Preprint: Why Americans Choose Raw Milk: Evidence from a National Quantitative Survey

 

#19,391

With reports of H5N1 infected dairy herds increasing again (see Washington State: H5N1 Detections in Cattle Triple (n=27) - 2nd County (Benton) Affected), we are seeing an uptick in warnings from health departments about the dangers of consuming raw milk. 

The King County, WA Dept. of Public Health unambiguously warns:

Raw (unpasteurized) milk and raw milk products

Consuming raw milk and raw milk products can pose health risks.
Raw milk and A(H5N1) virus‎

The CDC recommends against consuming raw milk contaminated with live A(H5N1) virus as a way to develop antibodies against A(H5N1) virus to protect against future disease. Consuming raw milk could make you sick.
 
Why is raw milk unsafe?

• Raw milk is milk from animals, typically cows and goats, which has not been pasteurized. Pasteurization is a process of heating raw milk to kill germs from the animal that are present in the raw milk.
• Some people believe that raw milk is more nutritious than pasteurized milk; however, the major nutrients in milk are not affected by pasteurization.
• Raw milk and raw milk products, such as cream, cheese and yogurt can be contaminated with harmful bacteria and cause serious infections.
• People with weakened immune systems, young children, the elderly, and pregnant women are at increased risk for severe infections from raw milk and milk products. It is especially important that young children, elderly persons, and persons with weakened immune systems consume only pasteurized milk and milk products.
• Read the label! In Washington state, it is legal to sell raw milk but raw milk products must be clearly labeled.

In the fall of 2024, we saw similar warnings after a number of household pets were infected with H5N1, some presumably from exposure to raw milk and/or raw pet food (see LA County Issues Another Raw Milk Warning).

Despite ample evidence of its dangers, most states allow its sale from farms or co-ops, and some states - like Washington - allow it to be sold in grocery stores alongside pasteurized milk.

                            State Laws on sale of raw milk - Credit CDC

A 2022 study published in the Journal of Food Protection found that:

Results show that 4.4% of U.S. adults reported consuming raw milk at least once in the past year, with 1.6% reporting frequent consumption of raw milk (once per month or more often) and 1.0% reporting consumption once per week or more often.

Today we have a new preprint - published Oct 28th - which suggests Americans' consumption of raw milk may be even higher than previously reported. 

It is based on a survey of 1,075 eligible US adults through an online panel in February of 2025, and it reports roughly 15% of US adults consumed raw milk in the preceding six months.

While it is possible that pro-raw-milk enthusiasts were more likely to respond to this survey, recruitment was done through Qualtrics Research Services - using demographic quotas - not an openly advertised public poll. 

I've posted the abstract below, but those wishing a deeper dive will want to follow the link to read the preprint in its entirety.

Why Americans Choose Raw Milk: Evidence from a National Quantitative Survey
Sophia Ruser, Cristina Rojo, Katherine J Koebel,  Calvin Slaughter,  Ece Bulut,  Renata Ivanek
doi: https://doi.org/10.64898/2026.10.26.26366487
This article is a preprint and has not been certified by peer review 
 
Preview PDF

Abstract

Raw milk consumption is a controllable source of foodborne pathogen exposure in the United States (US), yet existing national estimates of raw milk consumption behaviors are outdated and do not capture emerging factors such as consumers' trusted information sources, sociopolitical influences, and at-home risk mitigation behaviors.

We conducted a nationally representative cross-sectional survey of n=1078 US adults to estimate the prevalence of raw milk consumption and at-home thermal treatment practices and identify predictors of these behaviors. Multivariable logistic regression models were used to evaluate predictors of raw milk consumption and thermal treatment behavior using adjusted odds ratios (aORs).

Among 1,075 eligible respondents, 15% consumed raw milk in the last six months, including 5% exclusively and 10% in addition to pasteurized milk. 

In multivariable analysis, raw milk consumption was independently associated with younger age, cohabitation with high-risk individuals for foodborne infections (including children less than or equal to five years of age, and elderly, pregnant or immunocompromised individuals) who had consumed raw milk, and perceptions of raw milk taste and safety. 

Adults aged greater than or equal to 55 years had lower odds of consumption than those aged 18-24 years (aOR, 0.05; 95% CI, 0.02-0.15), while those living with a high-risk household member who consumed raw milk had higher odds of consumption (aOR, 4.39; 95% CI, 2.69-7.22). Perceiving raw milk to have higher risk of causing illness was associated with lower odds of raw milk consumption (aOR: 0.32, 95% CI: 0.17-0.62) compared to believing the risk to be equal across milk types, and thermal treatment was reported by 38% of exclusive raw milk consumers (n=58) and 47% of consumers of both milk types (n=106).

Raw milk consumption in the US appears to be substantially more common than previously reported and shaped by factors such as taste, safety, and household raw milk consumption among high-risk individuals for foodborne infections. The proportion of raw milk consumers already practicing at-home thermal treatment suggests a potential opportunity for risk mitigation.

While all of this is self-reported and unverified information, it appears that among the respondents to this poll that high-risk groups (young children, elderly persons, and persons with weakened immune systems) are often cited as household consumers of raw milk.

• 10.0% reported a child aged five or younger who had consumed it.
• 9.1% reported an adult aged 65 or older.
• 3.2% reported an immunocompromised person.
• 2.1% reported a pregnant person.

One potential bright spot, however, is the reported practice of heating or steaming raw milk (44% reported doing so > 50% of the time). Whether their heating temperatures and times were sufficient to kill pathogens is unknown.

Since we've seen multiple instances where H5N1 contaminated raw milk has reached store shelves (see California: CDFA Announces Another Recall of H5 Contaminated Raw Milk), the risks - while low - are genuine. 

But whether any of this will dissuade those currently inclined to consume raw milk - after decades of near universal public health advice to the contrary - remains to be seen.

WHO: Fatal H1N1v Infection In Brazil

 

#19,390

Overnight the World Health Organization published its latest Influenza at the human-animal interface summary and assessment, 7 October 2026, which describes one previously reported  H5N1 case from Cambodia, 4 recent H9N2 cases reported from Mainland China, and one fatal H1N1v case from Brazil.

The H1N1v case is unusual in that the adult female patient - who had (unspecified) pre-existing chronic conditions - died after a month-long hospitalization. Of note:  Her husband and three adult children also reported flu-like symptoms - were treated for a `viral infection' - but were never tested. 

According to the timeline provided by this report, the hospitalized case was only identified as having a novel flu (H1N1v) a week after her death.  As a result, epidemiological investigation wasn't begun until September 5th, roughly 7 weeks after she (and her family) first fell ill.

First, the WHO report, after which I'll return with more.

Swine influenza viruses in humans 

Influenza A(H1N1)v, Brazil

On 30 September 2026, Brazil notified PAHO/WHO of a laboratory-confirmed human infection with an influenza A(H1N1)v virus in an adult woman, with pre-existing chronic conditions, residing in the state of Santa Catarina. She developed symptoms of influenza-like illness on 16 July 2026 and sought medical attention on 20 July. 

Her husband and three adult children, who live in the same household,also experienced symptoms of an influenza-like illness; at that time, all were diagnosed, based solely on clinical examination, with a viral infection and received treatment.

  The woman, however, did not recover. On 27 July, the patient was hospitalized due to worsening respiratory symptoms. She received treatment, including the antiviral oseltamivir, and required intensive care, including ventilatory support. Despite intensive care, the patient passed away on 28 August.

A nasopharyngeal sample, collected on 29 July, tested positive for influenza A on 30 July and was subsequently subtyped as influenza A(H1N1) on 31 July. The sample was sent to the reference laboratory for respiratory viruses at the Oswaldo Cruz Institute (IOC/Fiocruz) in Rio de Janeiro for further characterization. On 4 September, genomic analysis identified an influenza A(H1N1)v virus.

According to information gathered during an epidemiological investigation conducted by municipal and state teams between 5 and 9 September, the patient had no history of travel or direct contact with swine. However, a possible indirect exposure to swine was identified through a neighbour who raises these animals for personal consumption.

Since 2015, twelve cases of human infection with swine-origin virus variants, including this one, have been detected within Brazil’s respiratory virus surveillance workflow.

This chronology illustrates just how difficult it can be to detect a novel virus, even when the patient is hospitalized with severe influenza. A few recent examples include:

• In November of 2025, Washington State reported the first known human infection with avian H5N5; a diagnosis that was delayed - according to an MMWR report - by  `early and repeated negative influenza test results from upper respiratory swab specimens'.

• In 2024, a Missouri patient was hospitalized with influenza A, and released, before being notified they had H5N1 (see Missouri DHSS: Human H5 bird flu case confirmed in Missouri). 

• Also in 2024, Australia treated a child with recent travel from India for severe flu, which resulted in respiratory failure. The child fell ill (in India) in late February, was hospitalized in Melbourne in early March, and was released after > 2 weeks. While respiratory samples were taken in early March, they weren't identified as H5N1 positive until mid-May.  

Complicating matters, most people experiencing mild or moderate flu symptoms are unlikely to seek medical care, and even when they do, they are often treated for a `viral illness' and never tested.  

We've seen past studies (see here, here, and here) suggesting that as few as 1 in 100 cases are identified in the community. 

In early 2025, the CDC issued a HAN: Accelerated Subtyping of Influenza A in Hospitalized Patients, requesting that all hospitalized patients with suspected influenza be subtyped within 24 hours. 

More recently, we saw Washington State: Updated guidance for novel influenza screening and influenza subtyping, which emphasized the importance of identifying those with acute respiratory illness (ARI) and specific epidemiologic risk factors.

The reality is, it takes a certain degree of luck to detect sporadic novel flu infections in the community. While better screening methods could improve detection rates, many mild and moderate infections will still likely fly beneath our radar. 

A reminder than anything we say about the current threat from H5N1, swine flu variants, MERS-CoV, or any other pandemic threat must carry an implied asterisk.

A disclaimer that says, ` * based on available, and likely incomplete, information. . . '.

Washington State: H5N1 Detections in Cattle Triple (n=27) - 2nd County (Benton) Affected

 

#18,389

While it hasn't shown up yet on the USDA's H5N1 in Livestock dashboard, the number of dairy herds in Washington State infected with HPAI has jumped from 9 late last week, to 27, with a second county (Benton) now reporting an infected herd.

Less than 3 weeks ago (Oct 8th) the USDA/APHIS announced the first detection of H5N1 in dairy cattle in Washington State, which was followed a week later by the first (reportedly mild) human H5N1 infection reported in the U.S. in 2026 (see Washington State Confirms Human Avian Flu Infection).

Other than the (above) update to the Washington State Dept. Agriculture dashboard, I have found no other public announcement of this jump in detections.  

Yesterday, the WSDA did publish a statement on the detection of H5N1 in a second county, which also states:

Media note: WSDA will issue a news release for each new county with confirmed HPAI in cattle. Subsequent detections in previously announced counties will be posted online.

Excerpts from yesterday's announcement follow:

WSDA confirms HPAI in dairy herd in Benton County

OLYMPIA – Oct. 26, 2026 – Washington State Department of Agriculture (WSDA) has confirmed a detection of highly pathogenic avian influenza (HPAI) H5N1 in a Benton County dairy herd. The virus was detected by the Washington Animal Disease Diagnostic Laboratory (WADDL) through routine surveillance, and the finding was confirmed by the USDA National Veterinary Services Laboratories (NVSL).

The dairy herd is under quarantine and has employed strict biosecurity measures. Veterinarians are working to treat sick cows. Pasteurized milk products remain safe for consumers, and milk supply shortages are not expected. WSDA urges dairy farmers statewide to report any clinical signs of illness to their veterinarian, including:

• Changes in milk appearance (thicker, often yellowish to brown)
• Decreased milk production
• Decline in feed intake
• Fever
• Respiratory symptoms
• Changes in manure
• Steep drop in rumination and rumen motility

If you notice any of these signs, isolate affected animals and contact your veterinarian and WSDA at 360-902-1878 or ahealth@agr.wa.gov. Most cattle affected by HPAI recover with supportive care with full herd recovery typically taking 4-6 weeks.

“Seeing the virus move to another county is disappointing but our dairy farmers are working hard to implement their biosecurity plans, share lessons learned and help each other get through this,” said Washington State Veterinarian Amber Itle, VMD, MS. "This isn’t new for the country, but it is new for Washington. I’ve been in awe of how hard our veterinarians and dairy farmers work together every day to keep their cows healthy, keep their workers safe and keep operating despite all the uncertainty this virus brings with it. This detection was through routine surveillance enabling us to detect the virus before cows got sick. We hope this will help us to implement measures on farm to prevent transmission within or between other dairy or poultry facilities.”

HPAI can spread between dairy cattle through infected animals and contaminated milk, equipment, vehicles, clothing, footwear and other materials or people that move between farms. Wild birds can also carry HPAI, but they are not considered the primary source of spread of the virus that affects dairy herds.

Poultry are also highly susceptible to HPAI. Other states have reported infections in commercial and backyard poultry flocks near dairy farms affected by H5N1. Poultry owners, including those who keep backyard flocks, should remain vigilant for signs of illness and practice strong biosecurity to help reduce the risk of infection.

(Continue . . .) 

According the WSDA, there are nearly 400 dairy farms in Washington State, which suggests that over the past 3 weeks roughly 7% of their dairy herds have tested positive for H5N1.

Dairy product safety

Pasteurization inactivates viruses and bacteria in milk, including HPAI virus, helping ensure the safety of the dairy supply. Infected cows can shed the virus in their milk, making raw milk and other raw dairy products unsafe for consumption. Avoid raw dairy product consumption, and do not allow your pets to consume raw milk or other dairy products, or raw foods such as raw meat.

While the State of Washington posted the above warning on October 8th, Washington allows the sale of raw milk in grocery stores, natural food markets, food co-ops, and direct-to-consumer farm stores.

 

Hopefully, the public is taking these risks seriously.

 

ECDC & CDC Updates On Ebola Multi-country outbreak 2026

Credit CDC

 

#19,388

With the number of confirmed cases nearing 10,000, the Ebola Bundibugyo outbreak in central Africa - which was first announced in mid-May in the DRC - is now the second largest in history, and shows no sign of stopping. 

Credit CDC

This outbreak has spilled over into neighboring countries, and an imported case was recently reported in Nigeria (see ECDC Threat assessment brief – Importation of Ebola disease cases caused by Bundibugyo virus to Kenya and Nigeria).

While sporadic exported cases are always possible, the public health risks outside of the DRC and surrounding areas is considered low. 

Yesterday the CDC (link) and the ECDC (link) both posted updated outbreak reports.  Excerpts from both follow:

Ebola disease: Multi-country outbreak 2026

This page is updated regularly. It was last updated on 26 October at 16:30.

An outbreak of Ebola disease caused by Bundibugyo virus has been ongoing in the Democratic Republic of the Congo (DRC) since May 2026. Cases were also reported in Kenya and Nigeria in October 2026 and have been reported in Uganda, where the outbreak has ended.

 
Key facts 

On 20 October 2026, an Ebola case was reported in Nigeria. The individual, who had travel history to Uganda, developed symptoms on 7 October, sought medical care on 11 October, and tested positive on 20 October. A total of 53 contacts have been identified to date, and further epidemiological investigations are ongoing.

As of 25 October, in Kenya, a total of nine confirmed cases, including two deaths, have been reported, all linked to the first case. The last case was reported on 20 October 2026 (close contact of the first case) and the second death on 23 October 2026.

As of 25 October 2026, the Democratic Republic of the Congo (DRC) has reported a total of 9 964 confirmed cases, including 4 851 related deaths (from data up until 24 October). Since the beginning of the outbreak, eight provinces have been affected: Ituri, Nord-Kivu, Sud-Kivu, Tshopo, Haut-Uélé, Bas-Uélé, Sud Ubangi and Nord Ubangi.
ECDC is monitoring the outbreak through its epidemic intelligence activities and actively liaising with partners to support the response.

ECDC is actively liaising with key partners, including Africa CDC, the European Commission, the World Health Organization, the European Union Delegation in Nigeria and Nigeria CDC to provide further support through the EU Health Task Force in response to the ongoing event in Nigeria.

For more detailed epidemiological information and updates on the outbreak, visit ECDC’s Public health events page.

Cases medically evacuated or imported to Europe

Since May 2026, four cases of Ebola disease linked to the outbreak in DRC have been medically evacuated or imported to the European Union/European Economic Area (EU/EEA). Three patients were medically evacuated for specialised care, two to Germany and one to the Netherlands. A fourth case was reported in France in July. All four cases involved people working in healthcare or humanitarian roles in affected areas of DRC. In July, a resident of the United Kingdom (UK) was also evacuated to the UK following potential exposure while treating Ebola patients in DRC.

ECDC risk assessment

On the basis of the available information, and given the uncertainties surrounding this outbreak, the likelihood of infection for people from the European Union/European Economic Area (EU/EEA) living in or travelling to affected areas is estimated to be low. Given the very low likelihood of importation and secondary transmission, the likelihood of infection for people living in the EU/EEA is estimated to be very low. This assessment will be reviewed as further information becomes available.

The CDC's update outlines some of the challenges in containing this outbreak:

Response challenges

• The response to this outbreak is challenging due to a number of complex circumstances in the region.
• Limited health infrastructure, including limited access to healthcare, diagnostic and laboratory services, infection prevention and control supplies, and other basic services make stopping this outbreak more difficult.
• Ongoing conflict in the area where the outbreak is occurring creates security issues and complicates contact tracing and infection prevention and control.
• Violence against healthcare workers and shortages of personal protective equipment are leading to healthcare workers becoming infected while treating patients.
• Frequent population movement and cross-border travel increase the risk of spread to Uganda, South Sudan, Rwanda, and to other areas.
• Lack of trust in the government and misinformation make communicating about Ebola more difficult.

 Additionally, the WHO points out:

Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation. Outbreak control relies on rapid case identification and investigation, isolation and care, contact tracing, safe burials and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.

On October 23rd, the WHO announced the start of a Phase 2/3 clinical trial to evaluate potential vaccine candidates; starting with  Ervebo (an Ebola Zaire-specific vaccine).  Details on this trial were published by CEPI late last week. 

These studies, however, will take months.  And positive results are not guaranteed. 

Which means there seems little chance that the outbreak in Africa will be brought under control anytime soon.

 

The UK's `Be Ready' Preparedness Campaign

 

#19,387

While Avian Flu Diary is primarily an infectious disease blog, individual and community preparedness (for all kinds of emergencies) is its secondary focus. In  its archives you'll find hundreds of preparedness articles (link).  

While calls for individual preparedness are common in the United States (see National Preparedness Month), in Europe is is far less often discussed. 

Eighteen months ago, however, the EU made headlines after calling for all households to prepare for a wide array of disasters (see excerpts below).

What type of crises is the EU preparing for? 

The EU is preparing for a broad spectrum of risks and threats, encompassing both natural and human-induced disasters. This includes:

• Natural disasters: floods, wildfires, earthquakes, and extreme weather events exacerbated by climate change.
• Human-induced disasters: industrial accidents, technological failures, and pandemics.
• Hybrid threats: cyberattacks, disinformation campaigns and foreign information manipulation and interference (FIMI), and sabotage of critical infrastructure.
• Geopolitical crises: armed conflicts, including the possibility of armed aggression against Member States.

       (SNIP)

Last December, we looked at the launch of  Denk Vooruit: The Netherlands National Citizen Preparedness Drive, on how to prepare for the first 72 hours of an emergency (e.g. extreme weather, cyberattacks, terrorist attack, even armed conflict, etc.).

Two months ago, in UK National Risk Register 2026 - Urges Citizen Preparedness, we looked at the UK government's sobering 223-page handbook for dealing with wide variety of  disaster scenarios. 

Late last week the UK quietly launched a new citizen preparedness campaign, which has gained a degree of internet notoriety over the weekend.  

Households encouraged to take small, simple steps to stay prepared in an emergency

Households are being encouraged to take a few simple steps to stay prepared if everyday services are temporarily disrupted, under updated advice published today.

From:Cabinet Office and The Rt Hon Dan Jarvis MBE MP

Published:22 October 2026


Advice helps people feel better prepared for events such as severe weather, which can occasionally affect services like power, water, and the internet.

Campaign bolsters UK’s preparedness for emergencies, in line with European peers including France, Ireland and The Netherlands.
Simple steps include actions that are completely free, like signing up to the Priority Services Register, a service helping utility companies identify people most in need.

Households are being encouraged to take a few simple steps to stay prepared if everyday services are temporarily disrupted, under updated advice published today.

The advice is the first stage of a three-year campaign to help households across the UK feel better prepared for events such as severe weather, which can occasionally affect services including power, water, phones and the internet.

The campaign focuses on straightforward things people can do in advance, including signing up to the Priority Services Register - a service that helps gas, water, and electricity companies identify customers that may need extra support in an emergency - and keep a small supply of non-perishable food and bottled water at home.

With storms last winter and the wildfires this summer showing how severe weather events can cause disruption to our everyday lives and impact the services we rely on, from phone signal to water and the internet, launching the campaign brings the UK into line with European peers who all run similar campaigns already.

The government has worked with other countries to learn from their experience and best practice. For example, the advice to be prepared for three days of disruption that is at the heart of the UK campaign is also used by France, Ireland and The Netherlands.

The government has also worked closely with local resilience forums across the UK to root the advice in what works for local communities.

Dan Jarvis MP, Security Minister, said:

Those who can follow this advice should follow this advice. By taking simple steps to be ready for everyday emergencies like severe storms, people can reduce pressure on emergency services, helping them prioritise people who need more support in an emergency.

This is just the sort of community-focused campaign the UK needs to improve our resilience as a nation. It will bring us into line with European counterparts, where advice like this is a normal part of everyday life.

The ‘Be Ready’ campaign will build gradually over time. More than five hundred organisations across the UK, from charities to businesses, have already signed-up to share messaging and campaign assets within their networks and communities. Government channels like GOV.UK and social media accounts will also amplify content.

Over the coming weeks and months, social media and radio advertising will help reach audiences who may be particularly at-risk in everyday emergencies: families with young children and older people.

To ensure the updated advice is relevant and accessible to all, the ‘Be Ready’ campaign has been built in collaboration with charities and campaigners that work with groups that are often under-represented, including people with insecure housing and people who use foodbanks.

Many of the simple steps are quick and cost-free, like signing up to the Priority Services Register, and other steps are designed to be as low-cost as possible. The intention is that, if households that can take these steps do, emergency services will be able to prioritise those most in-need if an emergency were to happen.

The Government has published resilience advice for households since May 2024. While the ‘Be Ready’ campaign has seen the previous “Prepare” website updated with new messaging and branding, much of the advice has not changed and remains evergreen for households to follow.

Laura Scott, British Red Cross Director for UK Resilience, said:

We can’t control when emergencies happen, but we can all take some simple steps to be prepared, so that when they do, we are ready to help our friends, families and neighbours.

We know from our work across the UK that local people know their communities best and want to play a part when a crisis happens. Having clear and trusted advice for people, especially those who may be more at-risk, could help reduce the impact of crises and even save lives.

You can visit the UK's Be Ready Campaign webpage for more details.

As we discussed a month ago in #NPM26: Making Preparedness a Priority, I consider 72 hours the bare minimum level of preparedness, and would strongly recommend striving for 7 to 14 days. 

But it's a start. And once you achieve it, it can be added to over time. 

While no one can predict with any certainty what the next big regional or national emergency will be (in the UK, or anywhere else in the world),  a modicum of general preparedness can go a long way towards making a bad situation a little less dire. 

So . . . if a disaster struck your area today, and the power went out, stores closed their doors, and water stopped flowing from your kitchen tap for the next 7 to 14 days . . . do you already have:

• A battery operated NWS Emergency Radio to find out what was going on, and to get vital instructions from emergency officials
• A decent first-aid kit, so that you can treat injuries
• Enough non-perishable food and water on hand to feed and hydrate your family (including pets) for the duration
• A way to provide light when the grid is down.
• A way to cook safely without electricity
• A way to purify or filter water
• A way to stay cool (fans) or warm when the power is out.
• A small supply of cash to use in case credit/debit machines are not working
• An emergency plan, including meeting places, emergency out-of-state contact numbers, a disaster buddy, and in case you must evacuate, a bug-out bag
• Spare supply of essential prescription medicines that you or your family may need
• A way to entertain yourself, or your kids, during a prolonged blackout

If your answer is `no’, then you're got some work to do. 

Eurosurveillance: Fatal encephalitis caused by Shamonda virus Europe 1 (SHAV-EU1) in a patient with a severely weakened immune system, France, 2026

Credit Wikipedia

#19,386

In early August, we looked at a statement from the Swiss FSVO (Federal Office for Food Safety and Veterinary Affairs) on their Investigation into an Unidentified Bovine Disease which produced fevers, diarrhea, and substantial milk drop in dairy cows.

A few days later Germany's FLI (Friedrich Loeffler Institut) announced the results of their own investigation, which had discovered high levels of a novel orthobunyavirus of the Simbu serogroup present in affected cattle.

Orthobunyaviruses are a large and growing family of `arboviruses' - viruses carried and spread by biting insects and ticks (mosquitoes, ticks & midges) - that mostly infect animals, but are sometimes zoonotic.

The FLI's press release dated August 3rd stated:

Viruses of the Simbu serogroup are not generally considered to be zoonotic agents and, based on current knowledge, do not pose a significant risk of infection to humans. However, in the case of newly emerging and insufficiently characterised viruses in this group, their potential zoonotic risk should be investigated as a precautionary measure and closely monitored as the situation develops.

Last Thursday, the journal Eurosurveillance published the first account of a (fatal) human infection with this virus in a highly immunocompromised patient living in a rural region of France.

For now, this appears to be a rare occurrence, but investigations continue into the epidemiology of Shamonda-Europe 1 (SHAV-EU1) virus.

Due to its length  and technical detail, I've only posted some excerpts from the Eurosurveillance report. Follow the link to read the Rapid Communication in its entirety.  

I'll have a bit more after the break.  

Open Access
Volume 31, Issue 42, 22/Oct/2026

Fatal encephalitis caused by Shamonda virus Europe 1 (SHAV-EU1) in a patient with a severely weakened immune system, France, 2026  
Margot Bonnet1,* , Hélène Labussière-Wallet2,* , Pauline Dumez3,* , Lucie Jauffret4 , Lyderic Aubert5 , Aurélie Avondo-Ray5 , Carole Seurret3 , Perrine Devic3 , Sabrine Souci3 , Syria Laperche6 , Léa Saint Martin7 , Emilie Frobert7,8 , Alexandre Gaymard7,8 , Jennifer Giorgi7 , Quentin Semanas7 , Richard Chalvignac7 , Antoine Oblette7 , Audrey Lapendry7 , Bruno Pozzetto9 , Thomas Perpoint10 , Mikail Kelleci11 , Aurélie Sécula11 , Charlotte Foret-Lucas11 , Clement Javaux10 , Florence Morfin7,8 , Antonin Bal7,8 , Elise Brottet12 , Catarina Krug12 , Frederic Jourdain12 , David Meyronet13 , Florence Ader10,14 , Jean-Luc Guérin11,** , Laurence Josset7,8,** , Grégory Destras7,8,**

Clinical presentation

On 23 September 2026 (day (D)0), a patient in their sixties developed acute cortical blindness and confusion, with normal brain magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) examination. This patient had a history of T-cell prolymphocytic leukaemia diagnosed in November 2025. They underwent first-line treatment with alemtuzumab (Campath) from December 2025 to February 2026, followed by an allogeneic haematopoietic stem cell transplantation (HSCT) on D−28 from a human leukocyte antigen (HLA) matched related donor. The conditioning regimen consisted of thiotepa, fludarabine and busulfan and the graft vs host disease (GVHD) prophylaxis consisted of post-transplant cyclophosphamide and cyclosporine. The patient lived in a rural area in the French Rhône-Alpes region. They had been hospitalised in Lyon continuously since 18 August 2026, corresponding to D−36 (Figure 1).

(SNIP)

Discussion
 
Here, we report the first human case of SHAV-EU1 infection, an emerging Orthobunyavirus that spread over Europe in summer 2026 affecting predominantly cattle. The patient, who had a severely weakened immune system, died from multi-organ failure including neuro-invasive disease, with primary neurological symptoms appearing on 23 September.

Investigations into the viral course revealed that the virus was present in the patient's blood for several weeks. At this point, we cannot date the time of infection as the earliest sample investigated was already positive for the virus on 2 July. Given that the first detections in cattle were reported in early July and clinical signs were documented in dairy cattle as early as June 2026, the patient was probably infected between mid-June and 1 July 2026. Investigation of the patient’s clinical history revealed that they developed an episode of diarrhoea and anorexia on 19 June, similar to symptoms observed in adult cattle [2] and could correspond to the first symptoms of this infection. Investigations on earlier blood and available respiratory samples are ongoing to determine the first detection of the virus over the clinical course by RT-PCR as well as by genomic investigation.

Route of transmission also remains unknown at this point. Graft transmission has been ruled out due to the negative PCR test of the graft and the previous positive PCR of the blood sample. Three different transmission hypotheses are currently investigated. As observed in animals, the most likely is the vector-borne transmission, presumably Culicoides spp. biting midges near the patient's home located in a rural area where animal transmission of SHAV-EU1 was officially documented in early July 2026, although transmission was likely already occurring in June 2026. The potential involvement of alternative arthropod vectors should also be explored. The two other routes (transfusion and food-borne) are less likely, given the sequence of events, and are not supported by any evidence at this point although investigations are ongoing to rule them out. Transfusion-related transmission would require an immunocompetent donor with asymptomatic viraemia in June, while viraemia is reported very transient in animals. Transmission by raw milk or raw cheese appears unlikely, as the presence of the virus in milk has not yet been reported and there is currently no evidence of direct contact-mediated transmission between animals.

(SNIP)

Conclusion

We present the first case of human infection by the Shamonda-Europe virus, specifically the clade EU1, which emerged in European animals in June 2026. However, given the patient’s significantly weakened immune system, this finding alone cannot currently be interpreted as a serious risk for the general immunocompetent population. 

The primary hypothesis of transmission remains Culicoides biting midges and although direct human-to-human transmission appears unlikely, transmission through blood transfusion or organ transplantation remains a potential concern. Further investigations are warranted to better characterise transmission routes, particularly potential vector-borne transmission. This case calls for an enhanced surveillance of Shamonda Europe virus in both human and animal settings in Europe.

        (Continue . . . )

Fifteen years and more than 15,000 blog posts ago, I wrote a piece called The Third Epidemiological Transition, based on the works of the now late (May 22, 1936 - May 15, 2014) anthropologist and researcher George Armelagos of Emory University.

The gist of his theory - which he first published in the mid-1990s - was that since the mid-1970s the world had entered into an age of newly emerging infectious diseases, re-emerging diseases and a rise in antimicrobial resistant pathogens.

While most of these threats will never rise to pandemic proportions, their impact on our lives and our economies can still be significant. Our current battles with measles in North America  and dengue fever in Florida, are just two of many examples. 

While the Shamonda-Europe virus seems unlikely to pose a significant public health threat, one can never truly predict what an emerging disease will do.  Viruses can evolve, environmental conditions can change, and suddenly a minor threat can become more formidable. 

Which is why there is value in our tracking these outbreaks, even when they seem mostly of academic interest at the time.