Bird flu found in sample of California raw milk: Officials
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(FRESNO, CA) — After bird flu was detected in a retail sample of raw milk produced and packaged by Raw Farm, LLC, the California Department of Public Health warned consumers on Sunday to avoid consuming any from the same lot.
At the state’s request, the Fresno County-based company also issued a voluntary recall of the affected product: cream top, whole raw milk from lot No. 20241109 with a “best by” date of Nov. 27.
Anyone in possession of the product will be able to pursue a refund from the location where the item was originally purchased.
Retailers have also been notified to take affected products off of their shelves.
The CDPH has also emphasized that pasteurized milk remains safe to drink.
Most cases of bird flu discovered in humans in the current outbreak are with people that worked directly with birds or cows. There are not any cases known to be associated with raw milk consumption, but the risks associated with raw milks have been long established.
The Food and Drug Administration has previously warned of the possible dangers of drinking raw milk.
In a statement from May 2024, it warned, “Raw milk can carry dangerous germs such as Salmonella, E. coli, Listeria, Campylobacter, and others that cause foodborne illness, often called ‘food poisoning.'”
Raw milk products do not undergo pasteurization, which is a heating process that kills bacteria and viruses.
Pasteurized milk and dairy products, however, are safe to consume because the heating process kills pathogens that can cause illness — including bird flu.
However, raw milk does have its proponents, including Robert F. Kennedy Jr.
Last month, in a post on X, called the FDA’s “aggressive suppression” of it part of the agency’s “war on health.”
In November, President-elect Donald Trump selected RFK Jr. to lead the Department of Health and Human Services. The appointment requires Senate confirmation.
As of Sunday evening, no illnesses had been reported in association with the finding of bird flu in the single lot of raw milk.
The contaminated sample was discovered as part of routine testing performed by the County of Santa Clara Public Health Laboratory, which tests raw milk products from retail stores as a second line of consumer protection. The finding was then verified by the California Animal Health and Food Safety Laboratory System.
In response to the positive test, the California Department of Food and Agriculture provided onsite testing at the Raw Farms facilities, which were negative for bird flu. CFDA will continue testing raw milk banks twice per week.
ABC News’ Claire E. Strindberg contributed to this report.
(NEW YORK) — A new report by March of Dimes found that over 5.5 million women live in U.S. counties experiencing limited to no access to maternity care resources that include hospitals or birthing centers, obstetric care or obstetricians.
The report is the latest by the maternity care-centric nonprofit to highlight a worsening state of maternity care in the U.S., with a rise in closure of hospital obstetric units contributing to what the organization calls “a growing maternal and infant health crisis.”
March of Dimes estimated that more than 2.3 million women of reproductive age live in counties deemed to be maternity care deserts, with approximately 150,000 births in these counties. More than three million additional women live in counties with limited maternity care access.
“We’re going from bad to worse. We already have the worst maternal mortality rate of our industrial peer countries, and we know that access matters,” Dr. Amanda Williams, March of Dimes’ chief medical officer, told ABC News. “If we don’t have access, then we don’t even have a chance.”
Maternity care deserts have a significant impact on health outcomes for expecting women. Data shows that women in maternity care deserts have a 13% chance of experiencing preterm birth, and receive inadequate prenatal care at higher rates, according to the report. Low-income and women of color are disproportionately affected.
People in maternity care deserts have to travel approximately 2.6 times further to receive care than those who live in counties where care exists, and early data has found that ob-gyns are leaving states with strictest abortion bans, Williams said.
“As the report suggests, the Dobbs decision — the effects of which have yet to be fully realized — is likely playing a major role in the already shrinking ob-gyn workforce in many rural areas of the country,” Dr. Stella Dantas, president of the American College of Obstetricians and Gynecologists, said in a statement.
“As we continue to find ways to increase access, we must also vigorously combat legislative interference in the practice of medicine so that clinicians are free to practice without fear of criminalization and patients are able to get the care they need and deserve in the communities they live and raise their families in,” the statement continued.
Approximately 35% of all U.S. counties are now considered maternity care deserts, having no birthing facilities or obstetricians. North Dakota, South Dakota, Alaska, Oklahoma and Nebraska are the most impacted states, according to March of Dimes.
Since 2022, over 100 counties experienced a decline in maternity care access, totaling over 100 hospitals closing their obstetric units, resulting in delayed access to emergency care and forcing families to travel farther to receive critical care, according to the report.
Between 2015 and 2022, the prevalence of pre-pregnancy hypertension rose by over 80%, according to March of Dimes. Preeclampsia, a potentially fatal condition that causes a pregnant woman’s blood pressure to rise, can lead to preterm birth, stroke, seizure, and other complications for expecting women.
In maternity care deserts, the rates of pre-pregnancy hypertension was 1.3 times higher than counties with full access to care, according to the report.
Leveraging telehealth services, improving reimbursement policies for obstetric services at hospitals, and improving access to midwifery services are some of the policy solutions to improve care, Williams noted.
“Not only are there people, a lot of people who live in these maternity care deserts, there are beautiful things, just as in the natural desert, you might find a gorgeous flower or cactus,” Dr. Williams said. “There are churches, there are community centers, there are community based organizations. And so we need to figure out how in healthcare and in public health, we can partner with some of those organizations to be able to extend care to those who live in maternity care deserts.”
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.
While the United States has made considerable progress fighting the HIV/AIDS crisis since its peak in the 1980s, headway has not been equal among racial/ethnic groups.
Overall, HIV rates have declined in the U.S. and the number of new infections over the last five years has dropped among Black Americans and white Americans. However, Hispanic and Latino Americans have not seen the same gains.
Between 2018 and 2022, estimated HIV infections among gay and bisexual men fell 16% for Black Americans and 20% for white Americans, according to data from the Centers for Disease Control and Prevention. Meanwhile, Hispanic Americans saw rates held steady, the CDC said.
There may be several reasons for the lack of decline, including Hispanic Americans facing health care discrimination, experts told ABC News. Some may also face the stigma that prevents patients from accessing services or makes them feel ashamed to do so. There is also a lack of material that is available in their native language or is culturally congruent, experts said.
“Where we are in the HIV epidemic is that we have better tools than ever for both treatment and for prevention, and we have seen a modest slowing in the rate of new infections, but we have seen a relative increase in the rate of new infections among Latino individuals, particularly Latino men who have sex with men,” Dr. Kenneth Mayer, a professor of medicine at Harvard Medical School and medical research director at Fenway Health in Boston, told ABC News.
“So, the trends are subtle, but they’re concerning because it does speak to increased health disparities in that population,” he continued.
Hispanic Americans make up more cases and more deaths
Although Hispanic and Latino Americans make up 18% of the U.S. population, they accounted for 33% of estimated new HIV infections in 2022, according to HIV.gov, a website run by the U.S. Department of Health and Human Services. This is in comparison with white Americans, who make up 61% of the U.S. population but just 23% of HIV infections.
Hispanic and Latino gay men currently represent the highest number of new HIV cases in the U.S.
What’s more, Hispanic males were four times likely to have HIV or AIDS compared to white males in 2022 and Hispanic females were about three times more likely than white females to have HIV over the same period, according to the federal Office of Minority Health (OMH).
Additionally, Hispanics males were nearly twice as likely to die of HIV Infection as white males and Hispanic females to die of HIV Infection in 2022, the OMH said.
Erick Suarez, a nurse practitioner and chief medical officer of Pineapple Healthcare, a primary care and HIV/AIDS specialist located in Orlando, Florida, told ABC News that watching the lack of progress made in the HIV/AIDS crisis for the Hispanic and Latino population is like “traveling back in time.”
“When I say traveling back in time for the Hispanic/Latino population with HIV, I mean [it’s like] they are living before 2000,” he said, “Their understanding of treatment and how to access it is in that pre-2000 world. … The state of HIV and AIDS in the Hispanic/Latino population in the United States right now is a few steps back from the general American population.”
He said many Hispanic/Latino HIV patients come to the United States unaware of their HIV status. If they are aware of their status, they come from countries where prevention and pre-exposure prophylaxis (PrEP) is hard to find or doesn’t exist.
When they get to the United States, they be afraid or unsure of where or how to access health care. Even Hispanic/Latino Americans whose families have been here for generations, have trouble accessing health care due to racial and ethnic disparities, Suarez said.
Previous research has shown Hispanic/Latino Americans with HIV reported experiencing health care discrimination, which could be a barrier to accessing care.
Facing discrimination, stigma
Hispanic and Latino patients with HIV report facing discrimination in health care, experts told ABC News. A CDC report published in 2022 found between 2018 and 2020, nearly 1 in 4 Hispanic patients with HIV said they experienced health care discrimination.
Hispanic men were more likely to face discrimination than Hispanic women and Black or African American Hispanic patients were more likely than white Hispanic patients to face discrimination, according to the report.
There may also be stigma — both within the general population and within their own communities — associated with HIV infection that could prevent patients from accessing services, according to the experts.
Suarez said one of his most recent patients, who is Cuban, traveled two hours to a clinic outside of their city to make sure no one in their familial and social circles would know their status.
“The interesting part is that even though I speak with them like, ‘You understand that everything that happens within these walls is federally protected, that it is private information. No one will ever know your information, and our goal is for you to get access healthcare. You can do this in your own city,'” Suarez said.
“Now, because of the stigma, they will travel long distances to avoid contact with anyone and make sure that no one knows their status. So, stigma is a huge factor,” he continued.
Rodriguez said this stigma and mistrust has led to many Hispanic and Latino Americans to not seek medical care unless something is seriously wrong, which may result in missed HIV diagnoses or a missed opportunity to receive post-exposure prophylaxis, which can reduce the risk of HIV when taken within 72 hours after a possible HIV exposure.
Making resources ‘available, attainable and achievable’ Experts said one way to lower rates is to make information on how to reduce risk as well as how to get tested and treated available in other languages, such as Spanish, and making sure it is culturally congruent.
However, Rodriguez says translating documents is not enough. In the early 2010s, when the CDC was disseminating its national strategy to reduce HIV infection, the agency began to circulate materials on how to reduce HIV incidence, reducing stigma and increasing use of condoms for sex, Rodriguez said.
He said that of a compendium of 30 interventions, maybe one was in Spanish. When he took the materials back to his native Puerto Rico, many were having trouble understanding the materials because it has been translated by someone who is of Mexican heritage.
Secondly, rather than the materials being written in Spanish, they had been translated from English to Spanish, which doesn’t always translate well, Rodriguez said.
“When we talk about Hispanics, we have to talk about, first of all, the culture. Our culture is very complex. Not one Spanish language can speak to all of the Hispanic communities,” he said. “And then we also have to look at the generations of Hispanics. Are you first generation, second generation, third generation? “
He added that the key is making resources “available, attainable and achievable.”
This month, the White House convened a summit to discuss raising awareness of HIV among Hispanic and Latino Americans and to discuss strengthening efforts to address HIV in Hispanic and Latino communities.
Mayer said it’s also important to make sure information is disseminated on social media that is culturally tailored for Hispanic and Latino experiences.
“It’s important for social media to seem culturally relevant, to make sure that they understand that HIV is not just a disease of old white guys, and that they may have a substantial risk,” he said. “Make sure that they’re educated by what they can do to protect themselves since we have highly effective pre-exposure prophylaxis, and we have ways to decrease STIs with a doxycycline post-exposure prophylaxis.
The experts added that having more Hispanics and Latinos represented in medicine, research and public health may encourage more Hispanic and Latino Americans with HIV or at risk of HIV to seek care or treatment.
“Seeing and being able to recognize that your healthcare provider looks like you, sounds like you, in some way it represents you, is a key aspect of getting people on treatment and access,’ Suarez said. “And not only that, but keeping them in treatment and having them come back and stay and keep that going, that’s a key issue.”
