Welcome to the thirty-ninth edition of FOI Clinical. Each week, we'll send you a briefing on outbreak news. When something urgent breaks, you'll get an alert the same day.
In this edition
Avian influenza: a death in Washington, and new dairy states – Measles: a child's death in New York – Influenza: the first pediatric death – E. coli: a pumpkin patch – National surveillance, week 42 – West Nile virus: California's worst year since 2017 – Dengue: Florida reaches 485 – Ebola: Kenya discharges its first patients – Shamonda virus: WHO on the first human case
National interest
Avian influenza — a death in Washington, and new dairy states
A Yakima County, Washington resident infected with avian influenza A(H5N1) has died. The Yakima Health District reported on October 31 that a second county resident had tested positive after exposure at a dairy with infected cattle. The patient was hospitalized with severe illness and underlying health conditions. On November 1, the district announced that the patient had died and that a third case in a county resident exposed at a dairy who has not been severely ill or hospitalized. The district is not releasing the patients' age or gender. Close contacts of both patients are being monitored, though transmission between people has not been documented in the United States. The state health department's case table now lists three dairy-associated human cases this year.
CDC's national page on bird flu, last updated October 15, still shows 72 cases and two deaths since 2024. CIDRAP counts the Yakima death as the first H5N1 death recorded this year and the third recorded in the United States since 2024.
The sequence-sharing platform GISAID reports that the Washington sequences cluster with recent B3.13 samples from Idaho and Utah and carry a mutation in the neuraminidase (NA) segment. It does not name the mutation or say what effect, if any, it has.
Reported outbreaks in dairy cattle are also increasing. The Washington state agriculture department's detection table lists 40 infected dairy herds.
Washington is not alone. USDA confirmed H5N1 genotype B3.13, the dairy-cattle genotype we described last week in Utah mink, in an Indiana dairy herd on November 2, the state's first. It was found through routine milk testing. Colorado's agriculture department reported its first dairy detection since August 2024, also B3.13, in a Weld County herd confirmed October 24 through bulk milk tank surveillance. USDA says dairy cattle in 21 states have now been infected since March 2024.
Clinical note: the Yakima district's press release recommends clinicians ask about eye redness or irritation, fever, cough, sore throat, runny nose, muscle aches, headache and fatigue, and notes that illness can range from mild to severe. The state health department's October 26 health alert asks providers to screen every patient with influenza-like illness for contact with sick or dead animals, including dairy cattle, and for raw milk exposure, and to report suspected cases immediately.
Measles — a child's death in New York
New York has recorded its first measles-associated death in more than 30 years. The state health department and Lewis County Public Health announced the death of a child in Lewis County. The county coroner told the New York Times that the child was a 7-month-old unvaccinated boy who died at home.