Hawaii Dept. of Health Statement on Detection of H5 Influenza In Wastewater

#18,412

With the caveat that it isn't clear whether this is an HPAI H5 detection, late yesterday the Hawaii Department of Health announced the detection of avian H5 influenza virus during sampling at one of their wastewater plants. 

This is, admittedly, a bit of a mystery as Hawaii is the only U.S. state that hasn't reported HPAI H5.  The State of Hawaii maintains an avian influenza information page  with the following advice.

• The current risk to the general public in Hawaii is low. 

• Hawaii is the only U.S. state without H5N1 detected among wild birds or poultry. Residents are encouraged to report sick or dead birds, especially when multiple birds are affected to Hawaii Department of Agriculture (808-483-7106 during Monday to Friday from 7:45AM to 4:30PM, or 808-837-8092 during non-business hours and holidays). 

• Hawaii residents who recently visited or worked on a farm in another state with known or suspected H5N1 animal infections should contact the Hawaii Department of Health’s Disease Reporting Line (808-586-4586) for a telephone risk assessment.

It is possible this is from a local avian LPAI source, although I'm not aware of any reports of LPAI H5 from the islands.  Further testing will hopefully yield additional information. 

In the meantime, the Hawaii Dept. of Health are urging people to avoid contact with sick or dead birds, livestock, or wild animals without wearing the proper PPE, and to`. . .report sick pets to their veterinarian.'

H5 AVIAN FLU DETECTED AT WASTEWATER SAMPLING SITE ON OʻAHU, DOH CLOSELY MONITORING SITUATION 

Posted on Nov 12, 2024 in Newsroom

HONOLULU — The Hawaiʻi Department of Health (DOH) is investigating possible sources of H5 avian influenza, which has been detected for the first time at a wastewater sampling site on Oʻahu. The specimen was collected on November 7, 2024, and DOH received the result today.

Wastewater sampling is routinely performed across Hawaiʻi as part of ongoing surveillance for infectious diseases including avian influenza. H5N1, also called Highly Pathogenic Avian Influenza (HPAI), is one type of H5 avian influenza. Whether this detection is HPAI is unable to be determined from wastewater testing. The wastewater testing provides a signal for further investigation to determine whether this detection is H5N1-related, and an opportunity to reinforce prevention measures, particularly among persons at increased risk of exposure.

H5N1 has been spreading among birds and mammals, leading to a nationwide outbreak. Human cases have been reported among those working closely with infected animals. There is no evidence of sustained human-to-human transmission of H5N1 in the United States. To date, Hawaiʻi has been the only state without H5N1 avian influenza detected in birds or animals. There are no reports of human or animal H5N1 cases in Hawaiʻi and the overall risk of H5N1 to Oʻahu and state residents remains low.

DOH, in partnership with federal agriculture and wildlife partners, will continue to support further investigation, prevention, and public health surveillance efforts.  

While the current risk of transmission to Hawaiʻi residents is low, DOH encourages residents to follow these best practices when around animals or when consuming animal products: 

• In general, do not touch birds, livestock, or wild animals that are sick or dead without personal protective equipment. 
• Residents are encouraged to report sick pets to their veterinarian. In addition, please contact the Animal Industry Division at Hawaiʻi Department of Agriculture at 808-483-7106, Monday to Friday from 7:45 a.m. to 4:30 p.m., or 808-837-8092 during non-business hours and holidays to report multiple or unusual illnesses or deaths in poultry, livestock, or wild birds or animals.
• Do not touch or consume raw milk or raw milk products, especially from animals with confirmed or susmorepected avian influenza infection. Pasteurized milk products are safe.

Contact the Department of Health without delay at 808-586-4586 if you develop symptoms of avian influenza and have been in close contact with sick or dead animals. Symptoms of avian influenza may include fever, cough, sore throat and conjunctivitis. Antiviral flu treatment is available and recommended as soon as possible for people with suspected or confirmed avian influenza infection.

More info. resources: 

Avian Influenza | Disease Outbreak Control Division 

Prevention and Antiviral Treatment of Avian Influenza A Viruses in People | Bird Flu | CDC 

Hawaii: State Agencies Respond to 3rd Possible Case of HPAI H5 (Kauaʻi)

Hawaii lies beneath the West Pacific Flyway

#18,986

Separated as it is by vast ocean distances - 2,400 miles to the U.S., 4,000 miles to Japan - Hawaii is considered the world's most isolated populated place on earth. 

And not surprisingly - until just over a year ago  - the state of Hawaii had never reported H5N1 in wild or domesticated birds. 

All that changed in November of 2024 after the virus was first detected in wastewater samples on Oahu, and at least two outbreaks in captive and/or wild birds the following week. 

A month later, another treatment plant on the island of Hilo reported the virus.

This year, the first reported case came in mid-October (see Hawaii: DOH, DAB, DLNR Investigate Possible Avian Flu Case in Waterfowl), followed a month later by Hawaii: State Agencies Respond to 2nd Confirmed Case of HPAI H5 (Maui).

Yesterday the State of Hawaii announced their 3rd presumptive positive HPAI H5 case of this fall (see below) - this time affecting a 4th Hawaiian  island (Kauaʻi).  

What was once unheard of has now become increasingly common now that the HPAI H5 virus has better adapted to seabirds (see 2022's Unprecedented `Order Shift' In Wild Bird H5N1 Positives), with many species; including gannets, gulls, guillemots and great skua now hosting the virus.

The behavioral shift has not gone unnoticed by Oceania (Australia/NZ) which have been on HPAI watch for several years (see Australia: Confirmation of H5 Bird Flu on Sub-Antarctic Heard Island).

First the announcement from the Hawaiian Department of Land and Natural Resources, after which I'll return with a bit more.

12/11/25 – STATE AGENCIES RESPOND TO THIRD POSSIBLE CASE OF HIGHLY PATHOGENIC AVIAN INFLUENZA IN HAWAIʻI

Posted on Dec 11, 2025 in Forestry & Wildlife, Main, News Releases, slider

HONOLULU – Three state agencies remain on alert after a third presumptive case of avian influenza was found in a wild bird — this time in an endangered native duck on Kauaʻi. Preliminary testing performed by the Hawaiʻi State Laboratory showed the bird was infected with an influenza A virus, though confirmation and subtype identification (e.g., H5N1) are pending further analysis by the National Veterinary Services Laboratories (NVSL).

A Koloa Maoli (Hawaiian duck) was found sick on November 26 at the U.S. Fish and Wildlife Service’s Hanalei National Wildlife Refuge in Hanalei, Kauaʻi. The bird died within 24 hours.

H5N1 is a highly infectious and often deadly subtype of influenza A that mainly affects birds. Human infections are rare but can occur with close contact. Hawaiʻi’s first detection of H5N1 occurred in November 2024 in a backyard flock on Oʻahu, followed by a hybrid duck found on Oʻahu’s North Shore. This year, two additional cases have been confirmed in migratory Koloa Māpu ducks—one on Oʻahu and one on Maui. This Kauaʻi detection is the first potential case in a native bird, likely introduced through infected migratory waterfowl.

The Hawaiʻi Department of Health (DOH), Department of Agriculture & Biosecurity (DAB), and Department of Land and Natural Resources (DLNR) continue coordinated monitoring of public health reports, poultry operations and wild bird populations for any signs of virus spread.

With migratory bird season underway, more birds traveling through the islands may carry avian diseases and it is recommended that the public avoid touching or handling wild birds, especially waterfowl or shorebirds.

If you encounter sick or dead birds, such as waterfowl:

• Avoid touching or handling wild birds, especially waterfowl or shorebirds.
• If capturing a dead or sick bird is necessary, wear gloves, minimize contact and follow biosafety protocols.
• To report multiple or unusual illnesses in poultry, livestock or other wild birds or animals, contact DAB’s Animal Industry Division at 808-483-7100, Monday through Friday from 7:45 a.m. to 4:30 p.m., or 808-837-8092 during non-business hours and holidays. Send email to DABIC@hawaii.gov

About H5N1/Avian Influenza:

• H5N1 is an avian influenza virus that mainly affects birds; human infections are uncommon but can happen following close contact with infected birds.
• The public risk in Hawaiʻi is currently low, so the DOH does not recommend restricting outdoor activities.
• Routine influenza vaccines in humans do not protect against H5N1; the best prevention is avoiding contact with sick or dead birds.

For more information, visit:

DOH: https://health.hawaii.gov/docd/disease_listing/avian-influenza/

DAB: https://dab.hawaii.gov/ai/ldc/avian-influenza-information/

This fall we've seen unprecedented numbers of avian flu reports across North America and much of Europe -  particularly in wild birds - but also affecting commercial and backyard flocks.

Credit ECDC/EFSA Avian influenza overview Sep–Nov 2025

After two less impactful years (see chart above), avian flu has reinvented itself and is back with a vengeance.  While it could fizzle again, right now there appears to be an immense amount of the virus circulating in wild birds, increasings the risks of spillovers into poultry, mammalian wildlife, and even humans.

Last July we looked at the results of a survey of stakeholders (backyard poultry owners, animal rescue, etc.) on their knowledge of HPAI (see Hawaii: Findings From DOH Bird Flu Survey For Backyard Flock Bird Owners And Bird Rescuers), which found sizeable knowledge gaps.

 

Two months ago, in UF/IFAS Extension: What Backyard Flock Owners Need to Know about Bird Flu (Influenza H5N1) we looked at some common-sense steps people who raise birds can take to reduce the risk of infection.

Admittedly, trying to predict what HPAI does next is a mug's game, but if there was ever a time to be extra diligent in avoiding exposure to wild birds, and for flock owners to increase their biosecurity, it is probably now. 

For some official advice from the ECDC/EFSA, you may wish to revisit:

Avian influenza in Europe: enhanced surveillance and strict biosecurity needed as detections surge

Hawaii: State Agencies Respond to 2nd Confirmed Case of HPAI H5 (Maui)

Hawaii lies beneath the West Pacific Flyway 

#18,949

In most places (outside of Oceania) outbreaks of HPAI H5 in wild birds and/or poultry have become commonplace to the point they are barely newsworthy, but it is still an unusual occurrence in Hawaii. 

It was just a year ago that the virus was first detected in wastewater samples on Oahu, and at least two outbreaks in captive and/or wild birds the following week.

Last month, we saw a lone duck presumptively test positive for the virus at the University of Hawaiʻi at Mānoa (Oahu). On Friday the state announced a second detection this time on the island of Maui, more than 100 miles to the south and east.

There are no details provided as to this year's genotype, but last year's arrival was characterised as  (A3).

First the announcement, after which I'll have a bit more. 

11/14/25 – STATE AGENCIES RESPOND TO SECOND CONFIRMED CASE OF HIGHLY PATHOGENIC AVIAN INFLUENZA IN HAWAIʻI

Posted on Nov 14, 2025
JOSH GREEN, M.D.
GOVERNOR
DAWN CHANG
CHAIRPERSON


STATE AGENCIES RESPOND TO SECOND CONFIRMED CASE OF HIGHLY PATHOGENIC AVIAN INFLUENZA IN HAWAIʻI



HONOLULU – Three state agencies are on alert after a second case of highly pathogenic avian influenza (HPAI) was confirmed in a migratory duck – this time on the island of Maui. This is the first confirmed detection of H5N1 on Maui.

The Northern pintail (koloa māpu) was found along the Wailea shoreline and submitted to the U.S. Geological Survey’s National Wildlife Health Center – Honolulu Field Station. Samples were sent to the National Wildlife Health Center in Madison, Wisconsin, where it tested positive for influenza H5. The National Veterinary Services Laboratories in Iowa later confirmed the bird was infected with the H5N1 virus.

H5N1 is a highly infectious and often lethal subtype of influenza A that primarily affects birds but can sometimes be transmitted to humans. H5N1 was first detected in Hawaiʻi in November 2024 in a backyard flock in Central Oʻahu and subsequently in a hybrid duck from the north shore of Oʻahu. This Maui case follows the October 2025 confirmation of H5N1 in another koloa māpu found on Oʻahu at the University of Hawaiʻi Mānoa campus.

This year to date, the USGS has tested 77 birds for influenza all of which have been negative except for the Maui koloa māpu. Given these data, the risk of infection to humans and poultry remains low.

The Hawaiʻi Department of Health (DOH), Department of Agriculture & Biosecurity (DAB) and Department of Land and Natural Resources (DLNR) continue coordinated monitoring of public health reports, poultry operations and wild bird populations for any signs of virus spread.

During the Hawaiʻi migratory bird season, migratory birds may carry diseases to the islands, so the public should remain vigilant.

If you encounter sick or dead birds such as waterfowl:

• Avoid touching or handling wild birds, especially waterfowl or shorebirds.
• If capture of a dead or sick bird is necessary for investigation or handling is necessary by wildlife professionals, use gloves, minimize contact and follow biosafety protocols.
• To report multiple or unusual illnesses in poultry, livestock, or other wild birds or animals, contact the Hawaiʻi Department of Agriculture and Biosecurity (DAB) Animal Industry Division at 808-483-7100, Monday to Friday from 7:45 a.m. to 4:30 p.m., or 808-837-8092 during non-business hours and holidays. You may also e-mail HDOAIC@hawaii.gov.

Continued Public Support Needed for Seabird Fallout Response

State agencies also remind the public that we continue to rely on community participation in responding to seabird fallout events, especially during peak fledgling seasons. If you find a grounded seabird – such as a wedge-tailed shearwater – please report it and consider assisting the bird by bringing it into a rescue facility. If you find a downed seabird and decide to rescue it, you can follow recommendations and information provided by the State Department of Health and guidance from the Centers of Disease Control. Practice proper hygiene and sanitize hands, clothes, towels and other items after handling any animal. Community assistance remains critical to ensuring these birds receive timely care and can be returned safely to the wild. For more information visit:

https://dlnr.hawaii.gov/wildlife/seabird-fallout-season/

About H5N1 / Avian Influenza:

•  H5N1 is an avian influenza virus that primarily affects birds; human infections are rare but can occur from close contact with infected birds.
• The public risk in Hawaiʻi is low at this time and DOH does not recommend limiting outdoor activity.
• Routine influenza vaccines in humans do not protect against H5N1; the best prevention is avoiding contact with sick or dead birds.

For more information, visit:

https://health.hawaii.gov/docd/disease_listing/avian-influenza/

Over the summer we looked at the results of a survey of stakeholders (backyard poultry owners, animal rescue, etc.) on their knowledge of HPAI (see Hawaii: Findings From DOH Bird Flu Survey For Backyard Flock Bird Owners And Bird Rescuers), which found sizeable knowledge gaps.

Since then avian flu has returned with a vengeance this fall in both North America and much of Europe, affecting both commercial and backyard flocks.

 

A little over a month ago, in UF/IFAS Extension: What Backyard Flock Owners Need to Know about Bird Flu (Influenza H5N1) we looked at some common-sense steps people who raise birds can take to reduce the risk of infection.

Hopefully people are taking this, and the USDA's advice, seriously, as we could be looking at a protracted, and heavy, avian flu season ahead.

Hawaii: DOH, DAB, DLNR Investigate Possible Avian Flu Case in Waterfowl

 

Hawaii lies beneath the West Pacific Flyway

#18,907

Last year Hawaii unexpectedly reported the detection of the H5 virus in wastewater samples on Nov 13th, and at least two outbreaks in captive and/or wild birds the following week, marking it the first known HPAI detections in that state.

A month later, another treatment plant on the island of Hilo reported the virus.

The good news is that genetic analysis showed that this was an older genotype (A3) - which was first detected in Alaska in 2022 - and has not been linked to human, or cattle, infection as have B3.13 and D1.x.

Although Hawaii's remote location had been long assumed to offer it some protection, last year showed just how well-traveled the virus has become. 

While it comes a month earlier than last year, yesterday Hawaii issued the following statement following the presumptive finding of the H5 virus in a sick duck. 

DOH, DAB, DLNR Investigate Possible Avian Flu Case in Waterfowl

Posted on Oct 14, 2025 in Main

Joint New Release from the Hawaiʻi Department of Health, Hawaiʻi Department of Agriculture and Biosecurity and the Department of Land and Natural Resources

Oct. 14, 2025

HONOLULU – Three state agencies are on alert after laboratory testing identified a presumptive case of avian influenza on Friday in an ailing duck that was found earlier in the week at the University of Hawaiʻi at Mānoa.

Preliminary testing of the bird revealed an unconfirmed result of the H5 subtype of influenza A virus. Confirmation and further characterization are pending an analysis by the National Veterinary Services Laboratories (NVSL).

At this time, the risk of infection to humans is considered low.

H5N1 influenza A is highly infectious among wild birds and poultry and has caused outbreaks in animals, with one type infecting dairy cattle in the continental U.S. The virus, also is known as Highly Pathogenic Avian Influenza (HPAI) was first confirmed in Hawaiʻi in a backyard flock of birds in Central Oʻahu in November 2024. Human infections remain rare and are primarily linked to direct animal exposure. The Hawaiʻi Department of Health (DOH), Department of Agriculture & Biosecurity (DAB) and Department of Land and Natural Resources (DLNR) are monitoring health reports, poultry farms and wild bird populations for any signs the virus has spread.

The duck was found by a UH student, who reported it to the Hawaiʻi Wildlife Center. The preliminary diagnosis came from tests conducted by the DOH State Laboratories Division. Those tests were sent to NVSL, which is expected to report results later this week or next week.

As Hawaiʻi enters migratory bird season, this latest case is a reminder that wild birds may carry diseases to the islands and the public should remain vigilant.

If you encounter sick or dead birds:

        Avoid touching or handling wild birds, especially waterfowl or shorebirds.

• To report multiple or unusual illnesses in poultry, livestock, or other wild birds or animals, contact Hawaiʻi Department of Agriculture and Biosecurity (HDAB) Animal Industry Division at 808-483-7100, Monday to Friday from 7:45 a.m. to 4:30 p.m., or 808-837-8092 during non-business hours and holidays. Email: dabic@hawaii.gov.
• If you need to remove a dead wild bird from your property, wear disposable gloves or turn a plastic bag inside out to pick up the carcass. Place the bird in a second bag, seal it and dispose of it with your regular household trash. Wash your hands thoroughly and disinfect any clothing or shoes that may have come into contact with the bird. Monitor your health for any unusual symptoms afterward. For more information, visit: https://www.aphis.usda.gov/sites/default/files/fs-hpai-dead-wild-bird.508.pdf

About H5N1 / Avian Influenza:

• H5N1 is an avian influenza virus that primarily affects birds; human infections are rare but can occur under close contact with infected animals.
• The public risk in Hawaiʻi is low at this time and DOH does not recommend limiting outdoor activity.
• Routine influenza vaccines in humans do not protect against H5N1; the best prevention is avoiding contact with sick or dead birds.
• For more information on avian flu, its symptoms and how to protect yourself, visit https://health.hawaii.gov/docd/disease_listing/avian-influenza/.

Seabird Fallout Season is here

Seabird fallout season (Sept. 15-Dec. 15) primarily affects young seabirds leaving their nesting burrows for the first time. The risk of these birds carrying H5N1 is very low. If you find a downed seabird, please help these young birds survive.

For more information, visit

https://dlnr.hawaii.gov/wildlife/seabird-fallout-season/#response.

Fearing just such a return, last March the DOH Launched a Bird Flu Survey For Backyard Flock Owners & Bird Rescuers, and we saw the results last July (see Hawaii: Findings From DOH Bird Flu Survey For Backyard Flock Bird Owners And Bird Rescuers).

As we've discussed often the past 6 weeks, avian flu has returned earlier than usual this fall in both North America and parts of Europe, affecting both commercial and backyard flocks. 

A week ago, in UF/IFAS Extension: What Backyard Flock Owners Need to Know about Bird Flu (Influenza H5N1) we looked at some common-sense steps people who raise birds can take to reduce the risk of infection. 

Hopefully people are taking this, and the USDA's advice, seriously, as we could be looking at a protracted avian flu season ahead.

EID Journal Dispatch: Novel Highly Pathogenic Avian Influenza A(H5N1) Virus, Argentina, 2025

 

#18,988

Last August, in H5Nx: Reassort & Repeat, we looked at HPAI's promiscuous ways, and its propensity to reinvent itself - via reassortment - after it meets up with compatible LPAI viruses.  

Twenty years ago, H5N1's range was primarily limited to Southeast Asia, and so its reassortment opportunities were limited to LPAI viruses common to the region. 

But a chance reassortment near Qinghai Lake, Tibet in 2005 produced a more biological `fit', and far more easily carried (by migratory birds) clade 2.2 of the virus (see H5N1 Influenza Continues To Circulate and Change 2006 by Webster et. al.), which led to the first major diaspora of the virus (eventually spreading to Europe, the Middle East, and Africa). 

Over the years, as the virus spread around the globe, it encountered - and reassorted with - scores of  different LPAI viruses, producing hundreds of new clades, subclades, genotypes, and even new subtypes (H5N5, H5N6, H5N9, etc.).

While many were biological failures, some proved competitive enough to advance the spread, evolution, and diversity of the virus. We saw huge changes to HPAI in 2014 (changeover to H5N8), in 2016 (the first major European Epizootic), and in 2017 the virus crossed the Equator on its way to South Africa.

As H5's range increased, so did its genetic diversity, giving it even more reassortment opportunities. While it was growing stronger,  HPAI's first attempt to invade the Western Hemisphere (in 2014-2015) fizzled after 6 about months (see map below).

In 2020 the virus reassorted back to H5N1 - and having become even more `biologically fit' - in 2021 it make a far more successful 2nd invasion of the western hemisphere. 

Remarkably, within months of arriving in North America, it had already generated more than 100 new genotypes, and for the first time became capable of infecting mammalian livestock (goats, cattle, alpaca, etc.)

The pattern has been pretty consistent; as HPAI spreads, it encounters new opportunities to increase its genetic diversity. It is one of the reasons why its recent spread to Hawaii, and its feared spread into Oceania, are of great concern. 

Today we've a report from South America, published in the CDC EID Journal, which describes a unique 4:3:1 triple-reassortment of HPAI H5N1 detected in a mixed backyard flock (chickens, ducks, and turkeys) in Chaco Province, northern Argentina.

This outbreak was notable because the infected flock presented with severe, and atypical (dominated by diarrhea) symptoms. The authors wrote: 

The predominance of gastrointestinal signs suggests possible shifts in tissue tropism or virulence. Also, the detection of a North American NP segment not previously identified in LPAI viruses from Argentina or elsewhere in South America highlights the need to strengthen regional AIV surveillance, even in the absence of active HPAI circulation.

 I've posted the link, and some excerpts, from the dispatch below. Follow the link to read it in its entirety.  I'll have a brief postscript when you return.

Volume 31, Number 12—December 2025
Dispatch
Novel Highly Pathogenic Avian Influenza A(H5N1) Virus, Argentina, 2025

Ralph E.T. Vanstreels, Martha I. Nelson, María C. Artuso, Vanina D. Marchione, Luana E. Piccini, Estefania Benedetti, Alvin Crespo-Bellido, Agostina Pierdomenico, Thorsten Wolff, Marcela M. Uhart, and Agustina Rimondi

Abstract

Genomic sequencing of reemerging highly pathogenic avian influenza A(H5N1) virus detected in Argentina in February 2025 revealed novel triple-reassortant viruses containing gene segments from Eurasian H5N1 and low pathogenicity viruses from South and North American lineages. Our findings highlight continued evolution and diversification of clade 2.3.4.4b H5N1 in the Americas.

Highly pathogenic avian influenza (HPAI) viruses were introduced to South America in 2022 by migratory birds from North America. The viruses belonged to the 2.3.4.4b clade of HPAI A(H5N1) virus that became widespread in Europe in 2020 and spread to North America in 2021. The trajectory of H5N1 in South America has differed from H5N1 in North America in several critical ways. First, nearly all South America outbreaks stem from a single introduction of H5N1 viruses from North America (1,2), whereas the North America epizootic was reseeded by multiple independent introductions from Europe and Asia (A1–A6) (3,4). Second, South America H5N1 outbreaks were driven by a single genotype (B3.2) that was introduced from North America and remained genetically stable during its spread across South America. In contrast, H5N1 viruses in North America underwent frequent reassortment with low pathogenicity avian influenza (LPAI) viruses, prompting new genotype nomenclature (using B, C, D) (3). Third, South America’s H5N1 epizootic is unique in establishing mammal-to-mammal transmission in marine mammals, enabled by the H5N1 (B3.2) virus acquiring mammalian-adaptive polymerase basic (PB) 2 mutations (Q591K and D701N) (1,2). That pattern has not occurred in North America, where H5N1 spillover into terrestrial and marine mammals was transient, except in United States dairy cattle (3).

Beyond the ecologic devastation among coastal wildlife, in 2023, H5N1 (B3.2) virus spread widely in birds across mainland South America, leading to poultry and wild bird outbreaks (5–8). Although in 2024 HPAI outbreaks occurred in Brazil and Peru (World Organisation for Animal Health, https://wahis.woah.orgExternal Link), there were no detections in Argentina during March 2024–January 2025.

The Study

On February 11, 2025, Servicio Nacional de Sanidad y Calidad Agroalimentaria (SENASA; Buenos Aires, Argentina), Argentina’s national organization for agricultural health and safety, was notified of an outbreak in a mixed backyard flock (chickens, ducks, and turkeys) in Chaco Province, northern Argentina. The flock experienced high mortality (33/81 chickens, 37/99 ducks) in just 1 week. When we inspected the living flock, two thirds of the remaining 48 chickens had diarrhea and 1 of the remaining 62 ducks was lethargic; 2 turkeys were asymptomatic.

The household was located within a remnant fragment of the Dry Chaco biome, a hot and semi-arid tropical dry forest, surrounded by agriculture cropland. The affected flock had free access to a small pond frequently visited by wild waterfowl (Appendix 1). We depopulated and disinfected the area. We inspected backyard poultry within the 3 km perifocal zone (1 household) and the 3–10 km surveillance zone (7 households) and detected no illness or death. We did not find any affected wildlife on site.

       (SNIP) 

Conclusions

We have documented a reassortment event between HPAI H5N1 and endemic South America LPAI viruses. South American PB2 and PA segments are divergent from global AIV diversity (9) (Figure 1), indicating reassortment has expanded H5N1 polymerase diversity. Although the H5N1-Arg_Feb2025 viruses have exchanged 5 gene segments, they retained the original Eurasian MP segment (Figure 2), which remains conserved in most reassortant H5N1 viruses in North America. That segment conservation suggests the Eurasian MP segment might confer a selective advantage in HPAI H5 viruses. To date, we found no evidence of those novel 4:3:1 triple reassortant viruses in other South America countries; however, if future detections confirm wider spread, designation of a new H5N1 genotype would be warranted. Of consequence, genotyping tools such as the US Department of Agriculture’s GenoFlu should be expanded to include South American lineage genes for systematic classification of new virus genotypes.

(SNIP)

Further research on the diversity of LPAI viruses circulating in Neotropical wildlife will be essential to understand potential interactions between H5N1 and South American lineage strains and to assess the long-term consequences of the introduction of HPAI viruses into the region. Our findings underscore the critical importance of sustained influenza surveillance coupled with whole-genome sequencing to track the evolution of HPAI H5N1 and support efforts to control and mitigate its effect on domestic animals, wildlife, and human health.

Dr. Vanstreels is a veterinarian and an associate researcher with the Karen C. Drayer Wildlife Health Center at the University of California, Davis. His research interests include South American and Antarctic wildlife health, with a special interest in the ecology and effects of highly pathogenic avian influenza H5N1 on wild bird and marine mammal populations.

As the following FAO map illustrates, there are large swaths of the globe where the HPAI virus is presumably circulating, but which provide little (or no) surveillance and/or reporting.  

Blind spots include all of Russia, Central Asia, much of Africa, Northern Canada, and the interior of South America (note: Australia/NZ are testing, but the virus has not shown up yet).

While many of these  regions are impossibly remote, or lack the resources to do in-depth surveillance, there are many countries that simply choose not to report outbreaks for political or economic reasons.

Once again (see here, here, here, here, and here) the authors of today's report call for improved influenza surveillance and the timely reporting of data. 

And rightly so - because with rapidly evolving HPAI viruses - what we don't know can hurt us.  

CDC H5 Bird Flu Update (Nov 18th)

#18,429

It's been a busy week, with HPAI reported for the first time in Hawaii, the first human infection in Oregon, another huge jump in infected dairy herds in California, and the addition of 7 human cases to the CDC's list.

Late yesterday the CDC published a lengthy update on HPAI H5, including a summary of the latest laboratory findings (see below).  

Of particular interest, they report finding the NA-S247N mutation in 3 poultry workers from Washington state, which has been previously linked to modestly reduced susceptibility to the antiviral oseltamivir (aka Tamiflu).  

Regular readers will recognize this as one of two mutations (I223V/S247N) which have increasingly turned up in A(H1N1)pdm09 viruses in recent yeas, which have sparked a number of studies, including:

EID Journal: Multicountry Spread of Influenza A(H1N1)pdm09 Viruses with Reduced Oseltamivir Inhibition, May 2023–February 2024

The Lancet Correspondence: Global Emergence of Neuraminidase Inhibitor-Resistant Influenza A(H1N1)pdm09 Viruses with I223V and S247N Mutations

Compared to the more common H275Y mutation- which can produce a 900-fold reduction in oseltamivir effectiveness - the impact of the NA-S247N mutation alone is relatively small, but in combination with other known resistance mutations, it can have a much more serious impact. 

Due to its length, I've only posted some excerpts, so follow the link to read it in its entirety. 

Situation Update

November 18, 2024 – CDC continues to respond to the public health challenge posed by a multistate outbreak of avian influenza A(H5N1) virus, or "H5N1 bird flu," in dairy cows, poultry and other animals in the United States. CDC is working in collaboration with the U.S. Department of Agriculture (USDA), the Food and Drug Administration (FDA), Administration for Strategic Preparedness and Response (ASPR), state public health and animal health officials, and other partners using a One Health approach.

Since April 2024, CDC, working with state public health departments, has confirmed avian influenza A(H5) virus infections in 52 people in the United States. Twenty-one of these cases were associated with exposure to avian influenza A(H5N1) virus -infected poultry and 30 were associated with exposure to infected dairy cows [A][B]. The source of the exposure in one case, which was reported by Missouri on September 6, could not be determined.

The 52 cases include 26 cases among dairy farm workers in California, five of which were confirmed by CDC on November 13 and 14, and one additional case in a poultry farm worker in Oregon. This is the first human case of H5N1 bird flu reported in Oregon. All recent cases have occurred in workers on affected farms. All available data so far suggest sporadic instances of animal-to-human spread. These farm workers all described mild symptoms, many with eye redness or discharge (conjunctivitis). Some workers who tested positive in Washington reported some mild upper respiratory symptoms. None of the workers were hospitalized.

CDC is aware of the human case of H5N1 bird flu reported in Canada and is in communication with the Public Health Agency of Canada (PHAC), which has confirmed that the case was caused by an H5N1 virus that is different than those causing outbreaks in dairy cows and other animals in the United States. More information about the case in Canada and ongoing epidemiological investigation is available in a statement from PHAC. Updated case counts for the United States, including by state and source of exposure, are recorded in a table on CDC's website. To date, person-to-person spread of H5 bird flu has not been identified in the United States. CDC believes the immediate risk to the general public from H5 bird flu remains low, but people with exposure to infected animals are at higher risk of infection.

On the animal health side, since March 2024, USDA has confirmed infected cattle in 505 dairy herds in 15 U.S. states. The number of affected herds continues to grow nationally, with almost all new infections identified in herds in California. USDA reports that, since April 2024, there have been H5 detections in 50 commercial poultry flocks and 38 backyard flocks, for a total of 25.61 million birds affected.

Among other activities reported in previous spotlights and ongoing, recent highlights of CDC's response to this include:

Laboratory Update

To date, CDC has confirmed 11 human cases of H5 bird flu in poultry farm workers in Washington. Genetic sequencing of influenza virus from clinical specimens from these cases showed no changes in the hemagglutinin (HA) associated with increased infectivity or transmissibility among people. However, in influenza specimens from three of these H5 cases, CDC identified a change, NA-S247N, that may slightly reduce susceptibility to the neuraminidase inhibitor oseltamivir in laboratory tests.

NA-S247N has been detected sporadically in seasonal influenza viruses and has rarely been found in A(H5N1) viruses. Historically, two H5N1 viruses with the NA-S247N change have been tested for susceptibility to oseltamivir: an A(H5N1) virus collected from a chicken in Laos in 2008 (A/chicken/Laos/13/2008; PMID: 20016036) and a clade 2.3.4.4b H5N1 virus collected from a dolphin in Florida in 2022 (A/dolphin/Florida/2022; PMID: 37494978 and PMID: 38637646). These laboratory studies found either mildly reduced or reduced inhibition by oseltamivir, with results well below what has been reported for oseltamivir resistance of other influenza viruses.

It is important to note that this change is not spreading in H5 viruses. Additionally, this change is not expected to have an impact on the ability of influenza viruses to replicate or spread more easily. While NA-S247N may slightly reduce antiviral susceptibility in laboratory testing, that is NOT the same as resistance. Results of laboratory studies demonstrating mildly reduced or reduced inhibition by oseltamivir may not indicate reduced effectiveness of antiviral treatment of a patient with H5N1 virus infection. NA-S247N is unlikely to have a meaningful impact on the clinical benefit of oseltamivir, which is the currently recommended antiviral for treatment for H5 bird flu. CDC continues to recommend oseltamivir for treatment of patients with H5N1 and for post-exposure prophylaxis of close contacts of confirmed H5N1 patients and those with higher risk exposures to animals infected with H5N1 viruses.

Due to low viral RNA concentrations in clinical specimens from these three cases and unsuccessful attempts to isolate virus in culture, multiple sequencing attempts were required to generate data sufficient to meet CDC quality thresholds for posting of partial NA sequences.

CDC also identified a different change in the polymerase acidic (PA) protein of a virus collected from a recently confirmed human case of H5N1 bird flu in California (A/California/150/2024). This change, PA-I38M, is associated with decreased susceptibility to the influenza antiviral medication baloxavir marboxil and has been sporadically detected in a small number of avian influenza viruses.

Baloxavir is not currently recommended for treatment or post-exposure prophylaxis of H5N1 virus infection. As indicated above, oseltamivir is the recommended antiviral treatment for H5N1 bird flu. No H5N1 patients in the U.S. have received baloxavir treatment for H5N1. There are no available data on baloxavir treatment of H5N1 patients worldwide. And the optimal dosing and duration of baloxavir for treatment or post-exposure prophylaxis of H5N1 virus infection in humans are unknown.

Influenza genetic sequence data from these and other recently confirmed cases of H5 bird flu in humans have been posted in GISAID and GenBank. Additional laboratory investigations are ongoing and planned at CDC to better understand the implications of these changes in the context of the currently spreading H5 viruses. In summary, although these particular changes have not been detected widely and are not spreading among dairy cattle or birds, these findings underscore the importance of ongoing surveillance and testing to analyze H5 viruses for any changes that could potentially impact their susceptibility to flu antiviral medications.

         (Continue . . . )

By itself, NA-S247N is unlikely to cause antiviral treatment failures, but in concert with other specific mutations (e.g. H275Y, I223V, etc.) it could become more of a factor.  

Continued monitoring for this, and other resistance mutations, remains critically important. 

For more on antiviral resistance in HPAI H5 viruses, you may wish to revisit:

Antiviral Research: Antiviral susceptibility of clade 2.3.4.4b HPAI H5N1 Viruses Isolated From Birds & Mammals in the United States, 2022

Hawaii: Taking The Pandemic Issue To The People

 

 

# 3012

 

 

Tonight, and on the following two Wednesday nights, NBC affiliate KHNL-8 TV will bring a one-hour panel discussion to the residents of Hawaii on the dangers of a pandemic and the need to prioritize any vaccine that might be available.

 

These show will air between 8pm-9pm.   That’s right.  Prime Time.  

 

And for those not in Hawaii – the show will be streamed live online at WWW.KHNL.COM.   Of course, the airtime will be in the middle of the night for those of us on the mainland.

Here is the schedule of airdates:

Vaccine: Surviving Hawaii's Next Pandemic

News Links

 

Preparing Hawaii for the next pandemic

Three one-hour panel discussions airing live on KHNL NBC 8 and live streaming on KHNL.com.

First program: Wednesday, April 15 8:00 PM HST on KHNL NBC 8 rebroadcast on Sunday on K5 The Home Team on Sunday, April 19 at 6:00 PM HST.

Second program: Wednesday, April 22 8:00 PM HST on KHNL NBC 8 rebroadcast on Sunday on K5 The Home Team on Sunday, April 26 at 6:00 PM HST.

Third program: Wednesday, April 29 8:00 PM HST on KHNL NBC 8 rebroadcast on Sunday on K5 The Home Team on Sunday, May 3 at 6:00 PM HST.

Viewers will be able to call in or email questions or comments.

This is just the start of a public awareness campaign kicking off in the island state of Hawaii where emergency officials are keenly aware of just how vulnerable their population could be in a pandemic.

 

The 1.2 million residents of Hawaii lie at the crossroads of the Pacific. Honolulu International Airport handles in excess of 21 million air travelers a year, with many travelers arriving each day from countries currently dealing with the H5N1 virus.

 

During a prolonged pandemic, Hawaii could also find itself at the end of a very long, and potentially broken, supply chain.

 

KHNL reports on the  upcoming broadcasts with this article. If you travel to their webpage, you’ll find a video report as well.

 

 

 

Preparing Hawaii for the next pandemic

Posted: April 15, 2009 01:02 AM

By Mari-Ela David

HONOLULU (KHNL) - Several thousand people in Hawaii died from the Spanish Flu Pandemic in 1918, and the islands saw even more deaths in the 1957 and 1968 pandemics.

 

When the next one hits, who should be the first to get a vaccine? Children? Mothers? The elderly?

The Department of Health wants the public's opinion.

 

<SNIP>

 

"Hawaii is in the crossroads. We are the gateway to the Asian countries," said Nerurkar.

 

Right now, the virus hasn't transformed where it can be passed from human to human, but when it does, and spreads worldwide you have a pandemic.

 

In Honolulu?

 

"We'll have a pandemic situation arising in a matter of days. That fast because once the virus comes in here by the time you know the virus is here, it's already infecting people," said Nerurkar.

(Continue . . .)

 

 

And coming in Mid-May, something completely different.

 

An online pandemic simulation-role playing game called Coral Cross.   

 

 

The website isn’t `live’ yet, but a few details are emerging on this `playable scenario’  that has been developed by the Hawaii State Department of Health and the Hawaii Research Center For Future Studies.

 

 

Here is a screen-shot of the Coral Cross website.

 

 

 

ARGNET, the Alternate Reality Gaming Network, has a preview of this `game’ on their website.

 

 

Coral Cross: Pandemic Preparedness from the Hawaii Department of Health

April 12, 2009 · By Michael Andersen

(excerpt)

The game is scheduled to launch during the second half of May, with each day representing one month of game time. While anyone can play, the game’s core audience will be located in Hawaii, particularly the island of Oahu. As Stuart Candy, researcher at the Hawaii Research Center for Futures Studies, explains,

 

First, we can make use of the limited geography — a captive audience, if you like — by using more real-life elements to augment the storytelling. Second, as a member of our design team observed, the fact that we’re tackling a global topic, pandemic flu, with a local tilt, not only gives it an interesting flavour, but it also helps the scenario. Instead of trying to evoke every last thing about how the world could transform as a result of a deadly disease sweeping across it, the island acts as a sort of microcosm in which, no matter where they’re from, people will be able to see what’s at stake more clearly and concretely, in particular how lives and communities are affected.

 

By restricting the geographic field of gameplay to a limited area, Coral Cross will hopefully be able to address the impact pandemics will have on local communities and social structures while providing a truly immersive experience for the participants.

 

 

For more on the how the Coral Cross scenario was developed, you can go to the Hawaii Research Center For Future Studies and read about the project.

 

As the website informs us:

 

Coral Cross is free and will run in the second half of May. Anyone interested can now visit coralcross.org to sign up.

 

I’m guessing a lot of my readers will.