On Tuesday, February 25, the National Governors Association Center for Best Practices hosted a State and Territorial Leader Advisor Call, where attendees learned more about current H5N1 trends from the Johns Hopkins Center for Outbreak Response and Innovation (CORI). State representatives from Colorado, Louisiana and Pennsylvania presented on surveillance, public health actions, and overall emergency preparedness and response to H5N1 Avian Flu.
Center for Outbreak Response and Innovation (CORI)
CORI began the call by sharing information around the economic, human and animal threat of H5N1. Currently, there are outbreaks in commercial and backyard poultry flocks. Although February 2025 data has shown decreasing detection rates, the disease is predicted to persist and has become widespread in cattle and detected in wastewater.
The risk to farm workers is high, while the risk of transmission to people remains medium to low. CORI recommendations include increasing avian flu testing, increased distribution of personal protective equipment (PPE), timely and accurate surveillance, and open communication and transparency.
- 2025 critical updates:
- 70 confirmed human cases.
- The D1.1 genotype is dangerous to humans; has been detected in cattle, spilled over from wild birds.
- Researchers have identified H5N1 mutations, indicating the virus may mutate rapidly in the event of human infection.
- 3 cases of human exposure from infected commercial poultry, 2 human exposures originating from backyard flocks.
Colorado
Since May 2024, Colorado has tested around 141 people, confirmed 10 human cases of H5N1, and lost one million birds. Colorado also has the second highest number of dairy cattle herds detected with H5N1 nationally.
Representatives from Colorado’s Department of Agriculture (CDA) and Department of Public Health and Environment (CDPHE) shared on mobilizing their Highly Pathogenic Avian Influenza Outbreak (HPAI) working group, issuing a disaster declaration, and developing vaccinations.
- Interagency coordination, including establishing a joint information center, holding town halls and conducting coordinated site visits, has been critical to success. Colorado has an established MOU with zoonotic response-focused partners.
- The Interagency Farmworker Health Workgroup is comprised of Colorado’s departments of Labor and Employment, Education CDPHE, and CDA.
- CDA leads the state’s response to H5N1, while CDPHE leads the human health response and distributes PPE to dairy and poultry workers.
- Both agencies coordinate/share media responses to ensure health communications are effective and consistent.
Louisiana
In January 2025, Louisiana was the first state to report a H5N1 related human fatality. The patient had preexisting risk factors and was exposed via backyard flock with proximity to ducks, waterfowl, and other migratory birds. Since then, Louisiana has had three infected backyard flocks and encourages early detection with surveillance measures.
Statewide effective communication strategies include press releases with important public health prevention messages, providing advisories to healthcare providers through Louisiana Department of Health’s (LDH) Health Alert Network, and daily updates to the Louisiana Governor’s Office. Coordination and collaboration among state agencies, including LDH, the Louisiana Department of Agriculture and Forestry (LDAF), and the Louisiana Department of Wildlife and Fisheries (LDWF) continues to be foundational to the state’s H5N1 response.
- LDH epidemiologists identified and monitored other exposed individuals, connected to the human fatality case, for 10 days following exposure, providing medication for individuals with high-risk exposure.
- Pre-established inter-agency relationships between LDH, LDAF, and LDWF have been effective to efficiently coordinate H5N1 response.
- Surveillance measures, including a 24/7 clinician hotline, Influenza A subtyping, syndromic surveillance data, wastewater surveillance, and bulk milk tank sampling are key to early detection.
- The Governor’s Office receives daily situation updates, and healthcare providers receive advisories through LDH’s Health Alert Network.
Pennsylvania
Pennsylvania was one of the last states in the mid-Atlantic region to experience an H5N1 outbreak. Twenty-two counties have experienced H5N1, with seven million birds from commercial and backyard flocks affected but no confirmed cases in dairy cattle or humans. Representatives from Pennsylvania’s Department of Health (DOH) and Department of Agriculture (PDA) shared strategies around developing, conducting, and evaluating biosecurity precautionary measures for agricultural workers and the public.
DOH and PDA highlighted their collaboration with Pennsylvania State University (PSU) to provide unified and effective health communications through press releases and weekly H5N1 reports to the Governor’s Office. Another successful collaborative approach, the Pennsylvania One Health Task Force led by the University of Pittsburgh, brings together federal, state, and academic stakeholders to promote cross-agency health efforts through sharing articles and research initiatives and holding monthly meetings.
- Pennsylvania’s DOH and PDA released this guidance for PPE use. The DOH provides PPE to farms at no cost, and PDA helps distribute the supply.
- PA Biosecurity Regulations: mandatory milk influenza testing (30,000 milk samples and 5,000 dairy herds have been tested), animal exhibition sanitation laws to minimize zoonotic disease transmission, and recommending that dairy farms develop biosecurity plans and premises IDs.
Next Steps
The NGA Center will continue to support states and territories in their work to improve emergency preparedness and response efforts through technical assistance, convenings and sharing resources. Please contact Asia Riviere (ARiviere@nga.org) or Grace Burns (GBurns@nga.org) for support or to answer any additional questions.
This article was developed by Asia Riviere, Grace Burns, and Marianne Gibson at the National Governors Association Center for Best Practices.
