BIRD FLU CHECK-IN — More cows and humans continue to test positive for avian influenza, but the CDC maintains that the risk to the public remains low. We checked in with several infectious disease experts to learn more about what the recent outbreak at poultry farms in Colorado means for the U.S. response to the virus. There have been several infections at two poultry farms in Colorado. What should the public take away from these cases? Jennifer Nuzzo, a professor of epidemiology and director of the Pandemic Center at Brown University School of Public Health: “The number of cases that we’re seeing in Colorado, and the involvement of a large number of people with symptoms at the same time at multiple farms, screams at us that this virus is not going away — that this is becoming a recurring hazard for farmworkers.” Dr. Michael Mina, chief science officer at digital health company eMed: “What is hard for the public generally to understand is that’s the current situation right now. The risk is low to the public, but it doesn’t mean that there is a low risk of some spread in the future.” Michael Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy: “One of the real challenges we have today with this issue is it has to be nuanced … no one really knows what the likelihood will be of H5N1 becoming a flu virus transmitted to people by people.” HHS recently made it easier for the FDA to authorize avian flu vaccines. If and when do you think they should be rolled out to those with high exposure to the virus? Nuzzo: “It should be rolled out before we have any indication of severe illness.” Mina: “Administering them right now … is a little bit putting the cart before the horse, relative to some other mitigation strategies we can take. The most important thing is to really improve our surveillance.” Osterholm: “If you’re going to vaccinate people to keep them from being infected, our current flu vaccine technology doesn’t permit that. If you’re going to try to keep them from having serious illness, we haven’t seen any serious illness yet in any of these individuals. And so I think the challenge is, what are we trying to do with these vaccines?” Do you think that we have a better understanding of the spread of the virus than we did in recent months? What do we still not understand? Nuzzo: “How is this moving between farms? We have a vague sense of the type of practices that may contribute, but they haven’t done definitive studies that show, yes, this is how it’s spreading. This is really important.” Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials: “The one thing that I do think that is clearly coming away from this is that it’s increasingly appearing that the disease, or the infection, is not as virulent as some of the H5N1 human infections we’ve seen in the past. The mortality rate used to be very, very high.” Mina: “We have a better understanding of the spread of the virus only insofar as we know that it’s very, very widespread.” Osterholm: “I don’t think we do. We have more questions now than ever.” IT’S TUESDAY. WELCOME BACK TO PRESCRIPTION PULSE. Watch out, parents: Hand, foot and mouth disease is, well, afoot in the Washington area. Send news and tips to David Lim (dlim@politico.com or @davidalim) and Lauren Gardner (lgardner@politico.com or @Gardner_LM).
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