Bird flu case reported in Los Angeles after state officials declare emergency
CDC and NIAID
Los Angeles County health officials reported the first human case of bird flu in the area less than a week after a statewide emergency declaration was announced.
In a statement released on Monday, the L.A. County Department of Public Health said the human case of H5 bird flu was detected in an adult who was exposed to livestock infected with the virus at a worksite.
The unnamed adult had mild symptoms, has been treated with antivirals and is recovering at home, according to the agency.
“The overall risk of H5 bird flu to the public remains low,” health officials said.
There are at least 65 confirmed human cases of bird flu nationally — with at least 36 in California, according to the CDC.
California Gov. Gavin Newsom declared a state of emergency on Dec. 18 as bird flu cases were detected in dairy cows on Southern California farms. The virus had also been previously detected in the state’s Central Valley.
“This proclamation is a targeted action to ensure government agencies have the resources and flexibility they need to respond quickly to this outbreak,” Newsom said in a statement last week.
Symptoms of bird flu in humans include eye redness or discharge, fever, cough or difficulty breathing, sore throat, muscle or body aches, diarrhea and vomiting, according to health officials.
Individuals working with infected animals, including cows, poultry or wildlife, continue to be at higher risk of exposure to the virus.
“People rarely get bird flu, but those who interact with infected livestock or wildlife have a greater risk of infection. This case reminds us to take basic precautions to prevent being exposed,” Los Angeles County health officer Muntu Davis, MD, MPH, said in the statement Monday.
“People should avoid unprotected contact with sick or dead animals including cows, poultry, and wild birds; avoid consuming raw or undercooked animal products, such as raw milk; and protect pets and backyard poultry from exposure to wild animals,” Davis added.
The health official also recommended getting the seasonal flu vaccine “which can help prevent severe seasonal flu illness and lower the risk of getting both seasonal and bird flu infections at the same time if exposed.”
(NEW YORK) — The FDA has expanded the approval of Eli Lilly’s obesity medication Zepbound to include treating moderate to severe obstructive sleep apnea for people with obesity — the first medication approved for the condition.
The new, expanded Zepbound approval means that insurance providers, including Medicare, will likely cover the medication for people with sleep apnea and obesity. Some insurance providers, including Medicare, do not offer reimbursement to treat obesity alone.
The new approval is for people with moderate to severe obstructive sleep apnea who are also living with obesity. Eli Lilly estimates that is about 15-20 million adults in the U.S.
Obstructive sleep apnea isn’t just an inconvenience, it’s a serious medical condition that impairs breathing and sleep quality. Obesity and obstructive sleep apnea are linked. People tend to see their obstructive sleep apnea get better when they lose a significant amount of weight. It’s likely the weight loss associated with the medication is helping improve the sleep apnea.
Right now, there is no medicine to treat obstructive sleep apnea — it’s only treated with a positive airway pressure device.
In a study, people who took Zepbound had at least 25 fewer breathing interruptions per hour while they slept. They also lost an average of 20% of their body weight.
The study also followed people over a year, and found that up to half of the adults taking Zepbound no longer had obstructive sleep apnea symptoms at the end of the year.
Obstructive sleep apnea is more common in men than women. Up to 34% of U.S. men have OSA compared to 17% of U.S. women, according to the American Academy of Family Physicians.
Common signs of sleep apnea include heavy snoring at night, long pauses in breathing while sleeping as well as excessive daytime sleepiness, forgetfulness and morning headaches. The symptoms of the disorder can lead to significant medical problems.
Three influenza A (H5N1/bird flu) virus particles (rod-shaped). Note: Layout incorporates two CDC transmission electron micrographs that have been inverted, repositioned, and colorized by NIAID. Scale has been modified. Image via CDC and NIAID.
(NEW YORK) — As seasonal influenza ramps up, and with bird flu continuing to circulate, some public health experts are worried there may be a strain on the public health system.
Since the bird flu outbreak began earlier this year connected to dairy cows and poultry, there have been 55 human cases reported in the U.S., according to the Centers for Disease Control and Prevention (CDC). This includes a child in California, who was confirmed on Friday by the agency to be the first pediatric case linked to the outbreak.
There is currently no evidence of person-to-person transmission of bird flu and the risk to the general public is low, federal health officials say. But with millions of seasonal flu infections around the corner, there is some concern about additional stress on how public health surveillance systems will track the virus.
“I think it does add a layer of stress, at least in the public health planning part of things, because we have to think about what resources would be necessary were we to have a significant outbreak of bird flu,” Dr. Tony Moody, a professor of pediatrics and infectious diseases specialist at Duke University, told ABC News.
Bird flu and seasonal flu at the same time
Currently, respiratory virus activity is low in the U.S., but the country is on the brink of entering traditional flu season.
Dr. Otto Yang, a professor of medicine and microbiology, immunology and molecular genetics at the David Geffen School of Medicine at the University of California, Los Angeles, said the flu season earlier this year in the Southern Hemisphere looked typical so the same can be expected for the Northern Hemisphere.
Countries in the Southern Hemisphere experience their flu season before countries in the Northern Hemisphere. This often provides a glimpse as to what the upcoming flu season may potentially look like for the Northern Hemisphere, though it is not fully predictive of what may occur in each individual country.
“It looks like everything so far points to a fairly typical flu season in terms of the numbers, not [an] especially severe flu season, but not one especially mild either,” he told ABC News.
So far, all bird flu cases in humans in the U.S. have been mild and patients have all recovered after receiving antiviral medication. Almost all confirmed cases have had direct contact with infected livestock.
Yang said he doesn’t see bird flu putting a major strain on the health system right now, but there are unknown factors such as whether COVID-19 or RSV will lead to a higher number of cases than normal.
Moody added that health systems have conversations every year about respiratory virus season regarding whether there are enough beds, enough staff and enough equipment to treat sick patients, and that unknown factors always present a threat.
“That’s what we would be thinking about, is, what can we do to try to blunt that as much as possible, because it’s not so much that the public health system can’t absorb it,” he said. “They just can’t absorb everything all at once.”
Testing for bird flu
With flu season expected to start ramping up in the coming weeks, it may be increasingly difficult to differentiate bird flu from seasonal flu without more extensive testing, experts say.
“The reality is, we want to be ahead of a problem. There’s a surveillance challenge that was easier in the summer because we didn’t have seasonal flu cycling,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and an ABC News medical contributor. “As we enter flu season, we’re going to have a respiratory mix that includes flu and may include cases of avian, and it’ll be an even greater needle in the haystack.”
Right now, a PCR test, which checks for genetic material, is needed to detect a novel flu virus in a patient. More than 60,000 tests have been completed by public health labs to detect any presence of bird flu since February of this year, according to the CDC.
Tests are sent to public health labs if there is suspicion of bird flu exposure from a clinician or a sample was submitted for surveillance purposes. Health care systems send in a quantity of flu samples to public health labs for additional testing to help detect any new bird flu cases, which is how a case in Missouri was initially identified.
“We’re doing some opportunistic sampling of cases that would get additional sequencing. [Our hospital] is sending five samples per week to state labs that would ultimately get deeper identification for bird flu,” Brownstein said.
The nation’s flu surveillance systems “are built to be able to detect novel flu infections even during peak flu season” the CDC told ABC News in a statement in part. “The level of testing performed is designed to scale with increases in seasonal flu activity so that we’re casting a wider net and maintaining the ability to detect rare infections with novel influenza viruses.”
Other surveillance methods like emergency department trends and wastewater data may become less reliable as seasonal flu ramps up, Brownstein said.
“Patients that have access to rapid tests at home also aren’t necessarily collected and connected to surveillance systems” he added.
Risk of recombination
Questions have swirled about whether or not bird flu and seasonal influenza could form a recombinant virus, meaning a combination of the two.
There is currently no evidence that this has happened and, although it is possible for either virus to mutate with each new case, experts believe this is unlikely considering bird flu is not yet showing evidence of person-to-person transmission.
“It certainly is possible, but generally you get recombination when you have hosts where both strains can get in easily, and at the moment the bird flu strain is not traveling human to human, and so very, very few humans are infected with it,” Yang said. “It’s been a handful of cases, so the risk is really tiny.”
Moody said so-called “recombination events” do happen, with people becoming infected with multiple viruses at the same time or multiple strains of a virus. However, most of the time, they are “failures,” he said.
“That’s an important thing to understand, these recombination events are happening all the time and, most of the time, it doesn’t go anywhere,” Moody said. “Very, very rarely it does, and then that becomes a possibility for transmission”
How to best protect yourself
Moody and Yang say they both recommend that people receive the flu shot. Flu vaccines are currently available for everyone six months and older, according to the CDC.
In the last flu season prior to the COVID-19 pandemic, flu vaccination prevented an estimated 7 million illnesses, 3 million medical visits, 100,000 hospitalizations, and 7,000 deaths in the U.S., the CDC said.
The seasonal flu vaccine does not protect against bird flu, but it can reduce the risk of human influenza viruses, and therefore lower the risk of co-infection.
“Is there the potential for some cross-benefit for the avian flu? There may be. It’s hard to say, because, of course, these viruses are distinct from one another,” Moody said.
(NEW YORK) — The Mediterranean diet — which emphasizes fruits, vegetables, lean proteins and whole grains — has once again topped U.S. News and World Report’s annual ranking of best diets.
The publication on Friday named the diet the best overall diet for the eighth year in a row.
The Mediterranean diet scored a 4.8 out of 5 based on an evaluation of several factors, including nutritional completeness, health risks and benefits, long-term sustainability and evidence-based effectiveness, according to U.S. News and World Report.
The diet also scored the top spot in 11 additional categories in the publication’s annual rankings, including easiest-to-follow, gut health, weight loss and mental health.
The DASH (Dietary Approaches to Stop Hypertension), which focuses on whole foods and low sodium, was ranked second on the Best Diets list, followed by the Flexitarian, MIND and Mayo diets. All of the top five diets embrace a plant-forward philosophy, minimizing the intake of red meats, processed foods, inflammatory fats, high-sugar foods and sugar-sweetened beverages, rather than enforcing strict rules or banning entire food groups.
If you’re looking to start the Mediterranean diet, here is what you need to know.
What is the Mediterranean diet?
The Mediterranean diet is not one way of eating but a broad term used to describe the eating habits popularized in the countries bordering the Mediterranean Sea including Italy, Greece, Morocco, Spain and Lebanon.
The way of eating focuses on the quality of foods consumed rather than focusing on a single nutrient or food group, according to U.S. News and World Report.
Nutrition experts say there’s no one diet that will work for everyone. Certain diets may be more beneficial depending on your circumstances, and some may be harmful depending on your health conditions. Anyone considering changes to their diet should consult with their doctor.
What types of foods are eaten on the Mediterranean diet?
Overall, the diet is mostly plant-based and focuses on healthy fats.
Healthy fats emphasized in the Mediterranean diet include extra virgin olive oil, avocados, nuts, salmon and sardines, according to the American Heart Association.
All types of vegetables and fruits are encouraged on the diet, as are non-meat sources of protein like beans and other legumes.
Fish is encouraged at least twice weekly and other animal proteins like poultry, eggs, cheese and yogurt are encouraged in smaller portions. Red meat consumption is should be limited to a few times a month.
The main source of hydration should be water.
Are any foods prohibited?
No, the Mediterranean diet does not totally eliminate any foods or food groups.
However, it is recommended to limit foods such as butter, processed foods like frozen meals and candy, and refined grains and oils. Fruits are encouraged for dessert over sugary sweets.
U.S. News and World Report describes the diet as leaving “little room for the saturated fat, added sugars and sodium that inundate the standard American diet.”
What are the health benefits?
According to U.S. News and World Report, “People who eat a Mediterranean-style diet have longer lifespans, report a higher quality of life and are less likely to suffer from chronic diseases such as cancer and heart disease.”
In a study of over 60,000 people, those who followed the Mediterranean diet more closely had a lower risk of dementia, regardless of genetic risk.
The American Heart Association says the Mediterranean diet can “play a big role” in preventing heart disease and stroke and reducing risk factors like diabetes, high cholesterol and high blood pressure. Consuming virgin olive oil, in particular, may help the body “remove excess cholesterol from arteries and keep blood vessels open,” according to the AHA.
Citing research, the Mayo Clinic touts the Mediterranean diet as a way to help maintain a healthy weight, improve brain health, increase longevity, support a healthy gut and lower the risk of certain cancers.
Dr. Brent Gawey, a member of the ABC News Medical Unit, contributed to this report.
