H5N1 Bird Flu: Risks, 1918 Lessons and How to Stay Safe

Author: Ian C. Langtree - View Credentials
Published: 23 Mar 2009 - Updated: 1 Nov 2026
Publication Type: Opinion Piece, Editorial

Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content

Synopsis

This information reviews the H5N1 avian influenza threat using current data from the CDC and the World Health Organization, which has recorded 1,002 human cases and 479 deaths worldwide since 2003, while CDC reports 72 U.S. human cases since 2024 and rates the current public health risk as low. It explains that infections so far have come from contact with infected birds, poultry and dairy cows rather than from other people, compares today's medical tools with those available during the 1918 pandemic, and sets out practical, evidence-based prevention steps. Older adults, nursing home residents and people with certain disabilities or neurologic conditions face a higher risk of serious flu complications, so the guidance is especially useful for them and their caregivers, and it replaces popular myths such as megadoses of vitamin C with recommendations from federal health agencies.

At a Glance

• 1 - Eye redness has been the most common symptom in recent U.S. bird flu cases.
• 2 - The first U.S. death from H5 bird flu was reported in Louisiana in January 2025.
• 3 - The seasonal flu vaccine is not designed to protect against H5N1, and no H5 vaccine is commercially available to the public.
• 4 - About 500 million people, one-third of the world's population, caught the 1918 flu, which was caused by an H1N1 virus with genes of avian origin.

Topic Definition

H5N1 Avian Influenza

H5N1 avian influenza is a highly pathogenic strain of influenza A virus that mainly infects wild birds and poultry and has spread to some mammals, including dairy cows in the United States. The name comes from two proteins on the surface of the virus, hemagglutinin subtype 5 and neuraminidase subtype 1. People rarely catch it, and nearly all human infections follow direct, unprotected contact with infected animals or contaminated surroundings. Illness ranges from mild eye redness to severe respiratory disease and death. Health agencies monitor H5N1 closely because it has not yet gained the ability to spread easily between people, and a change that allowed sustained human transmission could set off a pandemic.

Overview

Why H5N1 Bird Flu Still Matters

Warnings about a possible bird flu pandemic have circulated for more than two decades, and most of them concern highly pathogenic avian influenza A(H5N1). From 2003 to August 7, 2026, the World Health Organization recorded 1,002 confirmed human H5N1 cases in 25 countries, and 479 of those people died - a case fatality rate of about 48 percent [World Health Organization Western Pacific Region, 2026]. Because milder infections can go undetected, the true fatality rate among all infections is uncertain, but these numbers explain why health agencies watch this virus so closely.

In the United States, the virus has spread widely in wild birds and poultry and, since 2024, in dairy cows. The Centers for Disease Control and Prevention reports 72 human cases of A(H5) bird flu in the U.S. since 2024 and says the current public health risk is low [Centers for Disease Control and Prevention (CDC), 2026a]. Most U.S. infections have been mild, with eye redness as the most common symptom, though some people have been hospitalized [CDC, 2024a; CDC, 2025a]. The first U.S. death from H5 bird flu was reported in Louisiana in January 2025 [CDC, 2025b].

Has Bird Flu Spread From Person to Person?

Nearly all human infections have come from direct, unprotected contact with infected birds or other animals, or with surroundings contaminated by their saliva, mucus or droppings [CDC, 2024a]. CDC states that no person-to-person spread has been identified with the H5N1 viruses now circulating in the U.S. and around the world [CDC, 2025a]. The concern is that the virus could change. Avian influenza viruses could cause a pandemic if they gained the ability to spread easily and sustainably between people, which H5N1 has not done [CDC, 2024a].

Lessons From the 1918 Flu Pandemic

The 1918 pandemic shows what is at stake. Although it is commonly called the Spanish flu, there is no universal agreement on where the virus began. It was an H1N1 virus with genes of avian origin [CDC, n.d.-c]. In the U.S., the first outbreak of flu-like illness was detected in March 1918, when more than 100 cases were reported at Camp Funston at Fort Riley, Kansas. The mass movement of troops during World War I helped carry the virus around the world [CDC, n.d.-b].

The pandemic came in three waves between the spring of 1918 and the summer of 1919, and the deadly fall 1918 wave caused most U.S. deaths [CDC, n.d.-b]. At least 50 million people died worldwide, including about 675,000 in the United States [CDC, n.d.-a]. Unusually, death rates were high among healthy adults aged 20 to 40, as well as among children under 5 and adults 65 and older [CDC, n.d.-c].

The flu reached even remote communities, hospitals were overwhelmed, and children of the era jumped rope to a now well-known rhyme:

I had a little bird, its name was Enza. I opened the window, and in-flu-enza.

Health officials in 1918 had no vaccine against influenza and no antibiotics to treat secondary bacterial infections such as pneumonia. They relied on isolating the sick, quarantine, good hygiene, disinfectants and limits on public gatherings [CDC, n.d.-c].

How Today's Response Differs

Public health tools are far stronger today. Flu antivirals such as oseltamivir are recommended for people who develop symptoms after exposure to infected animals, and they work best when started within 48 hours of the first symptoms [CDC, 2024a]. No commercial H5 vaccine is available to the public, but CDC has developed H5 candidate vaccine viruses that could be used to make a human vaccine if needed [CDC, 2024a]. The annual seasonal flu vaccine is not designed to protect against H5N1, although CDC still urges people who work with animals to get it [CDC, 2025c].

Even so, a fast-moving pandemic would strain hospitals, staff and medical supplies, as 1918 and more recent emergencies have shown. Personal and community preparation still matters.

Practical Steps to Lower Your Risk of Bird Flu

CDC recommends the following steps to avoid bird flu [CDC, 2025c]:

• Avoid touching wild birds or other animals that are sick or found dead, and report them to your state veterinarian or the U.S. Department of Agriculture.
• Do not drink or handle raw milk or raw milk products - choose pasteurized milk.
• Cook poultry, eggs and beef to a safe internal temperature.
• Wear recommended protective equipment if you must be close to infected or possibly infected animals.

The everyday habits that slow seasonal flu also help limit the spread of any flu virus [CDC, 2026b]:

• Wash your hands often with soap and water, or use an alcohol-based hand rub.
• Cover coughs and sneezes with a tissue, then throw the tissue away.
• Avoid touching your eyes, nose and mouth.
• Avoid close contact with people who are sick, and consider wearing a mask for added protection.
• Stay home when you are sick, and return to normal activities only after your symptoms have been improving and you have had no fever without medication for at least 24 hours.

Skipping handshakes during an outbreak and keeping soap, tissues and hand sanitizer at home are simple ways to follow this advice. If you have a fever and a cough, stay away from public meetings, worship services and other gatherings, even if you were scheduled to take part.

What About Vitamin C?

Large doses of vitamin C have been promoted for decades as a way to fight colds and flu, most famously by Nobel laureate Linus Pauling. The evidence does not support this. The National Center for Complementary and Integrative Health reports that vitamin C does not prevent colds and only slightly reduces their length and severity, and that there is no strong scientific evidence that any natural product is useful against the flu. It notes that vaccination is the best protection against seasonal flu, which CDC recommends every year for everyone aged 6 months and older [National Center for Complementary and Integrative Health, n.d.].

Extra Precautions for Seniors and People With Disabilities

Some people are at higher risk of serious flu complications. These include adults 65 and older, residents of nursing homes and other long-term care facilities, people with neurologic and neurodevelopmental conditions, and people with certain disabilities - especially those who have trouble moving muscles, breathing or clearing their airways [CDC, 2024b]. Heart disease, lung disease, a past stroke and a weakened immune system also raise the risk [CDC, 2024b].

If you or someone you care for is in one of these groups, talk with a doctor before an outbreak about vaccination, antiviral treatment and what to do if symptoms start. Ask whether visits can be handled by phone or telehealth so you can avoid crowded waiting rooms during flu season. Caregivers and support workers should follow the same hygiene steps and stay away when they are sick. Anyone who becomes ill after contact with birds, livestock or raw milk should contact a health care provider promptly, since antiviral treatment works best when started early [CDC, 2024a].

If Person-to-Person Spread Begins

Health officials will announce it if H5N1 starts spreading efficiently between people. If that happens, follow guidance from CDC and your state or local health department, limit close contact with others, and keep up the hygiene habits above. Getting your information from official health sources rather than rumors is one of the most useful things anyone can do.

Frequently Asked Questions

Can you get bird flu from eating cooked chicken, eggs or beef?

Cooking poultry, eggs and beef to the proper internal temperature kills bacteria and viruses, including bird flu. Handle raw poultry carefully and wash your hands and kitchen surfaces after touching it.

What should I do if I find a dead bird in my yard?

Do not touch it with bare hands. Report sick or dead wild birds to your state veterinarian or to the USDA at 1-866-536-7593 so experts can test for avian influenza.

What do the H and N in H5N1 stand for?

They refer to two proteins on the surface of the virus, hemagglutinin and neuraminidase. Influenza A viruses are classified by the subtype of each protein, so H5N1 carries hemagglutinin subtype 5 and neuraminidase subtype 1.

What are the signs of a severe bird flu infection?

Moderate to severe illness can include high fever, trouble breathing, altered consciousness and seizures. Anyone with these symptoms, especially after contact with birds or livestock, needs urgent medical care.

Why should farm workers get a seasonal flu shot if it does not prevent bird flu?

It protects them against seasonal flu, and it may reduce the rare risk of human and bird flu viruses mixing to form a new virus. CDC recommends it for people who work with or often contact infected or potentially infected animals.

Who is most likely to be exposed to H5N1?

People with job-related or recreational contact with infected birds or animals face the greatest risk, including dairy and poultry workers, backyard flock owners and people who handle wild birds. The general public has a much lower chance of exposure.

How can travelers lower their risk of bird flu abroad?

Avoid contact with sick or dead birds and animals, wash your hands after touching uncooked poultry, and eat poultry and eggs only when fully cooked. Check travel health notices before visiting areas with outbreaks.

How does the World Health Organization track human H5N1 cases?

Countries report confirmed human infections to WHO, and its Western Pacific regional office publishes a weekly avian influenza update with the cumulative global count of H5N1 cases and deaths reported since 2003.

References

• Centers for Disease Control and Prevention. (n.d.-a). 1918 pandemic (H1N1 virus).
• Centers for Disease Control and Prevention. (n.d.-b). 1918 pandemic influenza: Three waves.
• Centers for Disease Control and Prevention. (n.d.-c). History of 1918 flu pandemic.
• Centers for Disease Control and Prevention. (2024a). About bird flu.
• Centers for Disease Control and Prevention. (2024b). People at increased risk for flu complications.
• Centers for Disease Control and Prevention. (2025a). Current situation: H5N1 bird flu in people.
• Centers for Disease Control and Prevention. (2025b). First H5 bird flu death reported in United States [Press release].
• Centers for Disease Control and Prevention. (2025c). Preventing bird flu infections.
• Centers for Disease Control and Prevention. (2026a). A(H5) bird flu: Current situation.
• Centers for Disease Control and Prevention. (2026b). Preventing seasonal flu.
• National Center for Complementary and Integrative Health. (n.d.). 5 tips: Natural products for the flu and colds: What does the science say?
• World Health Organization Western Pacific Region. (2026). Avian influenza weekly update number 1058.

Insights, Analysis, and Developments

Editorial Note: Bird flu has not learned to spread easily between people, and that single fact separates today's situation from the 1918 pandemic that killed at least 50 million people worldwide, about 675,000 of them in the United States. Health agencies now have antivirals such as oseltamivir, which work best when started within 48 hours of symptoms, along with candidate H5 vaccine viruses that could be used to make a human vaccine if needed - tools that did not exist a century ago. The habits that slowed the flu in 1918, such as hand washing, staying home when sick and avoiding crowds during outbreaks, still work today, and they matter most for the people who have the most to lose from a severe infection. Following official health sources and planning ahead with a doctor remain the most reliable ways to stay ready.

Author Credentials: Ian C. Langtree is a writer, editor, and the founder and Editor-in-Chief of Disabled World, which he established in 2004 as one of the longest-running independent resources for disability news and information. Over more than two decades, he has written and edited thousands of articles on disability rights, health, accessibility, and assistive technology. Drawing on a global perspective shaped by extensive travel and lived experience, Ian is a committed advocate of the Social Model of Disability, the framework developed by disabled activists in the 1970s that focuses on removing societal barriers rather than on individual impairments. His writing is grounded in that framework and in a lasting commitment to disability rights, accessibility, and social inclusion. To learn more about Ian's background, expertise, and accomplishments, visit his full biography.