Here’s the latest you need to know about bird flu

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What you need to know

  • Although bird flu continues to spread in wild birds, livestock, and humans, the risk to the public remains low.
  • The majority of U.S. bird flu cases have been reported in farm workers who had direct contact with infected birds and cattle. Health officials are working to monitor the spread of the virus and improve protections for those most at risk.
  • Recent data suggests that mutations in bird flu viruses could make them more dangerous to humans and potentially increase the risk of a pandemic.
  • On January 6, Louisiana health officials confirmed the first U.S. death from bird flu.

Throughout 2024, dozens of human cases of H5N1 bird flu were detected as the virus spreads rapidly in livestock. The current risk to humans is low but not nonexistent. Here’s everything you need to know about the current status and future outlook of H5 bird flu in the United States.

Current U.S. bird flu status (as of January 6, 2025)

As of January 6, 66 human bird flu cases have been reported in eight states. Over half of all cases are in California. The state’s governor declared a state of emergency as a “proactive” action against bird flu on December 18. 

On January 6, the Louisiana Department of Health reported the first U.S. bird flu death. The patient, a man over age 65, was previously confirmed to be the first severe bird flu case in the U.S. and the first case linked to backyard flocks. The department emphasized that the risk to the public is low and that no new cases or evidence of human transmission have been detected in the state.

All but two human bird flu cases this year were in farm workers who were exposed to infected livestock. The exposure source of the remaining cases—one in California and one in Missouri—is unknown. 

The CDC reported on November 22 that a child in California tested positive for bird flu, the first known pediatric bird flu case in the U.S. However, it is unclear how the child contracted the virus, as they had no known contact with infected animals. 

To date, there have been no reports of human transmission of bird flu during the current outbreak. Additionally, most human cases have not been severe, and no deaths have been reported. For these reasons, experts are confident that the bird flu risk to humans remains low. 

“In the short term, there is very little threat,” Dr. Scott Roberts, an infectious diseases specialist with Yale Medicine said. “The risk for the general public is so low,” he emphasized to Yale Medicine.

How the U.S. is monitoring bird flu 

The CDC continues to monitor the circulation of bird flu in humans as part of its year-round flu monitoring. The agency is also working to improve protections for farm workers, who are at the highest risk of contracting bird flu.

In November 2024, the CDC also announced expanded actions and updated guidance for farm workers, including improved access to and training for using personal protective equipment (such as N95 face masks), more rigorous testing procedures, and increased outreach. These updates followed a CDC report finding that 7 percent of participating dairy workers had signs of a recent bird flu infection. A second CDC study, also released in November, found inadequate use of personal protective equipment among dairy workers on farms with bird flu outbreaks. 

After the H5N1 virus was found in raw milk being sold in California, the U.S. Department of Agriculture announced on December 6 that unpasteurized milk must be tested for bird flu. The USDA order also requires dairy farms with positive bird flu cases to cooperate with health officials in disease surveillance. 

Is a bird flu pandemic possible?

In early November, a Canadian teen was hospitalized with bird flu caused by a virus that’s closely related to the H5N1 virus circulating in the U.S. The case has troubled experts for a few reasons. 

First, it is Canada’s first human bird flu case where the patient was not infected while traveling, and the source of exposure is unknown. Second, the teen experienced severe symptoms and developed a lung infection requiring critical care, raising concern that bird flu infections may be more severe in younger people. 

The final and biggest concern about the case is that genetic analysis revealed several changes in the virus’s DNA sequence, called mutations, that could potentially make the virus better able to infect humans. Researchers say that two of those mutations could make it easier for the virus to infect humans, and another one may make it easier for the virus to replicate after infecting a human. However, it’s unclear if the changes occurred before or after the teen was infected.

Scott Hensley, a professor of microbiology at the University of Pennsylvania, told Nature that “this should serve as a warning: this virus has the capacity to switch very quickly into a form that can cause severe disease.”

Notably, even in this more severe case, there is still no evidence of human transmission, which is necessary for a potential bird flu pandemic. However, the case underscores the risk of new and potentially dangerous mutations emerging as the H5N1 virus continues to spread and multiply. 

A study published in Science on December 5 found that a genetic change on a protein on the surface of the virus could make it easier for the virus to attach to and infect human cells. But none of the mutations observed in the Canadian case are those identified in the study. 

Importantly, the researchers stressed that the ability of the virus to attach to a specific part of human cells “is not the only [factor] required for human-to-human transmission of influenza viruses.” 

How to stay safe

Most people are not at high risk of being exposed to bird flu. The virus is spreading between animals and from animals to humans through direct contact. The CDC recommends avoiding the consumption of raw milk products and direct contact with wild birds and potentially infected livestock. 

“Pasteurization kills the bird flu virus and other harmful germs that can be found in raw milk,” says a November 24 California Department of Public Health press release. “CDPH advises consumers not to drink raw milk or eat raw milk products due to the risk of foodborne illnesses.”

Additionally, although the annual flu shot does not protect against bird flu, getting vaccinated helps prevent infection with seasonal flu and bird flu at the same time. In very rare instances, getting infected by two influenza viruses at the same time can result in a combination of genetic material that produces a new virus. 

This phenomenon, known as antigenic shift, triggered the 2009 swine flu pandemic.

Learn more about how to protect yourself and your loved ones against bird flu.

For more information, talk to your health care provider.

This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Fast Exercise – by Dr. Michael Mosley & Peta Bee

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve written before about the benefits of High-Intensity Interval Training (HIIT), but there’s more to say than we can fit in a short article!

    Dr. Michael Mosley, who hates exercise but knows his stuff when it comes to the benefits, teamed up with Peta Bee, who loves exercise and is a science journalist with degrees in sports science and nutrition, to bring us this book.

    In it, we learn a lot about:

    • the science of HIIT
    • what makes it so different from most kinds of exercise
    • exactly what benefits one can expect

    …in a very detailed clinical fashion (while still remaining very readable).

    By “very detailed clinical fashion”, here we mean “one minute of this kind of exercise this many times per week over this period of time will give this many extra healthy life-years”, for example, along with lots of research to back numbers, and explanations of the mechanisms of action (e.g. reducing inflammatory biomarkers of aging, increasing cellular apoptosis, improving cardiometabolic stats for reduced CVD risk, and many things)

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  • A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    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 KQEDNPR 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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  • Nobody’s Sleeping – by Dr. Bijoy John

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Firstly, let’s mention: yes, for the sake of being methodical and comprehensive this book does give the same baseline advice as every other sleep book out there. However, it gives something else, too:

    It goes beyond that baseline, to a) give more personalized advice for various demographics (e.g. per age, sex, health conditions, etc) and b) give direction for further personalizing one’s own sleep improvement journey, by troubleshooting and fixing things that may pertain to you very specifically and not to most people.

    This means, that if you’re doing “all the right things” but still having sleep-related problems, there is hope and there are more approaches to try.

    The style in which this is delivered is very readable, which is good, because if one hasn’t been sleeping well, then chances are that an intellectual challenge would be about as welcome as a physical challenge—that is to say: not at all.

    Bottom line: if sleep is not your strength and you would like it to be and all the usual things haven’t yet worked, this book may well help you to overcome the hurdles between you and a good night’s sleep each night.

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    The author, an aesthetician with a biotech background, explains about the overlap of skin health and skin beauty, making it better from the inside first (diet and other lifestyle factors), and then tweaking things as desired from the outside.

    In the broad category of “tweakments” as she puts it, she covers most of the wide array of modern treatments available at many skin care clinics and the options for which at-home do-it-yourself kits are available—and the pros and cons of various approaches.

    And yes, those methods do range from microneedling and red light therapy to dermal fillers and thread lifts. Most of them are relatively non-invasive though.

    She also covers common ailments of the skin, and how to identify and treat those quickly and easily, without making things worse along the way.

    One last thing she also includes is dealing with unwanted hairs—being a very common side-along issue when it comes to aesthetic medicine.

    The book is broadly aimed at women, but hormones are not a main component discussed (except in the context of acne), so there’s no pressing reason why this book couldn’t benefit men too. It also addresses considerations when it comes to darker skintones, something that a lot of similar books overlook.

    Bottom line: if you find yourself mystified by the world of skin treatment options and wondering what’s really best for you without the bias of someone who’s trying to sell you a particular treatment, then this is the book for you.

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  • Avocado vs Jackfruit – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing avocado to jackfruit, we picked the avocado.

    Why?

    In terms of macros, avocado is higher in fats (famously healthy ones, including a good dose of omega-3), fiber (nearly 5x more), and protein (despite jackfruit being more often used as a meaty element in recipes, avocado has slightly more). Meanwhile, jackfruit is about 3x higher in carbs. All in all, a clear win for avocado.

    Looking at vitamins, avocado has more of vitamins A, B2, B3, B5, B7, B9, E, K, and choline, while jackfruit has more of vitamins B1, B6, and C. Another win for avocado in this category.

    In the category of minerals, avocado has more copper, iron, manganese, phosphorus, potassium, selenium, and zinc, while jackfruit has more calcium. One more win for avocado.

    Adding up the sections makes for an easy overall win for avocado, but by all means enjoy either or both; diversity is good!

    Want to learn more?

    You might like:

    Jackfruit vs Durian – Which is Healthier? ← including some fun durian facts (such as how to pick a good one, and what happens if you eat durian and drink alcohol)

    Enjoy!

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  • How Regularity Of Sleep Can Be Even More Important Than Duration

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    A recent, large (n=72,269) 8-year prospective* observational study of adults aged 40-79 has found an association between irregular sleep and major cardiovascular events.

    *this means they started the study at a given point, and measured what happened for the next eight years—as opposed to a retrospective study, which would look at what had happened during the previous 8 years.

    As to what qualifies as major cardiovascular events, they counted:

    • Heart attack
    • Cardiac arrest
    • Stroke
    • Cardiovascular death (any)

    Irregular sleep, meanwhile, was defined per a bell curve of participants. Based on a sleep regularity index (SRI) score, those with a score of 87 or more were on the “regular” side of the curve, and those with a score of 72 or lower were on the “irregular” side of the curve.

    What they found is that irregular sleep is associated with major cardiovascular events, regardless of the actual amount of sleep that people got. So in other words, you could be sleeping 9 hours per day, but if it’s a different 9 hours each day, your cardiovascular risk will still be higher.

    How much higher?

    • For those in the middle of the curve (so, moderate irregularity), it was 8% higher than those on the “regular” side.
    • For those on the “irregular” side of the curve, it was 26% higher than those on the “regular” side.

    All of the above is after taking into account confounding variables such as age, physical activity levels, discretionary screen time, fruit, vegetable, and coffee intake, alcohol consumption, smoking, mental health issues, medication use, and shift work. Which is quite something, given that shift work is a very common reason for irregular sleep schedules in a lot of people.

    Limitations

    While, as noted above, they did their best to account for a lot of things, this was an observational study, not an interventional study or a randomized controlled trial, and as such, it cannot truly establish cause and effect.

    For example, an observational study in the 90s found that the sport most strongly associated with longevity was polo. For any unfamiliar, it’s a game played on horseback with mallets and balls. Why was this game so much better than, say, swimming? And the answer is most likely that polo is played almost entirely by very rich people. It wasn’t the sport that enhanced longevity—it was the wealth.

    So similarly here, it could be for example that people who are predisposed to heart conditions, are prone to having irregular schedules. We won’t know for sure until we have interventional studies (and we probably can’t get RCTs for this, for practical reasons).

    Still, it seems likely that the association is indeed causal, in which case, having a regular sleep schedule if at all possible seems like a very good way to look after one’s health.

    You can read more about the study here:

    Irregular sleep may elevate risk of major cardiovascular events

    Practical take-away

    This study strongly suggests that sleep regularity is even more important than sleep duration.

    This means that there is extra reason to not sleep in past one’s normal getting-up time, even if one had a less restful night.

    That’s the end of sleep that’s the most important in practical terms, too, because we can control our getting-up time, whereas we can’t really control our going-to-sleep time, because it’s perfectly possible to just lie there awake.

    So, controlling the getting-up time is really the key to the whole thing. See also:

    Calculate (And Enjoy) The Perfect Night’s Sleep

    And for scope, you might enjoy reading:

    Morning Larks vs Night Owls: How Much Can We Control Our Sleep Schedule?

    Enjoy!

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