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As more cases of bird flu emerge across the country, public health leaders in New York City are watching warily — and making preparations in case the virus becomes a more immediate threat.
There have been no confirmed cases of bird flu in humans in New York state. But cases have emerged recently among wild birds and poultry, including at a commercial farm on Long Island, which started euthanizing 100,000 ducks this week.
For New Yorkers who do not interact with infected animals, the risk of getting bird flu is low, public health experts and health officials say. While there is no evidence that the current highly pathogenic H5N1 bird flu virus can be transmitted between humans, that scenario remains a possibility — and one that, with certain mutations, could lead to a pandemic.
Since 2024, at least 67 people nationwide have been infected by the virus, according to data from the U.S. Centers for Disease Control and Prevention. Earlier this month, the CDC reported the first human death from bird flu, in Louisiana. Meanwhile, bird flu has appeared in animals across the country, from dairy herds to backyard chickens. This week, the poultry industry in Georgia — one of the nation’s largest — was working to contain an outbreak of the virus.
The United States has stumbled through its bird flu response, failing to stamp out the virus when it emerged on dairy farms in several states last year. Since then, slow federal interventions and depleted public health resources have created the conditions for what could become a pandemic.
The nationwide bird flu response is in limbo as President Donald Trump, who has vowed dramatic changes to federal health agencies, returned to the White House this week. Trump previously signaled that he would disband the Office of Pandemic Preparedness and Response Policy, which coordinated the bird flu response under the Biden administration. This week, the Trump administration instructed federal health agencies to pause all external communications.
Locally, some bird flu preparations are underway. Bellevue Hospital, part of the NYC Health + Hospitals system and a regional hub for special pathogen preparedness, is gearing up for the possibility that bird flu becomes a more serious public health threat. This month, the hospital announced that it would receive $2 million for bird flu preparedness efforts, part of a wave of federal funding released in the final weeks of the Biden administration.
“We’ve been tracking the avian influenza cases that have sprung up across the country,” said Dr. Vikramjit Mukherjee, the director of the Special Pathogens Program and of Critical Care Services at Bellevue. “We believe that it’s a matter of time before it becomes more significant.”
There’s low risk, but pandemic potential
In New York state, bird flu has been detected occasionally in wild birds, backyard flocks, and poultry since 2022. The state reported several cases in live poultry markets in Brooklyn and Queens in 2023. Last week, the Putnam County Health Department reported a bird flu case in a wild goose in Brewster, a village about an hour outside New York City.
This week, responding to the detection of bird flu on a Long Island farm, state officials said that individuals who may have had contact with infected birds were being monitored for symptoms, and that farmworkers were given personal protective equipment. The state Department of Agriculture and Markets is working with a division of the federal Department of Agriculture on surveillance and testing in the surrounding area, according to the state Department of Health.
“I urge everyone who has regular contact with livestock and wild birds to remain vigilant and take precautions by wearing personal protective equipment when you’re in contact with these animals,” Dr. James McDonald, the state health commissioner, said in a statement.
While the risk to the general public remains low, public health experts say that evidence of human-to-human transmission of bird flu would raise red flags, signaling a heightened threat — and pandemic potential. That possibility hinges on whether the virus is able to mutate enough to spread between people. In the recent death of a Louisiana resident from bird flu, CDC scientists found that the virus had started to mutate after infection.
“You have more and more spread now,” said Dr. Michael Merson, a clinical professor of global and environmental health at the NYU School of Global Public Health. “The question obviously is, is it going to be a mutation into humans, and we get person-to-person spread? That would be the most alarming situation.”
To public health experts, the emergence of bird flu cases during a worsening flu season is especially concerning, as it increases the risk of co-infection — having both viruses at the same time. Co-infection creates an opportunity for the two viruses to interact, exchange genetic material, and potentially become more dangerous to humans.
“That also is a way that we can have a pandemic situation, if a human virus mixes with the H5N1 virus,” said Dr. Denis Nash, an expert in infectious disease epidemiology and the executive director of the CUNY Institute for Implementation Science in Population Health. “During flu season, that is more likely to happen. That increases our risk a lot.”
As a protective measure, public health experts recommend that New Yorkers — and especially farmworkers — get the seasonal flu vaccine. While the flu shot won’t prevent a bird flu infection, it could help reduce the risk of co-infection.
Efforts have also ramped up to accelerate bird flu vaccine development. Last week, the federal Department of Health and Human Services announced it would provide about $590 million to Moderna to spur the development of an H5N1 mRNA influenza vaccine targeted at the current strain circulating in cows and birds.
In New York, Nash is part of a research team that has tested wastewater across the NYC Health + Hospitals system for infectious diseases including Covid, flu, and mpox. Researchers are in the process of setting up a wastewater test for H5N1, which could be an important tool for early detection in the city.
“The current outbreak in animals, and all of this spillover to humans, is of great concern and worrisome,” he said. “I don’t think we’re doing enough to mitigate the risk.”
Bellevue would help lead regional response
If bird flu were to become more of a threat — or a pandemic — Bellevue Hospital would be at the center of New York’s response effort.
Bellevue serves as the regional hub for special pathogen preparedness and cases of highly infectious diseases for New York, New Jersey, Puerto Rico, and the U.S. Virgin Islands. The hospital is also a member of the National Emerging Special Pathogens Training and Education Center, a preparedness consortium.
Earlier this month, HHS announced $306 million in awards for bird flu preparedness and response, of which Bellevue will receive $2 million. Mukherjee, who leads the hospital’s Special Pathogens Program, said he expects the funds to go toward shoring up regional PPE stockpiles, as well as training and education programs.
Other preparedness measures have begun, he said. In October, health care workers donned PPE to simulate transporting an H5N1 patient from Kings County Hospital Center to Bellevue. Mukherjee said that Bellevue has conducted PPE training, reviewed its pandemic protocols, and offered its expertise to other regional facilities. The hospital is also assessing its surge capacity, including plans for expanding patient spaces, ramping up staffing, and ensuring adequate PPE, ventilators, and other supplies.
At the New York City Department of Health and Mental Hygiene, a spokesperson said in a statement that the agency is “prepared to respond to any disease outbreak, including quickly ramping up vaccination, testing, and treatment, as appropriate, and working closely with providers and community partners to rapidly disseminate messaging.”
A strong bird flu response hinges on federal partnership, public health experts say. Establishing an efficient testing system for bird flu is key, Mukherjee said, noting that the lack of such a system was a significant vulnerability during the early Covid response.
“We have some work to do in that sphere,” he said.
Nash emphasized that a good bird flu preparedness plan would look a lot like what the United States should have had when Covid hit: quick, scalable access to testing and masks, effective and widespread public health messaging, and swift vaccine production.
“We’re hopefully not going to be in a place like we were with Covid, where we couldn’t tell the extent of the outbreak, and how fast and where it was spreading until it was way too late,” he said. “If that happens with something like this virus, if it’s more pathogenic than Covid, we’ll be in a really bad place.”
Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.
