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How bad is the flu right now? Can people get the bird flu? How do you get bird flu? What states have bird flu? Are measles going around? How contagious are measles?

AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, discusses the current bird flu outbreak 2025—including cases of avian flu among veterinarians. Also covering how dangerous seasonal flu is this year and the rising measles cases in the U.S. fueled by the Texas measles outbreak. AMA Chief Experience Officer Todd Unger hosts.

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Speaker

• Andrea Garcia, JD, MPH, vice president, science, medicine & public health, American Medical Association

Garcia: The CDC's latest MMWR, which did publish last Thursday, detailed three cases of U.S. veterinarians who work with cattle who unknowingly had H5 avian flu. Two of them reported no exposures to infected animals. 

Unger: Hello and welcome to the AMA Update video and podcast. Before we dive in today, I just want to take a moment to welcome the 140,000 new subscribers to the AMA YouTube channel. We've been doing the AMA Update for more than five years, so we are glad you've discovered us. 

Today's episode is our weekly look at the public health issues facing physicians and patients across the country with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's chief experience officer. Welcome, Andrea.

Garcia: Thanks, Todd. Glad to be here. 

Unger: And now, Andrea, it's been over a week since we last talked, and there's been some more news on bird flu. Let's get the update. 

Garcia: Sure Todd. The big news this week has been more hospitalizations with H5N1 avian flu, two cases to be exact. One of those cases was reported in a woman from Wyoming who had traveled to and is hospitalized in Colorado. The other case was a patient in Ohio. This now brings the number of confirmed human cases of H5 bird flu here in the U.S. up to 70. 

To put this in perspective, up until now, we had only seen two hospitalizations total in the U.S. The majority of people who have had confirmed bird flu here have had mild cases, some with conjunctivitis as their only symptom, and have fully recovered. As we talked about last time, a patient from Louisiana was the first person in the U.S. to die from an H5 infection. That patient was over 65 and had underlying medical condition. 

The other hospitalization we saw here in the U.S. was reported last year in Missouri. That patient recovered and was discharged home. These numbers do not include the Canadian teen we've talked about who also was hospitalized and critically ill with bird flu. That patient was also eventually well enough to be discharged home from the hospital. 

Unger: So still a relatively low number of cases but concern about the two new cases that you talked about. Are these folks infected with a new variant that we talked about last week, the one that could be potentially more dangerous to humans? 

Garcia: Well, Todd, that's something that we don't know at this point in time. Hopefully, we will know soon. As a reminder, though, most of the human cases we've seen have been the B3.13 genotype, which is thought currently to be less severe for humans, and until recently, it had been the only bird flu genotype that we've seen spreading between dairy herds and then also into some nearby poultry farms. 

The other genotype, which is known as D1.1, has really dominated the spread among wild migratory birds. That genotype has also contributed to the spillovers from wild birds to poultry flock and as we've talked about, have been driving up the egg prices nationwide. It was the D1.1 variant that sickened both the Louisiana patient and the Canadian patient. Last week, we did learn of the first known spillover of D1.1 into dairy cattle, which occurred in Nevada, and then more recently, the virus genotype has been detected in cows in Arizona, representing a separate introduction of the virus into dairy cattle. 

Unger: So now what do we know about the case in Wyoming so far? 

Garcia: According to a statement from Wyoming's public health department, the Wyoming patient was likely infected by handling sickened birds in a backyard flock. The state's veterinarian says flocks in the county where that patient lived did recently test positive for the B3.13 strain of the virus. We know the patient is an older adult, has other health conditions which may have made them more susceptible to the disease. Of course, to help protect the patient's privacy, their current condition has not been shared. 

Unger: And the case in Ohio? 

Garcia: We don't know as much about that case. According to a CBS News article, Ohio's health department confirmed this past Saturday that a farmer in the state was discharged from the hospital after being sickened by bird flu. Ohio's health department told CBS News via email that the individual had respiratory symptoms, was previously hospitalized, and has since been released. It is believed that that individual did also have direct contact with sick poultry. 

Unger: Well, given everything we've talked about to this moment, where do we stand right now? 

Garcia: Well, I think one concern is that in addition to these known cases, the virus may also be spreading undetected. In other words, we may be missing some of these infections. 

The CDC's latest MMWR, which did publish last Thursday, detailed three cases of U.S. veterinarians who work with cattle who unknowingly had H5 avian flu. Two of them reported no exposures to infected animals. One practiced in Georgia and South Carolina, which have had no known cases of the virus in cattle. None of the veterinarians experienced flu-like symptoms. These cases were detected through antibody tests of 150 veterinarians working across 46 states. 

Some health officials have said that there are some reassuring news here as well since only three of the 150 veterinarians tested had signs of prior infections. This suggests that the virus doesn't easily spread from animals to people. The dairy workers who have been infected have likely had more sustained contact with sick cattle and their milk than these veterinarians. 

Unger: Andrea, thanks so much for that update. We'll obviously continue to watch. 

Andrea, turning to seasonal flu, has that gotten any better since we checked in last time? 

Garcia: Unfortunately, no. Seasonal flu is still high, which is not completely unexpected at this time of year, but it is the first time the CDC has classified it as a high severity season for all age groups since the 2017-2018 flu season. 

We've also now seen seasonal flu outpace COVID hospitalizations and deaths, and this is something that hasn't happened since the COVID pandemic began. According to the latest CDC data, which is from February 8, this has been the worst flu season in 15 years with estimates of at least 29 million cases, the most since the 2009-2010 flu season. 

Unger: Wow, those are big numbers. Andrea, is that translating then into more hospitalizations and deaths from flu? 

Garcia: Yeah, we're seeing high numbers there, too. According to the CDC, there have been at least 370,000 hospitalizations, 16,000 deaths from flu as of February 8. That's on a pace to surpass the previous high which was recorded during the 2017-2018 flu season. 

Of particular concern this year is the severity of the illness we're seeing in kids. So far, there have been 68 flu deaths in kids. Pediatric flu deaths hit a record high of 200 last year, but this season is on track to be even worse. There have also been some reports of a limited number of pediatric cases with serious neurological complications associated with the flu. 

Unger: And we know it's never too late, of course, to get the flu vaccine, which may not prevent the flu, but it can mean less severe illness. Andrea, another disease gaining traction right now is the measles. What can you tell us about that? 

Garcia: Well, Todd, this is something we've been tracking as well, and it's been reported on by several news outlets. We've now seen 48 confirmed cases of measles in Texas with a few additional cases in nearby states. And according to recent news coverage, the outbreak shows no signs of slowing down. According to the Texas Department of State Health Services, last Tuesday, the state had 24 reported measles cases, and that number had doubled by Friday. 

A Department of Health spokesperson said that this marks the largest measles outbreak in the state in more than 30 years. All of the cases are in unvaccinated individuals or individuals whose vaccination status is unknown. 13 people have been hospitalized. Gaines County is reportedly the epicenter of the outbreak with 42 cases confirmed among residents. 

Unger: Now we're talking about Texas, but you mentioned other nearby states as well. What do we know about that? 

Garcia: Well, three cases of measles were also confirmed last week in New Mexico. Those occurred in Lea County, which borders Gaines County. Given the proximity, a connection is suspected but so far remains unconfirmed. According to the CDC, Alaska, Georgia, New York and Rhode Island have also reported measles cases this year. 

Coinciding with these outbreaks are higher than ever vaccine exemption rates among children here in the U.S. This is something that we really need to keep an eye on, given how quickly we know that measles can spread. According to the CDC, measles is one of the most contagious diseases known to humans. Just one infected patient can spread measles up to 9 out of 10 susceptible close contacts. And we do have a highly effective vaccine. We know that two doses of that MMR vaccine in childhood are 97% effective at preventing measles. 

Unger: So incredibly contagious and we do have a solution there, the vaccine that you mentioned. So, Andrea, we'll continue to watch that in the weeks ahead as well. 

Well, that wraps up this week's episode. And as always, Andrea, thank you so much for being here keeping us informed. If you found this discussion valuable, you can support more programming like it by becoming an AMA a member at ama-assn.org/join. You can find all our videos and podcasts at ama-assn.org/podcasts.

Thanks for joining us today. Please take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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