North Carolina, which are also major dairy-producing states, have provided PPE to less than a dozen farms.

“It looks like a failure in how we’re communicating on the public health side to producers,” said Bethany Alcauter, director of research and public health for the National Center for Farmworker Health, a Texas-based nonprofit that provides resources and training to farmworkers and advocacy groups across the country.

Alcauter said farm operators and processors don’t have the same knowledge and outlook as public health officials because sick workers and animals are often part of the job.

“It’s not to say that they’re not getting sick, but because it’s maybe not that different from what they experience normally, it’s not going to change their perception of the risk just because it’s a different pathogen,” she said.


How dairy-producing states differ in providing PPE to workers during bird flu outbreaks

When dairy workers are milking cows, raw milk can come into contact with their hands, faces and bodies, increasing the risk of infection. The CDC advises that dairy workers wear PPE, including gloves, rubber overalls and face shields, to minimize the spread of the virus.

The Occupational Safety and Health Administration, OSHA, states that employers of workplaces where exposure to bird flu viruses could occur are responsible for providing PPE to workers and keeping records on infected animals and employees.

However, OSHA cannot enforce its standards on farms with less than 11 employees, an exemption that has harmed dairy workers in the past when dairy worker deaths and injuries went unreported. This makes the enforcement and responsibility of safety measures hard to pin down, Alcauter said.

“Workers are on their own in terms of actually enforcing anything,” she said.

Michigan and Colorado Workers Aren’t Using or Getting PPE

In a recent CDC study, the agency said that the prevention of human infections is critical to mitigating changes in the bird flu virus that could lead to a pandemic.

Employers can best reduce the risk of infection by providing and educating workers on the use of PPE, as well as monitoring and testing animals and workers for the virus, the study said.

While PPE is a needed tool to prevent the spread, the practical application can be hard for workers who are working long hours and completing repetitive motion tasks in tight corners and hot environments.

Every worker who contracted the virus has been tasked with cleaning and working in milking parlors, according to the study.

After surveying the predominantly Spanish-speaking workers at Michigan and Colorado dairies, the agency found that none of the workers who were infected with the virus reported using PPE. In fact, the use of PPE was low among all workers.

“This investigation identified low PPE adherence among dairy workers, which has been an ongoing challenge in hot, tight spaces where visibility around large animals is important and the use of eye protection can be challenging,” the study states.

Records obtained by Investigate Midwest show inconsistent PPE distribution processes in both Michigan and Colorado, where dairy industries have been wrestling with the virus since early this year.

From January 2023 to late September 2024, records show only 11 dairy farms requested PPE for farmworkers in Michigan. Only 16 other operations requested PPE from the state during this time.

Farms that have requested PPE from the state have had an average of nine farmworkers per dairy farm, according to the self-reported request forms, which Investigate Midwest received through its records requests.

Conversely, the handful of poultry farms that have requested PPE have an average of 60 farmworkers per operation.

In Colorado, 40 dairy farms have requested PPE from the state agency between the beginning of 2023 and September 2024, according to documents and interviews with the agency.

Most requests came over the summer when Colorado started seeing repeated outbreaks of bird flu at dairy operations. As of early December, the state has had 64 confirmed cases in dairy herds.

The average number of dairy farmworkers operating on Colorado dairy farms that have requested PPE was roughly 40 people per farm.

“Some farms also reported that they had already purchased PPE and therefore didn’t need to make a request,” David Ellenberger, a spokesperson for the Colorado Department of Public Health and Environment, CDPHE, wrote in an email to Investigate Midwest.

“Additionally, CDPHE has sent bulk orders of PPE to an agricultural workers outreach group, who has relationships with individual workers, and was able to further distribute PPE on an individual level,” Ellenberger added.

Texas, California Take Different Approaches

Earlier this year, Texas was the first state in the country to have a confirmed case of bird flu in dairy cattle and, soon after, became the second site of mammal-to-human transmission of the virus in the country.

Since then, Texas has had nearly 30 cases of bird flu in cattle.

The state’s department of health has eight regional offices and it instructs farmers to contact their local office to request PPE.

“Each region fills them as they come in,” Texas spokesperson Douglas Loveday told Investigate Midwest.

In California, which now leads the country in the number of confirmed dairy cattle cases, the health and agriculture departments do not track or manage the distribution of PPE to farms and affected facilities. This task is left to the state’s 58 local health agencies.

In an email, a California Department of Public Health spokesperson said the state supported a one-time distribution of PPE to dairy farms earlier this year. When local requests can’t be fulfilled, the state agency fulfills the request.

As of early December, the agency has fulfilled or is currently fulfilling 43 PPE requests from dairy farms, six from poultry farms and 11 from farmworker organizations.

A similar system is used in Iowa and Idaho, which have also had numerous cases of bird flu in dairy cattle.

Ken Gordon, Ohio Department of Health spokesperson, told Investigate Midwest that when bird flu was detected in northwest Ohio earlier this year, the state made PPE available as the USDA investigated the outbreak. The state received two requests for PPE from agricultural operations during that time.

Now that the farm is no longer being investigated, the state is no longer offering PPE to farmworkers upon request.

“The state-level Ohio Department of Health made PPE available, via the survey, to farms and agricultural businesses on a temporary basis as the situation was new and evolving,” Gordon said.

Other states have received few requests or do not track disbursements:

  • As of early December, only one Oklahoma farm had requested PPE from the state’s health department to manage bird flu. The state agency used to have a formal request process for PPE, but it has since closed. “The purpose of this program was to support farms as part of the immediate response until these farms were able to ascertain PPE on their own,” an Oklahoma State Department of Health spokesperson wrote in an email to Investigate Midwest. 
  • Idaho Department of Public Health spokesperson AJ McWhorter said the agency worked with the industry group Idaho Dairymen’s Association and local public health districts to identify dairy worker needs for equipment and filled a one-time request for PPE for dairy workers in June.
  • An Iowa health department spokesperson told Investigate Midwest they direct people to local agencies or to the U.S. Department of Agriculture. 
  • In Wyoming, a state with one confirmed affected dairy herd, the health department said it did not track PPE requests or make a request form available to producers. Wyoming Department of Health spokesperson Kim Deti said the state’s poultry and dairy industries are small and PPE requests have been taken on a case-by-case basis.
Few Farms in North Carolina, New Mexico and Wisconsin Request PPE

North Carolina has one confirmed case of dairy cattle infected with bird flu. The state has also seen numerous cases of infected poultry, which is a major industry in the state.

One farm and four farmworkers requested PPE from the state during the ongoing outbreak. The majority of the state’s requests for PPE have come from farmworker organizations and advocacy groups.

The Association of Mexicans in North Carolina requested 2,000 face shields for dairy workers, stating that the association will make PPE available through health fairs aimed at farmworkers and contractors and their families held across the state.

In New Mexico, a state with nine confirmed outbreaks in dairy cattle, only two farms have requested PPE, according to state health department spokesperson David Morgan.

Some major agricultural states are preparing for outbreaks, even if a confirmed case hasn’t been reported.

When dairy workers are milking cows, raw milk can come into contact with their hands, faces and bodies, increasing the risk of infection. The CDC advises that dairy workers wear PPE, including gloves, rubber overalls and face shields, to minimize the spread of the virus. graphic provided by the CDC

In Wisconsin, a major dairy-producing state, the state health agency has received 11 requests for PPE from the beginning of 2023 to September of this year. The state has yet to have a confirmed case of bird flu in dairy cattle or humans.

Only one Wisconsin dairy farm and one egg production company have requested protective equipment for employees.

Most of the state’s requests have come from cheese or dairy product manufacturers in the state, as well as veterinary offices.

In addition to workers on farms with dairy cattle, employees who work in dairy processing plants are at risk of exposure to the virus. The CDC states that employees on dairy and poultry farms, dairy processing plants and poultry slaughter plants, should receive PPE to prevent the spread.  The virus is destroyed when raw milk is pasteurized at a processing plant.

A spokesperson for Dairy Farmers of America, the country’s largest milk co-op and owner of nearly 50 dairy processing plants nationwide, told Investigate Midwest that the company has a safety protocol to provide PPE for workers at their plants.

DFA was not listed as a PPE recipient in the state of Wisconsin, where the company has three plants.

“PPE is (and was) standard protocol at our plants, prior to the bird flu, as many of our employees work around cleaning chemicals, “ a DFA spokesperson told Investigate Midwest in an email. “To date, we’ve had no requests for extra PPE.”

Wisconsin Department of Health Services spokesperson Elizabeth Goodsitt, said the agency has worked alongside the state’s agriculture department to provide updates about bird flu to producers, including information on how producers and industry groups can receive PPE.

“We know from our experience across public health that getting resources to agencies, organizations, and individuals who are most trusted by specific populations is the best way to share important information,” she said.

“Producers should continue to enhance their biosecurity efforts and monitor and control disease in their herds and flocks,” she said in an email to Investigate Midwest.

Minnesota Stands from the Rest

Minnesota’s Department of Public Health has fulfilled more than 200 requests for PPE since May despite the state having far fewer confirmed outbreaks in dairy cattle compared to its peers.

As of December, Minnesota has had 9 outbreaks in dairy cattle herds.

The majority of the state’s requests came from dairy producers, with 138 farms requesting. Twenty poultry farms requested PPE and nearly a dozen processing facilities, either dairy or poultry, requested equipment.


This story was originally published on Investigate Midwest. This article originally appeared in Sentient at https://sentientmedia.org/ppe-dairy-farm-workers-bird-flu/.

Investigate Midwest is an independent, nonprofit newsroom. Our mission is to serve the public interest by exposing dangerous and costly practices of influential agricultural corporations and institutions through in-depth and data-driven investigative journalism. Visit us online at www.investigatemidwest.org

Hospital recommends virtual visits due current Covid spike and rise of RSV

by Matt Sheehan
OSF Healthcare

As many viruses continue to make the rounds in our communities, it is paramount to monitor your symptoms and know when the right time is to seek medical care in person.

PEORIA - OSF HealthCare hospitals, clinics, and emergency departments across the state continue to see a big influx of people seeking care. The increase in patients in waiting rooms can lead to elevated exposure of germs and viruses, plus longer wait times.

As many viruses continue to make the rounds in our communities, it is paramount to monitor your symptoms and know when the right time is to seek medical care in person. Sarah Overton, the Chief Nursing Officer for OSF Medical Group, Home Care and Employee Health, stresses the importance of virtual care when your symptoms are mild.

“That way we’re not exposing you to anyone in the public and you’re not exposing the health care worker to illness,” Overton says. “Unfortunately, we are seeing an increase in health care worker illness where our nurses and doctors have to stay home because they are being exposed to illness.”

Photo: Andrea Piacquadio/Pexels

Hospitals across the state and in the OSF Ministry network have been seeing a spike in COVID-19 patients. If you suspect you have COVID-19 but your symptoms are mild, take an at-home COVID-19 test.

The federal government has another stockpile of at-home tests that are free to order on COVID.gov. Every household can receive four free rapid tests. Dr. Brian Curtis, Vice President of Clinical Specialty Services with OSF HealthCare, says taking tests at home will help free up space at medical facilities.

“Coming in just to get tested takes up spots for the people that are really sick or are high-risk,” Dr. Curtis says.

“The Emergency Room is reserved for those true emergencies,” Overton adds. “We have patients that have heart attacks and lung issues with their COPD. Additional patients overflowing the Emergency Room takes away precious time from assessing those patients who shouldn’t be exposed to those viruses while being in our waiting rooms.”

But COVID-19 isn’t the only virus making the rounds in our communities right now. Influenza, Respiratory Syncytial Virus (RSV) and others are being seen often as well. So how can we stop the spread of viruses?

· Stay home when you aren’t feeling well.

· Wash your hands and use hand sanitizer regularly.

· Cough or sneeze into your elbow.

· Wipe down high-touch surfaces with disinfectant wipes.

· Don’t share glasses or silverware with others.

· Receive the flu shot.

For treating mild symptoms at home, Dr. Curtis offers some guidance for using over-the-counter options.

“You can take Tylenol or Motrin for fevers and aches. Make sure to drink plenty of fluids and get plenty of rest,” Dr. Curtis says.

Overton says to make sure you read the labels on any over-the-counter medication you buy. If you have any questions, you can ask a retail pharmacist, or send a message through MyChart to your OSF care team.

When is the right time to be seen?

“If you have a super deep cough that’s hanging on for quite a while or have a fever that lasts for several days,” Overton says. “Or if you have high-risk factors and may benefit from some of our medications for COVID, like Paxlovid, which are readily available in our retail pharmacy locations. We also have COVID-19 boosters able to be administered in our primary care offices.”

“There is a medication for influenza, but if you have a mild case, you’ll have more side effects from the medication than you are having from influenza itself. As far as RSV goes, there’s really no treatment for it except for supportive care.”

If you are sick and plan to visit a medical facility, please cover your face with a mask to decrease exposure to the health care workers.

Colds and viruses tend to last one to two weeks. If your symptoms are more serious or linger on much longer than that, reach out to your primary care team and schedule an appointment. You can also consider an in-person or virtual visit to OSF OnCall Urgent Care. A virtual visit is available 24/7.

Heart attack risks increase as people with HIV and hepatitis C age, according to recent study

by American Heart Association
DALLAS -- As people with HIV age, their risk of heart attack increases far more if they also have untreated hepatitis C virus, even if their HIV is treated, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

Since the introduction of antiretroviral therapies to treat HIV in the late 1990s, the lifespan of people with HIV has increased dramatically. However, even with treatment, studies have found the heart disease risk among people with HIV is at least 50% higher than people without HIV. This new study evaluated if people with HIV who also have hepatitis C – a viral liver infection – have a higher risk of heart attack.

"HIV and hepatitis C coinfection occurs because they share a transmission route - both viruses may be transmitted through blood-to-blood contact," said Keri N. Althoff, Ph.D., M.P.H., senior author of the study and an associate professor in the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore. "Due in part to the inflammation from the chronic immune activation of two viral infections, we hypothesized that people with HIV and hepatitis C would have a higher risk of heart attack as they aged compared to those with HIV alone."

Researchers analyzed health information for 23,361 people with HIV (17% female, 49% non-Hispanic white) in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) between 2000 and 2017 and who had initiated antiretroviral treatment for HIV. All were between 40 to 79 years of age when they enrolled in the NA-ACCORD study (median age of 45 years). One in 5 study participants (4,677) were also positive for hepatitis C. During a median follow-up of about 4 years, the researchers compared the occurrence of a heart attack between the HIV-only and the HIV-hepatitis C co-infected groups as a whole, and by each decade of age.

The analysis found:

  • With each decade of increasing age, heart attacks increased 30% in people with HIV alone and 85% in those who were also positive for hepatitis C.
  • The risk of heart attack increased in participants who also had traditional heart disease risk factors such as high blood pressure (more than 3 times), smoking (90%) and Type 2 diabetes (46%).
  • The risk of heart attack was also higher (40%) in participants with certain HIV-related factors such as low levels of CD4 immune cells (200cells/mm3, signaling greater immune dysfunction) and 45% in those who took protease inhibitors (one type of antiretroviral therapy linked to metabolic conditions).
  • "People who are living with HIV or hepatitis C should ask their doctor about treatment options for the viruses and other ways to reduce their cardiovascular disease risk," said lead study author Raynell Lang, M.D., M.Sc., an assistant professor in the department of medicine and community health sciences at the University of Calgary in Alberta, Canada.

    "Several mechanisms may be involved in the increased heart attack risk among co-infected patients. One contributing factor may be the inflammation associated with having two chronic viral infections," Lang said. "There also may be differences in risk factors for cardiovascular disease and non-medical factors that influence health among people with HIV and hepatitis C that plays a role in the increased risk."

    According to a June 2019 American Heart Association scientific statement, Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV, approximately 75% of people living with HIV are over the age of 45. "Even with effective HIV viral suppression, inflammation and immune dysregulation appear to increase the risk for heart attack, stroke and heart failure." The statement called for more research on cardiovascular disease prevention, causes and treatment in people with HIV.

    "Our findings suggest that HIV and hepatitis C co-infections need more research, which may inform future treatment guidelines and standards of care," Althoff said.

    The study is limited by not having information on additional factors associated with heart attack risk such as diet, exercise or family history of chronic health conditions. Results from this study of people with HIV receiving care in North America may not be generalizable to people with HIV elsewhere. In addition, the study period included time prior to the availability of more advanced hepatitis C treatments.

    "Because effective and well-tolerated hepatitis C therapy was not available during several years of our study period, we were unable to evaluate the association of treated hepatitis C infection on cardiovascular risk among people with HIV. This will be an important question to answer in future studies," Lang said.

    As Covid cases surge across the country, CDC only tracks a fraction of breakthrough cases


    Jenny Deam and Jodi S. Cohen, ProPublica


    Meggan Ingram was fully vaccinated when she tested positive for COVID-19 early this month. The 37-year-old’s fever had spiked to 103 and her breath was coming in ragged bursts when an ambulance rushed her to an emergency room in Pasco, Washington, on Aug. 10. For three hours she was given oxygen and intravenous steroids, but she was ultimately sent home without being admitted.

    Seven people in her house have now tested positive. Five were fully vaccinated and two of the children are too young to get a vaccine.

    As the pandemic enters a critical new phase, public health authorities continue to lack data on crucial questions, just as they did when COVID-19 first tore through the United States in the spring of 2020. Today there remains no full understanding on how the aggressively contagious delta variant spreads among the nearly 200 million partially or fully vaccinated Americans like Ingram, or on how many are getting sick.

    The nation is flying blind yet again, critics say, because on May 1 of this year — as the new variant found a foothold in the U.S. — the Centers for Disease Control and Prevention mostly stopped tracking COVID-19 in vaccinated people, also known as breakthrough cases, unless the illness was severe enough to cause hospitalization or death.

    Individual states now set their own criteria for collecting data on breakthrough cases, resulting in a muddled grasp of COVID-19’s impact, leaving experts in the dark as to the true number of infections among the vaccinated, whether or not vaccinated people can develop long-haul illness, and the risks to unvaccinated children as they return to school.



    If you’re limiting yourself to a small subpopulation with only hospitalizations and deaths, you risk a biased viewpoint.


    "It’s like saying we don’t count,” said Ingram after learning of the CDC’s policy change. COVID-19 roared through her household, yet it is unlikely any of those cases will show up in federal data because no one died or was admitted to a hospital.

    The CDC told ProPublica in an email that it continues to study breakthrough cases, just in a different way. "This shift will help maximize the quality of the data collected on cases of greatest clinical and public health importance,” the email said.

    In addition to the hospitalization and death information, the CDC is working with Emerging Infections Program sites in 10 states to study breakthrough cases, including some mild and asymptomatic ones, the agency’s email said.

    Under pressure from some health experts, the CDC announced Wednesday that it will create a new outbreak analysis and forecast center, tapping experts in the private sector and public health to guide it to better predict how diseases spread and to act quickly during an outbreak.

    Tracking only some data and not releasing it sooner or more fully, critics say, leaves a gaping hole in the nation’s understanding of the disease at a time when it most needs information.

    "They are missing a large portion of the infected," said Dr. Randall Olsen, medical director of molecular diagnostics at Houston Methodist Hospital in Texas. "If you’re limiting yourself to a small subpopulation with only hospitalizations and deaths, you risk a biased viewpoint."

    On Wednesday, the CDC released a trio of reports that found that while the vaccine remained effective at keeping vaccinated people out of the hospital, the overall protection appears to be waning over time, especially against the delta variant.

    Among nursing home residents, one of the studies showed vaccine effectiveness dropped from 74.7% in the spring to just 53.1% by midsummer. Similarly, another report found that the overall effectiveness among vaccinated New York adults dropped from 91.7% to just under 80% between May and July.

    The new findings prompted the Biden administration to announce on Wednesday that people who got a Moderna or Pfizer vaccine will be offered a booster shot eight months after their second dose. The program is scheduled to begin the week of Sept. 20 but needs approval from the Food and Drug Administration and a CDC advisory committee.



    No vaccine is 100% percent effective against transmission, health officials warned.


    This latest development is seen by some as another example of shifting public health messaging and backpedaling that has accompanied every phase of the pandemic for 19 months through two administrations. A little more than a month ago, the CDC and the FDA released a joint statement saying that those who have been fully vaccinated "do not need a booster shot at this time.”

    The vaccine rollout late last year came with cautious optimism. No vaccine is 100% percent effective against transmission, health officials warned, but the three authorized vaccines proved exceedingly effective against the original COVID-19 strain. The CDC reported a breakthrough infection rate of 0.01% for the months between January and the end of April, although it acknowledged it could be an undercount.

    As summer neared, the White House signaled it was time for the vaccinated to celebrate and resume their pre-pandemic lives.

    Trouble, though, was looming. Outbreaks of a new, highly contagious variant swept India in the spring and soon began to appear in other nations. It was only a matter of time before it struck here, too.

    "The world changed," said Dr. Eric Topol, director of the Scripps Research Translational Institute, "when delta invaded."

    The current crush of U.S. cases — well over 100,000 per day — has hit the unvaccinated by far the hardest, leaving them at greater risk of serious illness or death. The delta variant is considered at least two or three times more infectious than the original strain of the coronavirus. For months much of the focus by health officials and the White House has been on convincing the resistant to get vaccinated, an effort that has so far produced mixed results.

    Yet as spring turned to summer, scattered reports surfaced of clusters of vaccinated people testing positive for the coronavirus. In May, eight vaccinated members of the New York Yankees tested positive. In June, 11 employees of a Las Vegas hospital became infected, eight of whom were fully vaccinated. And then 469 people who visited the Provincetown, Massachusetts, area between July 3 and July 17 became infected even though 74% of them were fully vaccinated, according to the CDC’s Morbidity and Mortality Weekly Report.

    While the vast majority of those cases were relatively mild, the Massachusetts outbreak contributed to the CDC reversing itself on July 27 and recommending that even vaccinated people wear masks indoors — 11 weeks after it had told them they could jettison the protection.

    And as the new CDC data showed, vaccines continue to effectively shield vaccinated people against the worst outcomes. But those who get the virus are, in fact, often miserably sick and may chafe at the notion that their cases are not being fully counted.

    "The vaccinated are not as protected as they think," said Topol, "They are still in jeopardy."

    The CDC tracked all breakthrough cases until the end of April, then abruptly stopped without making a formal announcement. A reference to the policy switch appeared on the agency’s website in May about halfway down the homepage.

    "I was shocked," said Dr. Leana Wen, a physician and visiting professor of health policy and management at George Washington University. "I have yet to hear a coherent explanation of why they stopped tracking this information.”

    The CDC said in an emailed statement to ProPublica that it decided to focus on the most serious cases because officials believed more targeted data collection would better inform "response research, decisions, and policy."

    Sen. Edward MMarkey, D-Mass., became alarmed after the Provincetown outbreak and wrote to CDC director Dr. Rochelle Walensky on July 22, questioning the decision to limit investigation of breakthrough cases. He asked what type of data was being compiled and how it would be shared publicly.

    It is unclear how often breakthroughs occur or how widely cases are spreading among the vaccinated.

    "The American public must be informed of the continued risk posed by COVID-19 and variants, and public health and medical officials, as well as health care providers, must have robust data and information to guide their decisions on public health measures," the letter said.

    Markey asked the agency to respond by Aug. 12. So far the senator has received no reply, and the CDC did not answer ProPublica’s question about it.

    When the CDC halted its tracking of all but the most severe cases, local and state health departments were left to make up their own rules.

    There is now little consistency from state to state or even county to county on what information is gathered about breakthrough cases, how often it is publicly shared, or if it is shared at all.

    "We’ve had a patchwork of information between states since the beginning of the pandemic,” said Jen Kates, senior vice president and director of global health and HIV policy at Kaiser Family Foundation.

    She is co-author of a July 30 study that found breakthrough cases across the U.S. remained rare, especially those leading to hospitalization or death. However, the study acknowledged that information was limited because state reporting was spotty. Only half the states provide some data on COVID-19 illnesses in vaccinated people.

    "There is no single, public repository for data by state or data on breakthrough infections, since the CDC stopped monitoring them,” the report said.

    In Texas, where COVID-19 cases are skyrocketing, a state Health and Human Services Commission spokesperson told ProPublica in an email the state agency was "collecting COVID-19 vaccine breakthrough cases of heightened public health interest that result in hospitalization or fatality only."

    Other breakthrough case information is not tracked by the state, so it is unclear how often breakthroughs occur or how widely cases are spreading among the vaccinated. And while Texas reports breakthrough deaths and hospitalizations to the CDC, the information is not included on the state’s public dashboard.

    "We will be making some additions to what we are posting, and these data could be included in the future," the spokesperson said.

    I thought, ‘COVID is over and I’m going to Disney World,’

    South Carolina, on the other hand, makes public its breakthrough numbers on hospitalizations and deaths. Milder breakthrough cases may be included in the state’s overall COVID-19 numbers but they are not labeled as such, said Jane Kelly, an epidemiologist at the South Carolina Department of Health and Environmental Control.

    "We agree with the CDC,” she said, "there’s no need to spend public health resources investigating every asymptomatic or mild infection.”

    In Utah, state health officials take a different view. "From the beginning of the pandemic we have been committed to being transparent with our data reporting and … the decision to include breakthrough case data on our website is consistent with that approach," said Tom Hudachko, director of communications for the Utah Department of Health.

    Some county-level officials said they track as many breakthrough cases as possible even if their state and the CDC does not.

    For instance, in Clark County, Nevada, home of Las Vegas, the public health website reported that as of last week there were 225 hospitalized breakthrough cases but 4,377 vaccinated people overall who have tested positive for the coronavirus.

    That means that less than 5% of reported breakthrough cases resulted in hospitalization. "The Southern Nevada Health District tracks the total number of fully vaccinated individuals who test positive for COVID-19 and it is a method to provide a fuller picture of what is occurring in our community,” said Stephanie Bethel, a spokesperson for the health district in an email.

    Sara Schmidt, a 44-year-old elementary school teacher in Alton, Illinois, is another person who has likely fallen through the data hole.

    "I thought, ‘COVID is over and I’m going to Disney World,’" she said. She planned a five-day trip for the end of July with her parents. Not only had she been fully vaccinated, receiving her second shot in March, she is also sure she had COVID-19 in the summer of 2020. Back then she had all the symptoms but had a hard time getting tested. When she finally did, the result came back negative, but her doctor told her to assume it was inaccurate.

    "My guard was down," she said. She was less vigilant about wearing a mask in the Florida summer heat, assuming she was protected by the vaccination and her presumed earlier infection.

    On the July 29 plane trip home, she felt mildly sick. Within days she was "absolutely miserable." Her coughing continued to worsen, and each time she coughed her head pounded. On Aug. 1 she tested positive. Her parents were negative.

    Now, three weeks later, she is far from fully recovered and classes are about to begin at her school. There’s a school mask mandate, but her students are too young to be vaccinated. "I’m worried I will give it to them, or I will get it for a third time," she said.

    But it is doubtful her case will be tracked because she was never hospitalized. That infuriates her, she said, because it downplays what is happening.

    "Everyone has a right to know how many breakthrough cases there are," she said, "I was under the impression that if I did get a breakthrough case, it would just be sniffles. They make it sound like everything is under control and it’s not."

    This story was originally published by ProPublica on August 20, 2021. ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.


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