Bird flu crisis enters new phase

• The outbreak is intensifying as the Trump administration maintains a pause on most external federal health agency communications, including publication of CDC's Morbidity and Mortality Weekly Report (MMWR), a venerable source of scientific reports on public health.

Driving the news: The Department of Agriculture last week confirmed 81 detections of highly pathogenic avian flu in wild birds collected across 24 states between Dec. 29 and Jan. 17.

• Wild birds can be infected and show no signs of illness, allowing them to spread the virus to new areas and potentially expose domestic poultry.
• Officials in Pennsylvania and New York have culled thousands of wild geese, as well as commercial poultry flocks, after detecting cases of flu.

What they're saying: "If you look at what's happened the last eight weeks, the number of poultry operations that have gone down — and more recently, the duck operations — is absolutely stunning," Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota told Axios.

• The virus is being spread as wild birds comingle with birds in commercial poultry operations.
• Changes in migratory patterns may be worsening the issue in northern states, which now see certain wild birds stay for the winter because water sources aren't freezing, Osterholm said.

"There is a lot of H5N1 out there. And we're going to see more cases in humans," he said.

• But "they're going to be single, isolated cases," he said.

The intrigue: A new strain of avian flu called H5N9 was recently identified on a duck farm in California that had an outbreak of the more common H5N1 flu last fall.

• The new type is a sign that two or more viruses could be infecting the same animal and swapping genetic material. Ducks make good hosts for what scientists call "reassortment" because they aren't badly sickened by many types of avian flu.
• About 119,000 birds on the farm were euthanized following the discovery.

Such mutations, in and of themselves, may not pose a greater threat to human health.

• The H5N9 strain originated in China and is itself a mix of several other strains. It isn't thought to be more of a threat to humans than the H5N1 strain that's widely circulating in U.S. poultry, cattle and wild birds.
• But its presence could become a major problem if there was a reassortment between avian flu and a seasonal human flu, Richard Webby, director of the World Health Organization's Collaborating Center for Studies on the Ecology of Influenza, told the Los Angeles Times.
• That combination could result in a virus that is more easily transmitted between people.

Catch up quick: The bird flu crisis has struck 113 flocks in the past 30 days, affecting more than 19 million birds, per USDA. It's also been confirmed in 943 dairy herds, the vast majority in California.

• The Trump administration hasn't publicly outlined steps it's taken yet to address the spread. HHS didn't respond to a request for comment.
• HHS Secretary-designate Robert F Kennedy Jr. said he intended to "devote the appropriate resources to preventing pandemics" during confirmation hearings this week, leading some Democratic senators to point to past statements he made about giving infectious disease research "a break."

Between the lines: The partial blackout on health communications has effectively blocked publication of a pair of studies on bird flu, including one on whether veterinarians who treat cattle have been unknowingly infected by the virus, KFF Health News reported.

• The other report looked at whether people carrying the virus might have infected domestic cats.
• The reports were due to appear in the MMWR, which hasn't published since January 16 and is subject to the pause ordered by acting HHS Secretary Dorothy Fink to allow the new administration to set up a process for review and prioritization.

The communications freeze has been met with outrage in some medical and science circles. "This idea that science cannot continue until there's a political lens over it is unprecedented," Anne Schuchat, a former principal deputy director at the CDC, told KFF Health News.

• There's a lot of uncertainty around whether the administration is merely pausing communication or making a wholesale change in how the agency functions, Patrick Jackson, a UVA Health infectious diseases expert, said on a call with reporters Friday.
• "Frankly, getting CDC up and running at full speed is going to be essential to keep track of avian influenza," he said.