The Emerging Threat of H5N1 to Human Health
The New England Journal of Medicine (NEJM)
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December 31 2024
Highly pathogenic avian influenza (HPAI) A(H5N1) emerged in 1997.1 Since then, it has spread globally by migratory birds, resulting in infections in animals on every continent. HPAI A(H5N1) clade 2.3.4.4b emerged in 2021 and resulted in fatal infections in poultry as well as terrestrial and marine mammals.1 In early 2024, influenza A infection was first recognized in dairy cows with mastitis in Texas. Infection in dairy cows is now widespread in the United States, affecting more than 875 herds in 16 states. Most cow infections are genotype B3.13, whereas most outbreaks in wild birds and poultry are genotype D1.1.
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