Fears of a pandemic brewing as overflowing hospitals are told to test all patients for bird flu

Doctors in New York are being urged to test hospitalized patients for bird flu amid growing concerns over human-to-human spread.

The state’s health department issued an alert to physicians on February 3 telling them to test people with type A influenza for the H5N1 strain ‘within 24 hours of admission’.

Type A is a family of influenza viruses that includes several strains, including the one that caused the 2009 swine flu pandemic and H5N1 which is currently tearing through dairy and poultry farms in the US.

Minnesota has also issued advisories urging doctors to test type A flu patients for H5N1 ‘as soon as possible… ideally within 24 hours’.

Experts said the orders highlighted the growing concerns about the virus mutating and spreading between people. 

Fears over a potential flu pandemic have been quietly building for months amid the worst outbreak of the virus in nearly three decades.

Data shows that 7.75 percent of patients visiting the ER had a flu-like illness in the week to February 1, the latest data available, which is the highest for that time period since the CDC started tracking the metric in 1997.

This year, the outbreak is being driven by type A flu viruses. The concern is that if more bird flu cases infect people they could go undetected or mistaken for common strains.

New York shuttered its live poultry markets for deep cleaning on Friday after bird flu was detected in the three boroughs of New York City. 

The state has not detected a case of the virus in a human to date.

Hospitalizations in New York state for flu are at their highest level in at least four years, after 3,138 patients were admitted in the latest week — also up 12 percent in a fortnight.

Dr Aaron Glatt, an epidemiologist at Mount Sinai, told DailyMail.com that his hospital was experiencing the worst outbreak he had ever seen in his career. 

‘We see a lot of flu A, we are seeing probably, according to the CDC, the worst flu season ever,’ he said.

‘That’s also in terms of my own experience too, in terms of what I see myself and in the hospital and with colleagues.’

Across the US this year, the CDC estimates that more than 24million people have been sickened with flu while 310,000 have been hospitalized and 13,000 have died.

Forty-five states, including New York, have flu levels that are either ‘high’ or ‘very high’, while schools in at least ten states have been forced to close because of the virus.

More than 75 percent of flu cases recorded every year tend to be type A, which includes the H1N1, or swine flu, virus that caused the 2009 pandemic and H5N1, or bird flu.

A total of 68 people have tested positive for H5N1 in the US.

Most of the patients have suffered from only mild symptoms, such as conjunctivitis — or redness in the eye, and no respiratory symptoms.

Nearly all the cases have been linked to contact with cattle or domestic or wild birds.

The CDC says there have been no cases of human-to-human transmission so far, and adds that the risk to the public is ‘low’.

The alert was published by New York state on its own Health Alert Network — used for sending urgent updates to clinicians — on February 3.

It read: ‘CDC is now recommending ordering subtyping for all influenza A-positive specimens collected from hospitalized individuals within 24 hours of hospital admission to help rapidly detect any human cases of avian influenza A(H5N1).’

Minnesota released its advisory urging doctors to test hospitalized type A flu patients for bird flu on January 23.

The CDC also issued a nationwide alert, or Health Alert Network (HAN) notice, on January 16 telling all states to ‘expedite’ testing of hospitalized flu patients.

It said the testing should be done for all patients with type A strains, but especially those in the ICU, to allow for optimal care and proper infection prevention measures — such as isolating patients and their close contacts.

Both the Minnesota and New York updates were issued after the CDC communications ‘blackout’ was ordered on January 21 amid the transfer of power.

After admission, patients are tested for the type of flu they are infected with to establish whether they have type A.

Swabs positive for this type may then be sent for further analysis in hospital or state laboratories to determine whether a patient is infected with H5N1, or bird flu.   

Dr Eric Feigl-Ding, an epidemiologist based in Washington DC, said on X: ‘The rise of unknown subtyping flu A has led NY to issue a new alert to subtype all Flu A immediately for bird flu.

‘I think they are worried about airborne transmission and human-to-human potential given how the memo was worded.’

Hospitals in at least nine states have brought back face masks, while at least three schools are now being interrupted because of surging cases.

Experts say the surge could also be driven by weakened immunity due to Covid lockdowns, a less effective flu vaccine this year or fewer people taking steps to control their infection — like staying home when sick — could be behind the surge. 

Covid cases are falling in the US, with the test positivity rate — the proportion of swabs that detect the virus — being 5.3 percent in the week to January 25, the latest available, compared to 5.8 percent the previous week. This is also well-below the 13 percent rate recorded last winter.

RSV infections are also dropping, with the hospitalization rate being 2.9 per 100,000 in mid-January, down 17 percent in a week, while norovirus cases are also dropping.

Hospitals in Minnesota, North Carolina, Massachusetts, Wisconsin, California, Illinois, Indiana, New Jersey and New York are among those to bring back face mask requirements.

Hospitals say that the masks can help to curb the spread of infections, despite several studies suggesting they have little to no impact.

School districts in parts of Alabama, Tennessee and Texas have also closed temporarily to try to limit the spread of viruses.