Survey: States and territories capable of testing for highly pathogenic H5N1

Today JAMA published a research letter noting that public health authorities in almost all states and territories surveyed (50 out of 55) said they had the capacity to monitor and test people exposed to highly pathogenic avian influenza A (HPAI) H5N1.

However, jurisdictions varied in their ability to monitor exposed individuals, in their recommendations for when to use antivirals, and in their potential use of H5N1 vaccines, if available, among first responders.

Also today, the Kaiser Family Foundation (KFF) published a new report on the current demographics of farm employees, and found that a significant number are uninsured and live in low-income households.

H5N1 was first identified in wild birds in North America in late 2021 and has since been detected in wild birds in 49 states, in mammals in 27 states, and in livestock in a small number of states. It has caused outbreaks in commercial poultry or backyard bird flocks in 48 states, the authors said.

In recent weeks, detections in dairy cattle and a farm worker in Texas have raised alarm bells for public health officials across the country. In it JAMA In the survey, respondents answered an online preparedness questionnaire distributed from January 10 to March 6, 2024, before H5N1 was identified in livestock.

A third of jurisdictions would offer post-exposure antivirals

As of January 2022, people exposed to animals infected with the A(H5N1) virus and monitored for symptoms were reported in 50 (91%) jurisdictions. said the authors of the JAMA study. Human exposure occurred 88% of the time due to backyard flocks, commercial poultry (82%), wild birds (54%), and sick or dead mammals (18%).

Among the 49 jurisdictions with capacity to test for the H5 virus, 29 (59%) reported testing respiratory samples from symptomatic people since January 2022. But in 66% of jurisdictions, public health authorities reported difficulties in monitor people exposed to H5N1 due to staff shortages or lack of funds.

One-third of jurisdictions said they would recommend post-exposure antiviral prevention for close contacts of anyone with laboratory-confirmed H5N1, and 67% said they would offer a vaccine to veterinary staff caring for infected animals if it were available.

“The reported challenges in monitoring exposed persons and differences in antiviral recommendations highlight the need to strengthen and standardize public health preparedness and response to HPAI A(H5N1) viruses in the US, particularly if they occur. Additional events of transmission of the A(H5N1) virus from animals to humans are reported,” the researchers concluded.

20% of agricultural workers are uninsured

To assess the potential risk to dairy farm workers, KFF reported the demographic characteristics, income, and health coverage of animal production and aquaculture workers in the United States using data from the 2022 American Community Survey. .

KFF found that 22% of workers were Hispanic and 13% were noncitizen immigrants. An average of 20% had no health insurance and 18% had household incomes less than $40,000 a year. Overall, 16% had limited English language skills.

In most affected states for which sufficient data are available, uninsured rates are higher among animal production workers than among general workers in a statistically significant manner.

In most affected states for which sufficient data are available, uninsured rates are higher among animal production workers than among general workers in a statistically significant manner. the authors said. For example, in Texas, 31% of animal production workers are uninsured, compared to 19% of workers overall, and in Ohio, 29% of animal production workers are uninsured, compared with 7% of Ohio workers.