Everything You Need to Know About H5N1 Bird Flu

An article with ongoing updates.

Photo by National Institute of Allergy and Infectious Diseases on Unsplash

Something is happening, and we knew it would.

A recent piece in Bloomberg has finally declared in the mainstream what some of us have been saying for two years now:

Bird flu is a big threat, and we should take it more seriously.

It could be spreading through the wind via aerosolized bird droppings from ducks, which “could explain several of the 67 recent human cases with no known route of exposure.” In other words, you could be exposed to bird flu just by going to a park or being near wild birds, via their droppings. As we head into migration season, that’s not the best news in the world. But it’s also just as likely that H5N1 is showing early signs of airborne transmission. We’re seeing the most flu activity in 15 years, and some of us have even been getting text messages from local pharmacies about the unusually high flu activity in our areas.

Instead of investigating, the current administration has twisted the previous one’s apathy and neglect into a more malicious, intentional campaign to suppress information about the virus. As the Trump team suspends regular flu reporting to WHO agencies, they’ve also just gutted the CDC’s ability to track diseases, eliminating the Epidemic Intelligence Service.

This feels very intentional.

As one important account recently announced, a surge of Flu A has started to overwhelm hospitals as patients go on ventilators in Indiana as well as New York. Hospitals are trying to subtype the virus, but we don’t have much more information than that. On a related note, coroners are starting to report a substantial uptick in dead bodies. As Darin Wolfe posted, “The only time in [my] medical career I’ve seen this… is during the absolute height of Covid.”

It’s worth remembering the 1918 flu appeared mild at first, so mild that doctors around the world dismissed it as harmless. Then it mutated into something highly contagious and deadly. The Woodrow Wilson administration devoted their energy to censoring information and manipulating public sentiment instead of preparing. As historian Guy Beiner notes in Pandemic Re-Awakenings, the 1918 flu caused more devastation than previously understood, with higher mortality and disability tolls than reported, and it likely altered the course of human history, beginning with the rise of fascism. It might be about to happen again.

The Trump administration is operating from the Woodrow Wilson playbook. It’s also worth noting that, like Trump and his team, Wilson was a card-carrying eugenicist who believed only “the strong” should survive. Bird flu could ignite a pandemic in a global population whose immune systems are already beaten down by another disease. Once again, this would echo how the 1918 pandemic began, by targeting soldiers who had already been trounced by measles and pneumonia.

As this virus continues to make headlines, we’re all left wondering what’s going to happen next, when it will become officially airborne, whether it’s safe to consume meat or dairy products, and what we should do to prepare. Last year, I started gathering information about the virus and how to get ready.

We’re not going to get answers from our leaders.

So, here they are:

Can you get sick from dairy products?

Yes, you can get sick from drinking raw milk.

Pasteurization works for now.

Studies have found that cats and mice can both catch bird flu from raw milk. A recent study in Emerging Infectious Diseases found that infected milk killed several cats, leading the authors to conclude that raw milk "might potentially transmit infection to other mammals via unpasteurized milk." Another recent study in the New England Journal of Medicine found that not only does raw milk infect mice, but it remains infectious for up to five weeks when it's refrigerated.

If you’re concerned about cheese, you can buy hard cheeses like sharp and extra sharp cheddar aged for a year or longer. You can also find plant-based cheeses and sour cream. (They taste just fine.)

Public health officials and major media outlets have ensured everyone that meat and dairy products remain safe, but they're just guessing. One recent study suggests that the normal pasteurization process isn't always enough to kill the virus, and that we should be upping our standards.

The USDA has refused.

According to Alexander Tin's notes from a conference call with public health agencies, officials didn’t want to raise the standards of pasteurization for milk because it could hurt the flavor. The principal deputy director of the CDC (Nirav Shah), said they have plenty of testing capacity for bird flu, but they're not using it because they're worried about "happening just to pick up a stray amount of virus from their nasal passage..." With the new administration, you can count on seeing even more of this attitude.

So, that’s your risk from dairy.

Can you get sick from meat?

Yes, you can.

That's why we have publications like The Journal of Food Protection, dedicated entirely to protecting our food from dangerous diseases. Very recently, they published a study explaining that if you're going to insist on eating chicken, eggs, and beef, make sure you cook them thoroughly to an internal temperature of 71.1C (160F). Don't eat them raw or even rare. Also, fun fact: About 10 percent of American beef products come from culled dairy cows. Given that bird flu infections in dairy cattle have triggered a state of emergency in California, that’s worth remembering. It’s extremely unlikely that other states won’t see similar emergencies.

Just recently, bird flu infections have halted all poultry sales in Georgia, the nation’s largest producer—for the first time.

Other mammals can get sick from eating infected meat. We know for a fact that bears, foxes, seals, sea lions, and dogs have gotten sick and died from bird flu by eating dead birds. As experts tell us about these infections, "we see carnivores...particularly those that are known to scavenge."

The Biden administration was already failing to hire enough meat inspectors and avoiding overtime pay for their current ones. According to one update, the federal food safety program “can’t focus on food inspection as they have other duties and have to travel to two to five plants in one day.” As you can already tell, the Trump administration will make the situation even worse.

H5N1 doesn't care if you're a fox or a human.

That’s your risk from meat.

How long can bird flu last in meat?

Generally, it can last for weeks.

A 2021 study in The Lancet found that the H7N9 strain of highly pathogenic bird flu can survive in raw poultry for up to nine days at -20C degrees and up to four days at 25C degrees. The H5N1 strain of bird flu lasts much longer. A 2017 study in Applied and Environmental Microbiology found that "tissue type could strongly affect viral survival." H5N1 can survive in muscle tissue (meat) for 100 to 160 days at 4C degrees and 8-14 days at 20C degrees. The virus can survive longer in feathers, up to 240 days at 4C degrees. The authors review previous studies that found H7N1 virus can survive for 135 days in meat at 4C degrees. Other studies of similar viruses found survival lengths of 40-81 days in poultry meat at 0C degrees, 11 to 14 days at 10C degrees, and 2-3 days at 20C degrees.

So we have a good sense that H5N1 lasts for months in the refrigerator, and probably even longer in the freezer. That's not great news for meat lovers, and it puts extra pressure on them to cook their meat properly.

Or maybe just give it up.

Is bird flu airborne?

We're seeing the early signs of airborne respiratory spread.

A study in the Journal of General Virology found that H5N1 can now replicate in "bovine airway epithelial cells." The researchers documented "rapid increases in viral genome loads and infectious virus during the first 24 hours post-inoculation." Their discussion confirms that the more practice this virus gets at infecting mammals, the better it gets at replicating and shedding in respiratory tracts and airways. Another study in Nature found that H5N1 has started mutating to infect human airways. So, it’s learning to jump from cows to humans.

Why is all this taking so long?

One little gene called BTN3A3 protects the upper and lower respiratory tracts of humans from infection. Researchers at the University of Glasgow Center for Virus Research discovered it last year and published their findings in Nature. The lead author did an interview with Reuters, where he said, "About 50 percent of H5N1 strains circulating globally so far in 2023 are resistant to BTN3A3." Once the virus overcomes that barrier, human cases will go up.

Most of the corporate media coverage has emphasized how "mild" the infections are, but they’re wrong. They describe eye bleeds as “pink eye,” and they’ve downplayed the fact that cases of bird flu have been resulting in hospitalization. Furthermore, as history shows, the 1918 bird flu began as a mild infection and then evolved to become more contagious and deadly.

We’re on that path.

Are there vaccines? Treatments?

The U.S. will only have 10 million doses of a targeted H5N1 vaccine by spring 2025. That’s not going to be enough. Several companies are working on vaccines and treatments, and the U.S. government has recently awarded Moderna hundreds of millions for H5N1 vaccine development. One company is even on the verge of creating a universal flu antiviral. The question is whether these drugs will become widely accessible. Under Trump, I wouldn’t hold my breath.

Meanwhile, you can go ahead and get your seasonal flu shot. Contrary to what the CDC says, several studies do indicate that a regular shot offers some degree of cross-over protection. That’s because H5N1 shares some genetic similarities with earlier flu viruses. It won’t keep you from getting infected, but it could very well reduce your likelihood of severe illness and death.

It sure beats nothing.

What happens if you get sick?

If you get sick, and you can’t get proper medical attention, there’s a chance that you’ll be dealing with it on your own. It wouldn’t be a bad idea to dig into plant-based treatments, find something that suits your needs, and have some on hand for yourself and the ones you care about.

Here’s a list.

What symptoms should you look for?

Look for neurological symptoms, not just cold symptoms.

In 1918, doctors misdiagnosed the flu as a dozen other major diseases. It caused severe organ and brain damage. We think of the flu as a respiratory virus. It’s not. It’s a multi-system infection that does lasting damage.

(Does that remind you of anything…?)

An article in Science News reviews the research on H5N1 outbreaks in wildlife, including the lesions they're finding in the lungs, hearts, livers, kidneys and brains of infected animals. It's causing seizures and paralysis, just like H1N1 did in 1918. This family of viruses "is exceptionally good at making copies of itself inside a variety of cells, including nerve cells." Lucky us, our brains are "covered in birdlike sialic acid proteins." Similar cells line our nasal passages, creating "a direct entry route to the brain from your nose." You could say we're bird brains.

So we shouldn't just be looking for respiratory symptoms or pink eye. We should also be watching out for neurological signs like disorientation, paralysis, lack of coordination, uncontrolled shaking, and tremors.

It will happen.

How long does H5N1 last on surfaces?

One disturbing study from 2010 in Environmental Science & Technology found that H5N1 can last for two weeks on glass and steel surfaces at temperatures around 39F (3.9C), and up to two months under even cooler temperatures. A 2022 study in Emerging Infectious Diseases found that H5N1 can last longer than most other flu viruses, up 24-26 hours on plastic surfaces and 3-4.5 hours on human skin. Fortunately, disinfectants with 40 percent alcohol solution killed H5N1 and other flu viruses within 15 seconds.

Studies on other viruses have shown that flu and coronaviruses can last several days or up to several weeks. They last longer on hard surfaces like plastic, glass, and steel than porous surfaces like cardboard.

Some people want to know if it's time to start wiping down groceries again. Well, that doesn't sound weird at all. If you want to build a UVC decontamination box to make life easier, this 2020 article in the Journal of Medical Systems explains how. You can also make disinfectants with alcohol or hypochlorous acid to help with surface transmission. You can read more here, here, and here. You can also find various online stores that sell HOCl generators.

Some people have even recommended making nose sprays and humidifier solutions with HOCL, since it’s a compound your immune system already produces to fight infections. I’ve done both, and I’m alive.

So, there’s that.

Should you wear a mask?

Yes, masks work.

Aaron Collins can help you up your mask game.

Despite widely misinterpreted studies about their effectiveness, overwhelming evidence indicates that an N95 mask works when you wear it properly. A major study in eBioMedicine (a Lancet Journal) reached similar conclusions, stating that “an N95 is significantly better than the other options.” The authors of the study have stated very clearly that “N95 masks should be the standard of care in high-risk situations, such as nursing homes and healthcare settings.” They work even without training or fit-testing. How do surgical masks stack up? Not well. In this study, even cloth masks with a good fit outperformed them.

A review of studies by Michael Klompas and Chanu Rhee in the Journal of Infectious Diseases also shows that “surgical masks provide substantially less protection against viral inoculation of the respiratory tract compared to fitted N95 respirators” and refers to “a wealth of real-world studies that document failures of surgical masks worn by healthcare workers… to prevent transmission, as well as case-control studies that found respirators to be more protective than surgical masks.” In fact, the authors end by declaring it’s time for the CDC to update its infection control guidelines in the face of such overwhelming evidence.

In fact, we had a growing body of evidence in favor of N95 masks before the pandemic began. One 2017 study in Influenza and Other Respiratory Viruses found that N95 masks “provide superior protection” for droplets.

You have to keep it on. You can’t take it down to eat or drink in public. You can’t take it down to say hello to someone. You can’t take it down because you think you’re alone. Virus particles remain in the air for hours. That’s why we need clean air, and why we need cities and counties to stop passing mask bans. These efforts actively undermine everyone’s efforts to keep each other safe.

Our governments should be encouraging masks.

They won’t.

Should you wear eye protection?

You should start thinking about eye protection. Don’t just pick up goggles from the hardware store. You need lab safety goggles.

Here’s a breakdown on that.

Should you clean the air?

Yes, absolutely.

We have an overwhelming amount of information that HEPA air purifiers work. Carl Van Keirsbilck has written an extensive review of studies on the effectiveness of air purifiers. Nina Notman provides an extensive overview on the benefits of clean air, including air purifiers and why certain people might be so reluctant to embrace them. So does Andrew Nikiforuk.

The CDC found that adding two HEPA air purifiers “reduced overall exposure to simulated exhaled aerosol particles by up to 65 percent without universal masking.” When you add masks, it goes up to 90 percent. They recommend HEPA purifiers as part of an overall clean air strategy. A review of more than 50 different studies in Indoor Air found that “when HEPA filters were utilized, regardless of the type of ventilation, number of ACH [air changes per hour] or hospital area, minimal surface-born and no airborne SARS-CoV-2 RNA was detected.” HEPA filters can significantly reduce the amount of virus in the air, even when you might struggle to ventilate a space. A study in Aerosol Science and Technology found that when researchers installed four air purifiers in a high school classroom, “the aerosol concentration” of Covid “was reduced by more than 90 percent within less than 30 min” and the reduction “was homogeneous throughout the room…” A study in Infection Control & Hospital Epidemiology found that by using two HEPA air purifiers, “99% of aerosols could be cleared within 5.5 minutes.”

And:

A study in Building and Environment found that combining air purifiers with ventilation in a gym “can reduce aerosol particle concentrations” by up to 90 percent, “depending on aerosol size.” Another study in the same journal found that adding a portable air purifier to a hospital patient’s room “could prevent the migration of nearly 98% of surrogate aerosols…”

So, they work.

Should you panic?

It’s fine to feel fear.

Fear drives appropriate action. In this case, appropriate action means masks, vaccines, treatments, and clean air. We live in an age of increased threats from a range of viruses, not to mention wildfires and pollution. Unfortunately, our government has taken money from public health and wasted it on police and military spending while convincing the public to “remain calm.”

That’s the situation.

Should you be training your immune system?

No, you can’t “train” your immune system.

Most Americans base their knowledge of the immune system on lore, including standup comedy by George Carlin. He was right about a lot of things, but he was wrong about your immune system. It sounds good to say your immune system gets stronger with practice, but that’s misleading. Phillip Dettermer’s Immune explains how our immune systems actually work. You have an innate immune system that doesn’t benefit from “practice” or training. Your immune system develops a memory of specific strains and variants of pathogens it has seen before. Sometimes, just a slight mutation can throw it off.

That goes double for anyone with a dysregulated or weak immune system. Thanks to Covid, that pretty much includes everyone…

Even if they don’t know it.

What’s going to happen next?

According to John Barry’s history of the 1918 pandemic, the government did absolutely nothing to prepare for the flu, even as a first “mild” wave circulated the globe and sent up warning signals. Virtually no politician said a word. Newspapers who dared to report the truth were threatened with prosecution. The U.S. was entirely focused on war as death swept over cities. Public health agencies told the public to wash their hands and chew their food properly.

The truth spilled out, after it was too late.

The new administration’s actions tell us to expect the same thing, only worse. They’re not going to give us a heads up.

There will be no warning.

Get ready.