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H5N1 avian influenza, commonly known as the "Bird Flu," has been in the news since a Louisiana man died of the disease on January 6, 2025. This was the first recorded bird flu fatality in the U.S. You may have heard that bird flu could cause the next human pandemic. So just how scary is it, and should you be doing anything to protect yourself?
First, let's go over the basic facts. Bird flu is a subtype of influenza A that naturally infects both wild and domestic birds. Influenza A has been detected in domestic poultry since 1955, and has likely circulated in wild birds for much longer. The current subtype of highly-pathogenic (disease causing) avian H5N1 was first described in 1997 after 18 humans were infected in Hong Kong. The vast majority of human infections have occurred in people who were directly exposed to sick animals. Human-to-human transmission of bird flu is incredibly rare, and there have been no reported cases since 2007.
That said, flu viruses are always mutating, and an old virus can learn new tricks. H5N1 did exactly this in March 2024 when it was discovered in dairy cows in Texas. Since then hundreds of dairy herds have tested positive for the virus. H5N1 is shed in the milk of affected cows, and is easily transmitted by the milking equipment on dairy farms.
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Cattle aren't the only animals susceptible to avian H5N1 infection. The H5N1 virus has been detected in both domestic and wild animals. These include hawks, falcons, owls, crows, geese, swans, ducks, teal, cats, dogs, foxes, bears, seals, sea lions, and goats. But so far, every known human outbreak of avian H5N1 has been traced to domesticated poultry or dairy cattle, so it is extremely unlikely you'd get it from a wild animal or a pet.
How big of a problem is the 2024-2025 H5N1 outbreak? Between March 2024 and January 13, 2025, there have been 66 human cases and 1 death in the U.S., spread out among 10 states. That is an incredibly tiny number compared to the estimated 9-16 million cases of flu in the 2024-25 season. Thus far, the only effect most people have noticed from bird flu has been on our pocketbooks. More than 20 million egg-laying hens have died or been culled due to bird flu, leading to high egg prices across the U.S.
However, it's always possible that an influenza subtype that can be passed from animals to humans could gain the ability to transmit efficiently between humans. The last time this happened was the 2009-10 H1N1 swine flu pandemic, which caused millions of infections worldwide, but had a very low rate of severe or fatal illness. It's impossible to predict if or when such a mutation will happen, and whether it will cause more severe or less severe disease. What we do know is that avian H5N1 has infected wild animals around the globe for many decades without causing a human pandemic. Thus, the risk of causing a pandemic in any given year is low.
Is there anything you should do to protect yourself from bird flu? Since the current subtype of H5N1 does not have human-to-human transmission, those of us without animal contacts are completely safe from the virus. Even if you do work with animals, current CDC guidelines do not recommend any special protective equipment unless you have known bird flu infections in your region. All animal workers should monitor animals and humans alike for signs of illness.
In theory, domestic cats could be a source of bird flu exposure at home. Bird flu infections have shown cat-to-cat transmission with a high cat fatality rate. There are no known cases of cat-to-human transmission. You can decrease your cats' risk of H5N1 by keeping them indoors so they don't eat wild birds, and by not feeding your cat raw meat or raw milk.
What about therapeutics? Since avian H5N1 is a subtype of influenza A, many of the drugs that work against everyday human flu should work against bird flu. Oseltamivir (Tamiflu) is the most commonly used antiviral in the U.S. and appears to have good results in a lab setting against H5N1. In addition, H5N1 vaccines can be produced using techniques similar to regular seasonal flu vaccines. The U.S. vaccine stockpile already includes poultry vaccines and human vaccines against H5N1. Therefore, even if avian H5N1 were to spread more widely, we would have tools available to fight the pandemic.
In summary, the H5N1 bird flu is not new. It has never demonstrated any signs of being highly pathogenic in humans. And even the bird flu it did become a human pandemic, there are drugs and vaccines available to combat it.
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