The Bird Flu 2025: What Nurses Need to Know

Is the bird flu the next pandemic? Here are the latest statistics, updates, and predictions for the bird flu and what nurses can do to stay prepared.

As we head into 2025, many of us feel like the COVID-19 pandemic was just yesterday. The fears, uncertainty, tensions, and stress—especially for nurses—still feel fresh. The fact that the impacts of the coronavirus pandemic are still playing out is exactly why news about the H5N1 bird flu can feel alarming. 

The bird flu officially spread to humans in 2024 and the virus can cause severe, life-threatening illness in humans. Will the bird flu become the next pandemic in humans? Here are the latest statistics and updates nurses should know about the bird flu. 

What is the Bird Flu?

The bird flu is referred to as avian influenza by the World Organisation for Animal Health (WOAH) and is known as a particularly devastating infection because it can kill entire flocks of birds. Avian flu viruses are particularly dangerous because they:

• Are extremely resistant
• Can survive even at low temperatures
• Survive for long periods of time
• Can survive on farm equipment
• Spread easily, even among healthy-appearing animals

The WOAH explains that anytime there is an outbreak of avian flu, there will be a handful of human infections as well. In March 2024, the bird flu also spread to cows for the first time in history, which has caused a severe avian flu outbreak in dairy cattle. Currently, 913 dairy farms across the U.S. have been reported to have been struck with the bird flu. 

Bird Flu Risk Level and Symptoms in Humans

As of January 2, 2025, the Centers for Disease Control and Prevention (CDC) states that the overall risk of bird flu to the general public is low. It's low because the virus has only infected humans who had direct contact with poultry or farm equipment and because those infected individuals did not spread the disease to anyone else. 

According to the CDC:

• There is an ongoing multi-state outbreak in dairy cows and on dairy farms across the U.S.
• Wild birds have a severe outbreak
• 66 humans have been infected through direct contact
• There are no cases of human-to-human spread

Currently, there have been no human-to-human reported cases of bird flu. All of the human cases of bird flu have occurred from direct contact with an infected animal or farm equipment. As with any virus, epidemiologists remain concerned about the virus's potential to mutate to allow for human-to-human transmission, which could lead to the start of a new and dangerous pandemic. However, the CDC says that the viruses that have infected humans were low pathogenic avian influenza (LPAI)* A(H7N2) viruses, meaning they didn't have a high capacity to spread. 

Historically and currently, there are very few human infections with avian flu outbreaks and most cases are mild. That being said, as with any virus, there is a risk of serious complications. For instance, the 13-year-old girl who developed avian flu in November 2024 had life-threatening symptoms that included:

• Conjunctivitis
• Fever
• Cough
• Vomiting
• Diarrhea 
• Respiratory distress 
• Hemodynamic instability
• Respiratory failure
• Pneumonia
• Acute kidney injury
• Thrombocytopenia
• Leukopenia

The patient received bilevel positive airway pressure, then intubation and ECMO, daily plasma removal, continuous renal replacement therapy, combination antiviral treatment, and preventive antibiotic therapy. As of January 1, 2025, the patient is reported to no longer be infectious and has been off supplemental oxygen since December 18. 

In describing her case, the New England Journal of Medicine concluded that "highly pathogenic avian influenza A(H5N1) virus infection acquired in North America can cause severe human illness. Evidence for changes to HA that may increase binding to human airway receptors is worrisome."

Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital, also told CBC that the key to keeping bird flu as a minimal threat to humans is minimizing the spread to mammals, as the virus will develop an increased ability to mutate in a way that could give it mammal-to-mammal transmission capabilities and allow humans to catch and spread it. 

According to the CDC, if the number of human infections rises significantly or begins to spread from human to human, the risk to public health will increase. 

What Nurses Can Do About the Bird Flu

Currently, anyone who works directly with poultry, dairy cattle, or farm equipment is at the highest risk of becoming infected with the bird flu. Nurses can encourage any farm workers to use protective measures, including gloves, boots, masks, eyewear, and coveralls when handling equipment or animals, then follow up with at least 20 seconds of handwashing with soap and water. 

The signs and symptoms of bird flu are similar to any other type of influenza, but the predominant sign of avian flu has been redness and irritation (conjunctivitis) in both eyes. Full symptoms include:

• Eye redness 
• Low-grade fever 
• Cough
• Sore throat
• Runny or stuffy nose
• Muscle or body aches
• Headaches

Serious complications of the bird flu include seizures, acute kidney injury, respiratory failure, and inflammation of the brain. Nurses should encourage anyone with flu symptoms and eye redness to seek medical attention. 

Bird Flu Prevention Steps

Along with being aware of the signs and symptoms of avian flu, nurses can educate themselves on the facts about bird flu prevention. Currently, basic protective measures are advised. Regular influenza vaccination will not help or prevent the bird flu. There are no current plans in place to authorize a bird flu vaccine because the overall risk of infection to the general public remains low. There are candidates for a bird flu vaccine, but they would need FDA authorization for human testing, Becker Hospital Review reports. The FDA is continuing to monitor the spread of bird flu. For instance, the FDA found the virus in wastewater, indicating the virus is already spreading more widely than previously thought, so the agency is now testing raw milk-aged cheese in the U.S. to look for evidence of the virus. 

As of December 26, 2024, the CDC affirms that the overall risk of H5N1 to the public is low, but suggests that especially people who work directly with animals should take additional precautions to avoid getting sick or spreading the bird flu. If you work with animals, the CDC recommends that you:

• Wear personal protective equipment if you work directly with animals.
• Avoid direct contact with sick or dead wild birds, poultry, and other animals. Observe them only from a distance.

Additionally, the CDC advises that everyone—animal workers or not—should avoid drinking raw milk or consuming products made with raw milk. Unpasteurized raw milk can contain and spread the H5N1 virus, so drinking or consuming raw milk products could potentially infect you or spread the virus to others. 

The reason that the CDC is stressing the importance of avoiding raw milk and raw milk products right now is because currently, social media has a lot of discourse on the purported benefits of raw milk vs. pasteurized milk. Raw milk proponents claim that unpasteurized milk contains more nutritional and health benefits than pasteurized milk, while public health experts and doctors say that the evidence is overwhelmingly supportive of the fact that pasteurization does not affect the available nutritional quality of milk and can be life-saving, especially for very young children, pregnant people, and the elderly, who can be impacted by the pathogens raw milk can contain. 

The official stance of leading health agencies is that while heat-treating milk (pasteurization) does slightly denature the whey protein case in milk, any potential health associations keeping those proteins intact may have (none of which have been officially proven and according to the Ohio Dairy Industry Resources Center, denatured whey proteins are actually more digestible to humans) are negligible when compared to the pathogenic risk of drinking raw milk. Those risks increase in times of outbreaks, like the bird flu, which is currently impacting dairy cattle. Even research focused on finding potential health impacts of raw milk, especially in developing countries, acknowledges the need for pathogen removal with "microbiologically safe" milk. 

Social Media Reacts To Bird Flu

Raw milk discourse aside, paying attention to social media comments from the general public can be an important way nurses can stay prepared for a pandemic or serious illness outbreak -- this can help nurses prepare for patient encounters. For instance, while the CDC's epidemiological advice is relatively basic—avoid directly handling dead animals and take basic protective measures—comments on their Facebook post speak to the potential mistrust that some of the general public might have in the health agency for both infection control and even basic health guidance. 

• "These guys are not here to help you man…..raw milk is the best thing that you can drink. these guys are the enemies"
• "What everyone should be asking is, what are they doing to our food?"
• "Does anyone believe this crap anymore?
• "Like we are gonna believe a word you say ever again."
• "Put arrows on the floor in stores that tell us what direction to walk in so we don’t spread it"
• "Whatever these idiots say just do the opposite"

The struggles and stressors caused by the COVID-19 pandemic are evident in the public's wariness, fatigue, and even confusion on what advice to trust and follow, which could be indications of how the next pandemic could impact humans. Containing, treating, and controlling the spread of a pandemic relies largely on both action from public health agencies and the general population following advice from those public health figures. Without action on all sides, getting ahead of a pathogen causing a pandemic can be very challenging.

Nurses are taking to social media to discuss the ongoing effect of the COVID-19 pandemic on the profession as a whole, with influencer and nursing advocate Sarah Warren of @shesinscrubs most recently sharing a very candid video on the topic. 

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A post shared by Sarah Warren (@shesinscrubs)

 

So what will a future pandemic look like? According to some experts, COVID-19 was considered "moderate" in the pandemic world, and a future global pandemic is not only very likely but practically a given—and it could be even more severe than COVID-19, given the overall evolution of pathogens. While evidence suggests the bird flu is currently not a human pandemic threat, the chances are another pandemic that will threaten humans are very high. Managing a future pandemic will take considerable work in repairing the trust of public health agencies and supporting public health measures. 

Nurses can play a vital role in all of these actions, from working within public health organizations, supporting public health and prevention measures, and educating patients and the public on accurate information, action steps, and working once again, on the frontline, treating patients should another pandemic occur.

Nurses, what is the current state of bird flu in your area? Join the conversation on @nurse_org Instagram.