Issues with raw diets and H5N1 influenza risk in cats (and dogs) have gotten a lot of attention in the last week or two. Like most emerging disease situations, it’s still fluid, and we’re learning more as time goes on, but we know enough at this point to at least make some basic assessments and recommendations. Here’s my current take on it.
What are the concerns with H5N1 influenza and raw diets for pets?
The unprecedented pandemic of H5N1 highly pathogenic avian influenza (HPAI) has ongoing for more than 2 years. Massive numbers of wild birds have been affected around the world. Spillover into domestic animals is an ever-present risk where this virus is circulating in wild birds, with domestic poultry being the most severely affected. Millions of domestic poultry have died or been depopulated due to infection, and spillover infections have also occurred in mammals, including many cats and at least one dog.
Recently, H5N1 influenza infection has been linked to consumption of contaminated raw meat diets in at least two cats. It’s been well established for some time that ingestion of infected birds can lead to H5N1 influenza infection in cats, based on earlier studies and field observations. It is therefore unsurprising that infections could occur if infected poultry makes its way into raw diets fed to cats, and unfortunately the infection in cats is often fatal. The risk to dogs is less clear, but infection was reported in one dog that died shortly after close contact (chewing on) an infected bird. Dogs may be less susceptible to H5N1 influenza than cats, but they are still susceptible and infection can have dire consequences, so the same concepts apply to both species.
What types of raw diets for pets pose a risk of H5N1 influenza infection?
Poultry-based diets are the main concern, including chicken, turkey and duck, as all poultry are highly susceptible to H5N1 influenza. However, the virus is now also widespread in dairy cattle in the US, particularly in certain states (like California at the moment). Work done by the Food Safety and Inspection Service (FSIS) in the US has found no evidence of virus in retail beef samples and only very low levels of virus in samples from 1 of 185 cull dairy cows tested (the positive cow did not enter the food chain). More investigation is needed, but it is likely that viral loads in muscle of infected cattle are far less than those in poultry. Risks from beef are presumably low, but the potential for the virus to be present in meat from infected dairy cattle cannot be dismissed.
Does use of “human grade” meat in raw diets eliminate the risk?
Human grade meat does not mean pathogen-free – it only means that the meat would have been allowed for sale for human consumption based on more rigourous requirements for the animals, facilities, processing and handling. These presumably reduce, but do not eliminate, the risk of H5N1 infected animals entering the pet food chain.
Does high-pressure pasteurization of raw diets eliminate H5N1 influenza virus?
High pressure pasteurization (HPP) of food products uses high pressure (rather than high heat, as in cooking) to reduce contamination with bacteria and viruses. Many commercial raw diets for pets are high pressure pasteurized (which is good). The pressures achieved during this process should inactivate influenza virus, but there are no standard methods for HPP. The effectiveness of HPP depends on the pressure, temperature, and composition of the food matrix. It is unclear whether manufacturers have developed and validated the method for their wide range of diets and pathogen risks. Recalls of high-pressure pasteurized raw diets because of Salmonella contamination have been regular occurrences, and a recent infection in a cat was linked to such a diet. High pressure pasteurization should be considered a risk reduction step, not a risk elimination step.
Are frozen or freeze-dried raw diets lower risk for H5N1 influenza?
Freezing and freeze drying are effective preservation methods for viruses, so its unlikely that these methods substantially reduce the risk of viral contamination in raw diets. Ultralow freezing is used for longterm preservation of viruses, but shorter-term survival is also possible at temperatures achieved using normal freezers (-20C). A study of the survivability of H7N9 influenza on raw chicken meat (Dai et al. Lancet 2022) reported that viral infectivity was maintained for 9 days at -20C, 4 days at 4C and 4 days at 25C. This was a rather small study, so it is possible that somewhat longer survival could occur in some situations. In nature, long term (e.g. overwintering) survival of influenza virus in ice has been suspected.
While the survival kinetics of this virus with freezing are not clear, it should be assumed that the virus could survive frozen for at least a week, and possibly much longer. Freezing should not be assumed to be a risk mitigation measure for viral contamination of raw diets.
Freeze drying is a highly effective virus preservation method. Survival of virus in freeze dried food has not been assessed, but in the absence of specific evidence, it is reasonable to assume that influenza virus would survive for long periods of time in such diets.
My cat is doing well on a raw diet and I don’t want to change. What can I do?
Raw diets can be cooked so that the cat receives a diet with the same ingredients but without the risk from H5N1 influenza (and other pathogens). There is no evidence that cooking reduces the health benefits of a diet. Cooking the food to an internal temperature of 165F/74C will inactivate influenza virus and other pathogens such as Salmonella.
My cat has eaten a raw diet that’s been recalled diet. What should I do?
You should observe your cat closely and contact your veterinarian in you are concerned or your cat develops any signs of illness. Antiviral prophylaxis could be considered in particularly high-risk situations where it is likely that the cat has eaten contaminated food. This may not be the case for all recalled diets and would depend on the nature of the recall. Early signs of H5N1 influenza in cats are not well established, but often seem to be vague signs such as lethargy, malaise and decreased appetite. Rapid progression to severe disease can occur so veterinary care should be sought as soon as possible.
My cat has eaten a raw diet that’s not been recalled. What should I do?
Unless there is evidence that the diet has been implicated in disease, the odds of a problem developing are low. However, it would still be ideal to transition the cat to a cooked diet, whether that’s a commercial wet or dry diet, a home-cooked diet or cooking the cat’s current raw diet. Monitoring of your cat for illness, as above, is still indicated, as always.
What are risks to people from contact with contaminated raw diets?
The risk to people from H5N1 influenza from handling contaminated raw diets is likely quite low but not zero. Exposure could happen from inadvertent ingestion of the virus from contaminated surfaces (e.g. food prep surfaces, refrigerator, food bowls). That would likely be low level exposure, but the infectious dose of the virus is not known so it could still be relevant. There are similar risks with these diets from pathogens such as Salmonella, so good food handling practices are always warranted. These include avoiding cross-contamination with human foods and kitchen surfaces, careful cleaning and disinfection of in contact surfaces, dishes and utensils, and thorough handwashing (or use of an alcohol-based hand sanitizer) after contact with the raw diet or food bowls.
The greatest risk to people would be from exposure to a cat (or less likely a dog) infected with H5N1 influenza. An infected animal might be shedding enough virus to infect people, although the risk of this is still unclear. Any cat or dog with suspected influenza should be handled sparingly, and with use of good infection control measures, including a mask (ideally an N95 respirator) and eye protection.
Closing thoughts
My opinions on raw diets have been pretty clear all along. I don’t think there’s any evidence that raw diets have any health benefits over an appropriate cooked diet, but raw diets come with numerous infectious disease risks. I’ve seen enough dogs and cats (and sometimes owners) sickened from raw diets to be confident in that. At the same time, I’m a realist and know that some people will continue to feed pets raw diets regardless. That’s why we have a infosheet about raw diets that includes ways to reduce the infectious disease risks for those who choose to feed them to their pets.
The current situation doesn’t really change anything for me. I’m still opposed to raw diets for pets, and this simply adds yet another layer of risk to pets and people that consume/feed them.
If someone is adamant that they are going to feed their pet a raw diet, here’s what I currently recommend:
- Avoid diets that contain poultry (including duck)
- Use a diet treated with high pressure pasteurization (realizing it reduces risk, but does not eliminate it)
- Take care to avoid cross contamination of human food, and use good food handling and hygiene practices (always)
- If your pet has been fed raw meat and gets sick, make sure your veterinarian knows about the diet so they can consider whether that might be relevant
- Pay attention to the news and recalls so that you can stop feeding a diet if there are any known issues (but realize that we don’t typically know about any issues until one or more animals gets really sick or dies from the diet)