Bird flu has been detected in a pig in the US. Why does that matter?
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The United States Department of Agriculture last week reported that a pig on a backyard farm in Oregon was infected with bird flu.
As the bird flu situation has evolved, we’ve heard about the A/H5N1 strain of the virus infecting a range of animals, including a variety of birds, wild animals and dairy cattle.
Fortunately, we haven’t seen any sustained spread between humans at this stage. But the detection of the virus in a pig marks a worrying development in the trajectory of this virus.
How did we get here?
The most concerning type of bird flu currently circulating is clade 2.3.4.4b of A/H5N1, a strain of influenza A.
Since 2020, A/H5N1 2.3.4.4b has spread to a vast range of birds, wild animals and farm animals that have never been infected with bird flu before.
While Europe is a hotspot for A/H5N1, attention is currently focused on the US. Dairy cattle were infected for the first time in 2024, with more than 400 herds affected across at least 14 US states.
Bird flu has enormous impacts on farming and commercial food production, because infected poultry flocks have to be culled, and infected cows can result in contaminated diary products. That said, pasteurisation should make milk safe to drink.
While farmers have suffered major losses due to H5N1 bird flu, it also has the potential to mutate to cause a human pandemic.
Birds and humans have different types of receptors in their respiratory tract that flu viruses attach to, like a lock (receptors) and key (virus). The attachment of the virus allows it to invade a cell and the body and cause illness. Avian flu viruses are adapted to birds, and spread easily among birds, but not in humans.
So far, human cases have mainly occurred in people who have been in close contact with infected farm animals or birds. In the US, most have been farm workers.
The concern is that the virus will mutate and adapt to humans. One of the key steps for this to happen would be a shift in the virus’ affinity from the bird receptors to those found in the human respiratory tract. In other words, if the virus’ “key” mutated to better fit with the human “lock”.
A recent study of a sample of A/H5N1 2.3.4.4b from an infected human had worrying findings, identifying mutations in the virus with the potential to increase transmission between human hosts.
Why are pigs a problem?
A human pandemic strain of influenza can arise in several ways. One involves close contact between humans and animals infected with their own specific flu viruses, creating opportunities for genetic mixing between avian and human viruses.
Pigs are the ideal genetic mixing vessel to generate a human pandemic influenza strain, because they have receptors in their respiratory tracts which both avian and human flu viruses can bind to.
This means pigs can be infected with a bird flu virus and a human flu virus at the same time. These viruses can exchange genetic material to mutate and become easily transmissible in humans.
Interestingly, in the past pigs were less susceptible to A/H5N1 viruses. However, the virus has recently mutated to infect pigs more readily.
In the recent case in Oregon, A/H5N1 was detected in a pig on a non-commercial farm after an outbreak occurred among the poultry housed on the same farm. This strain of A/H5N1 was from wild birds, not the one that is widespread in US dairy cows.
The infection of a pig is a warning. If the virus enters commercial piggeries, it would create a far greater level of risk of a pandemic, especially as the US goes into winter, when human seasonal flu starts to rise.
How can we mitigate the risk?
Surveillance is key to early detection of a possible pandemic. This includes comprehensive testing and reporting of infections in birds and animals, alongside financial compensation and support measures for farmers to encourage timely reporting.
Strengthening global influenza surveillance is crucial, as unusual spikes in pneumonia and severe respiratory illnesses could signal a human pandemic. Our EPIWATCH system looks for early warnings of such activity, which can speed up vaccine development.
If a cluster of human cases occurs, and influenza A is detected, further testing (called subtyping) is essential to ascertain whether it’s a seasonal strain, an avian strain from a spillover event, or a novel pandemic strain.
Early identification can prevent a pandemic. Any delay in identifying an emerging pandemic strain enables the virus to spread widely across international borders.
Australia’s first human case of A/H5N1 occurred in a child who acquired the infection while travelling in India, and was hospitalised with illness in March 2024. At the time, testing revealed Influenza A (which could be seasonal flu or avian flu), but subtyping to identify A/H5N1 was delayed.
This kind of delay can be costly if a human-transmissible A/H5N1 arises and is assumed to be seasonal flu because the test is positive for influenza A. Only about 5% of tests positive for influenza A are subtyped further in Australia and most countries.
In light of the current situation, there should be a low threshold for subtyping influenza A strains in humans. Rapid tests which can distinguish between seasonal and H5 influenza A are emerging, and should form part of governments’ pandemic preparedness.
A higher risk than ever before
The US Centers for Disease Control and Prevention states that the current risk posed by H5N1 to the general public remains low.
But with H5N1 now able to infect pigs, and showing worrying mutations for human adaptation, the level of risk has increased. Given the virus is so widespread in animals and birds, the statistical probability of a pandemic arising is higher than ever before.
The good news is, we are better prepared for an influenza pandemic than other pandemics, because vaccines can be made in the same way as seasonal flu vaccines. As soon as the genome of a pandemic influenza virus is known, the vaccines can be updated to match it.
Partially matched vaccines are already available, and some countries such as Finland are vaccinating high-risk farm workers.
C Raina MacIntyre, Professor of Global Biosecurity, NHMRC L3 Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW Sydney and Haley Stone, Research Associate, Biosecurity Program, Kirby Institute & CRUISE lab, Computer Science and Engineering, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Better Brain – by Dr. Bonnie Kaplan and Dr. Julia Rucklidge
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We’ve reviewed books about eating for brain health before, but this is the first time we’ve reviewed one written by clinical psychologists.
What does that change? Well, it means it less focus on, say, reducing beta amyloid plaques, and more on mental health—which often has a more immediate impact in our life.
In the category of criticisms, the authors do seem to have a bit of a double-standard. For example, they criticise psychiatrists prescribing drugs that have only undergone 12-week clinical trials, but they cite a single case-study of a 10-year-old boy as evidence for a multivitamin treating his psychosis when antipsychotics didn’t work.
However, the authors’ actual dietary advice is nonetheless very respectable. Whole foods, nutrients taken in synergistic stacks, cut the sugar, etc.
Bottom line: if you’d like to learn about the impact good nutrition can have on the brain’s health, ranging from diet itself to dietary supplements, this book presents many avenues to explore.
Click here to check out “The Better Brain”, and eat for the good health of yours!
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Is TikTok right? Are there health benefits to eating sea moss?
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Sea moss is the latest “superfood” wellness influencers are swearing by. They claim sea moss products – usually in gel form – have multiple health benefits. These include supporting brain and immune function, or protecting against viruses and other microbes.
But do these health claims stack up? Let’s take a look.
Plataresca/Shutterstock What is sea moss?
Sea moss is produced using a kind of seaweed – particularly red algae – that grow in various locations all around the world. Three main species are used in sea moss products:
- Chondrus crispus (known as Irish moss or carrageenan moss)
- Eucheuma cottonii (sea moss or seabird’s nest)
- Gracilaria (Irish moss or ogonori).
Some products also contain the brown algae Fucus vesiculosus (commonly known as bladderwrack, black tang, rockweed, sea grapes, bladder fucus, sea oak, cut weed, dyers fucus, red fucus or rock wrack).
Most sea moss products are sold as a gel that can be added to recipes, used in smoothies, frozen into ice cubes or eaten on its own. The products also come in capsule form or can be purchased “raw” and used to make your own gels at home.
Several kinds of red algae are used in commercially-available sea moss products. Nancy Ann Bowe/Shutterstock What’s the evidence?
Sea moss products claim a host of potential health benefits, from supporting immunity, to promoting skin health and enhancing mood and focus, among many others.
But is there any evidence supporting these claims?
Recent studies have reviewed the biological properties of the main sea moss species (Chondrus crispus, Eucheuma cottonii, Gracilaria and Fucus vesiculosus).
They suggest these species may have anti-inflammatory, antioxidant, anticancer, antidiabetic and probiotic properties.
However, the vast majority of research relating to Chondrus crispus, Gracilaria and Fucus vesiculosus – and all of the research on Eucheuma cottonii – comes from studies done in test tubes or using cell and animal models. We should not assume the health effects seen would be the same in humans.
In cell and animal studies, researchers usually administer algae in a laboratory and use specific extracts rich in bioactive compounds rather than commercially available sea moss products.
They also use very different – often relatively larger – amounts compared to what someone would typically consume when they eat sea moss products.
This means the existing studies can’t tell us about the human body’s processes when eating and digesting sea moss.
Sea moss may have similar effects in humans. But so far there is very little evidence people who consume sea moss will experience any of the claimed health benefits.
Nutritional value
Eating sea moss does not replace the need for a balanced diet, including a variety of fruits and vegetables.
Chondrus crispus, Eucheuma cottonii and Gracilaria, like many seaweeds, are rich sources of nutrients such as fatty acids, amino acids, vitamin C and minerals. These nutrients are also likely to be present in sea moss, although some may be lost during the preparation of the product (for example, soaking may reduce vitamin C content), and those that remain could be present in relatively low quantities.
There are claims that sea moss may be harmful for people with thyroid problems. This relates to the relationship between thyroid function and iodine. The algae used to make sea moss are notable sources of iodine and excess iodine intake can contribute to thyroid problems, particularly for people with pre-existing conditions. That is why these products often carry disclaimers related to iodine sensitivity or thyroid health.
Is it worth it?
So you may be wondering if it’s worth trying sea moss. Here are a few things to consider before you decide whether to start scooping sea moss into your smoothies.
A 375mL jar costs around $A25–$30 and lasts about seven to ten days, if you follow the recommended serving suggestion of two tablespoons per day. This makes it a relatively expensive source of nutrients.
Sea moss is commonly sold as a gel that can be eaten on a kitchen bench. April Sims/Shutterstock Sea moss is often hyped for containing 92 different minerals. While there may be 92 minerals present, the amount of minerals in the algae will vary depending on growing location and conditions.
The efficiency with which minerals from algae can be absorbed and used by the body also varies for different minerals. For example, sodium is absorbed well, while only about 50% of iodine is absorbed.
But sea moss has also been shown to contain lead, mercury and other heavy metals – as well as radioactive elements (such as radon) that can be harmful to humans. Seaweeds are known for their ability to accumulate minerals from their environment, regardless of whether these are beneficial or harmful for human nutrition. Remember, more doesn’t always mean better.
What else am I eating?
While you won’t get a full nutritional breakdown on the jar, it is always wise to check what other ingredients you may be eating. Sea moss products can contain a range of other ingredients, such as lime, monk fruit powder, spirulina and ginger, among many others.
These ingredients differ between brands and products, so be aware of your needs and always check.
Despite their health claims, most sea moss products also carry disclaimers indicating that the products are not intended to diagnose, treat, cure or prevent any disease.
If you have concerns about your health, always speak to a health professional for accurate and personalised medical advice.
Margaret Murray, Senior Lecturer, Nutrition, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It?
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A much-awaited treatment for postpartum depression, zuranolone, hit the market in December, promising an accessible and fast-acting medication for a debilitating illness. But most private health insurers have yet to publish criteria for when they will cover it, according to a new analysis of insurance policies.
The lack of guidance could limit use of the drug, which is both novel — it targets hormone function to relieve symptoms instead of the brain’s serotonin system, as typical antidepressants do — and expensive, at $15,900 for the 14-day pill regimen.
Lawyers, advocates, and regulators are watching closely to see how insurance companies will shape policies for zuranolone because of how some handled its predecessor, an intravenous form of the same drug called brexanolone, which came on the market in 2019. Many insurers required patients to try other, cheaper medications first — known as the fail-first approach — before they could be approved for brexanolone, which was shown in early trials reviewed by the FDA to provide relief within days. Typical antidepressants take four to six weeks to take effect.
“We’ll have to see if insurers cover this drug and what fail-first requirements they put in” for zuranolone, said Meiram Bendat, a licensed psychotherapist and an attorney who represents patients.
Most health plans have yet to issue any guidelines for zuranolone, and maternal health advocates worry that the few that have are taking a restrictive approach. Some policies require that patients first try and fail a standard antidepressant before the insurer will pay for zuranolone.
In other cases, guidelines require psychiatrists to prescribe it, rather than obstetricians, potentially delaying treatment since OB-GYN practitioners are usually the first medical providers to see signs of postpartum depression.
Advocates are most worried about the lack of coverage guidance.
“If you don’t have a published policy, there is going to be more variation in decision-making that isn’t fair and is less efficient. Transparency is really important,” said Joy Burkhard, executive director of the nonprofit Policy Center for Maternal Mental Health, which commissioned the study.
With brexanolone, which was priced at $34,000 for the three-day infusion, California’s largest insurer, Kaiser Permanente, had such rigorous criteria for prescribing it that experts said the policy amounted to a blanket denial for all patients, according to an NPR investigation in 2021.
KP’s written guidelines required patients to try and fail four medications and electroconvulsive therapy before they would be eligible for brexanolone. Because the drug was approved only for up to six months postpartum, and trials of typical antidepressants take four to six weeks each, the clock would run out before a patient had time to try brexanolone.
An analysis by NPR of a dozen other health plans at the time showed Kaiser Permanente’s policy on brexanolone to be an outlier. Some did require that patients fail one or two other drugs first, but KP was the only one that recommended four.
Miriam McDonald, who developed severe postpartum depression and suicidal ideation after giving birth in late 2019, battled Kaiser Permanente for more than a year to find effective treatment. Her doctors put her on a merry-go-round of medications that didn’t work and often carried unbearable side effects, she said. Her doctors refused to prescribe brexanolone, the only FDA-approved medication specifically for postpartum depression at the time.
“No woman should suffer like I did after having a child,” McDonald said. “The policy was completely unfair. I was in purgatory.”
One month after NPR published its investigation, KP overhauled its criteria to recommend that women try just one medication before becoming eligible for brexanolone.
Then, in March 2023, after the federal Department of Labor launched an investigation into the insurer — citing NPR’s reporting — the insurer revised its brexanolone guidelines again, removing all fail-first recommendations, according to internal documents recently obtained by NPR. Patients need only decline a trial of another medication.
“Since brexanolone was first approved for use, more experience and research have added to information about its efficacy and safety,” the insurer said in a statement. “Kaiser Permanente is committed to ensuring brexanolone is available when physicians and patients determine it is an appropriate treatment.”
“Kaiser basically went from having the most restrictive policy to the most robust,” said Burkhard of the Policy Center for Maternal Mental Health. “It’s now a gold standard for the rest of the industry.”
McDonald is hopeful that her willingness to speak out and the subsequent regulatory actions and policy changes for brexanolone will lead Kaiser Permanente and other health plans to set patient-friendly policies for zuranolone.
“This will prevent other women from having to go through a year of depression to find something that works,” she said.
Clinicians were excited when the FDA approved zuranolone last August, believing the pill form, taken once a day at home over two weeks, will be more accessible to women compared with the three-day hospital stay for the IV infusion. Many perinatal psychiatrists told NPR it is imperative to treat postpartum depression as quickly as possible to avoid negative effects, including cognitive and social problems in the baby, anxiety or depression in the father or partner, or the death of the mother to suicide, which accounts for up to 20% of maternal deaths.
So far, only one of the country’s six largest private insurers, Centene, has set a policy for zuranolone. It is unclear what criteria KP will set for the new pill. California’s Medicaid program, known as Medi-Cal, has not yet established coverage criteria.
Insurers’ policies for zuranolone will be written at a time when the regulatory environment around mental health treatment is shifting. The U.S. Department of Labor is cracking down on violations of the Mental Health Parity and Addiction Equity Act of 2008, which requires insurers to cover psychiatric treatments the same as physical treatments.
Insurers must now comply with stricter reporting and auditing requirements intended to increase patient access to mental health care, which advocates hope will compel health plans to be more careful about the policies they write in the first place.
In California, insurers must also comply with an even broader state mental health parity law from 2021, which requires them to use clinically based, expert-recognized criteria and guidelines in making medical decisions. The law was designed to limit arbitrary or cost-driven denials for mental health treatments and has been hailed as a model for the rest of the country. Much-anticipated regulations for the law are expected to be released this spring and could offer further guidance for insurers in California setting policies for zuranolone.
In the meantime, Burkhard said, patients suffering from postpartum depression should not hold back from asking their doctors about zuranolone. Insurers can still grant access to the drug on a case-by-case basis before they formalize their coverage criteria.
“Providers shouldn’t be deterred from prescribing zuranolone,” Burkhard said.
This article is from a partnership that includes KQED, NPR and KFF Health News.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Yoga that Helps You on the Loo
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How This Video Helps You Poo
When you’re feeling a bit bloated, Yoga With Bird’s 10-minute yoga routine promises to help you release…your gas. And, perhaps, more.
From a tabletop flow to soothing twists, each pose allows you to sync your breath with movement, helping to promote organic relief.
With options to modify with pillows for extra support, this video (below) caters to everyone needing a digestive reset.
Other Toilet Tricks
If yoga isn’t your thing, or you’re interested in trying to use different methods to make your visits to the bathroom a bit easier, we’ve spoken about the ways to manage gut health, and use of probiotics or fiber, and even the prevention of hemorrhoids.
Namaste and goodbye to bloat!
How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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Make Time – by Jake Knapp and John Zeratzky
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We live in an information-saturated world, and we have done for so long now that it’s easy to forget: we did not evolve for this!
It’s easy to say “unplug”, but the reality is:
We also have to actually function in this fast-paced info-dense world whether we want to or not, and we are expected to be able to handle it.
So… How?
Appropriately enough, authors Knapp and Zeratsky present the answer in a skimmer-friendly fashion, with summaries and bullet points and diagrams and emboldened text forease of speed-reading. Who uses such tricks?!
In short, less living life in “default mode scramble” and more about making an impact in the ways you actually want to, for you.
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Real Self-Care – by Pooja Lakshmin MD
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As the subtitle says, “crystals, cleanses, and bubble baths not included”. So, if it’s not about that sort of self-care, what is it about?
Dr. Lakshmin starts by acknowledging something that many self-help books don’t:
We can do everything correctly and still lose. Not only that, but for many of us, that is the probable outcome. Not because of any fault or weakness of ours, but simply because one way or another the game is rigged against us from the start.
So, should we throw in the towel, throw our hands in the air, and throw the book out of the window?
Nope! Dr. Lakshmin has actually helpful advice, that pertains to:
- creating healthy boundaries and challenging guilt
- treating oneself with compassion
- identifying and aligning oneself with one’s personal values
- asserting one’s personal power to fight for one’s own self-interest
If you’re reading this and thinking “that seems very selfish”, then let’s remember the “challenging guilt” part of that. We’ve all-too-often been conditioned to neglect our own needs and self-sacrifice for others.
And, while selfless service really does have its place, needlessly self-destructive martyrdom does not!
Bottom line: this book delivers a lot of “real talk” on a subject that otherwise often gets removed from reality rather. In short, it’s a great primer for finding the right place to draw the line between being a good-hearted person and being a doormat.
Click here to check out Real Self-Care and “put your own oxygen mask on first”!
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