
The H5N1 influenza situation in North America has been quieter lately (apart from saga with the BC ostriches, but that’s a different story). There’s been less spillover into domestic animals recently and less attention in the news, but the virus is still out there and causing problems. (H5N1 flu activity has already started to increase in some areas as the fall wild bird migration gets underway.)
I’ve written about the risks of H5N1 flu (and other pathogens) from raw pet food many times, so the latest report about 2 cats from a household in California that got sick and died after eating commercial raw pet food isn’t a surprise. It doesn’t change anything, but it’s yet another reminder that this virus is still a risk, and there are completely avoidable death occurring in pets (primarily cats).
Both of the cats from the report were nominally indoor only. That narrows down the potential sources nicely to start. Both cats were fed a commercially available raw pet food. The first cat got sick and rapidly deteriorated and developed severe neurological disease. That’s quite common in cases of H5N1 influenza in cats that have been reported to date, but the first cat wasn’t tested. Five days after the first cat got sick, the second cat became ill with similar signs, starting with fever and loss of appetite and ending with severe neurological disease. It tested positive by PCR for H5N1 influenza after it died.
- With that time frame, we have to consider whether the second cat could have been infected from the diet or from the first cat. The latter would be the worst scenario, as cat-to-cat transmission would be a significant concern, and also indicate potential risk of cat-to-human transmission. Unfortunately there isn’t any way to determine the transmission route in this type of situation.
Further testing showed that it the genotype of the virus from the second cat was the B3.13. That’s the main strain found in dairy cattle in the US, though it is also still possible to find it in wild birds and poultry. Presumably a poultry-based raw diet was the source, but since it was B3.13, I assume they investigated raw milk exposure too, as well as direct or indirect exposure to dairy farms.
The implicated raw diet is currently being investigated. It’s the logical source of infection in these cats, but confirmation would require detection of the virus in the food. Unfortunately, the time lag from ingestion to illness to diagnosis to investigation in cases like this often means the food that was the potential source is long gone before testing can be done, especially with raw diets that are often made in small batches (vs kibble diets). If the lot of the diet is known, then there’s the potential to find other samples from the same lot, but we also don’t know how evenly distributed the virus (or any other contaminant) would be within a batch of food. It can therefore be hard to show a definitive link, but it’s been done before so we clearly know raw food-associated H5N1 flu is an issue.
The report does not name the commercially available food that’s being investigated.
- On one hand, you can understand why: the link is not confirmed at this point.
- On the other hand, if there is contaminated food out there that’s yet to be eaten, or if there are sick cats that haven’t been diagnosed because people don’t know about the risk, holding back the information can be a problem.
I understand why this particular information is being withheld at this point, but hopefully more information will be released as the investigation continues.
What should cat owners do?
- Avoid feeding raw poultry-based diets to cats (and other pets that may be susceptible).
- If a raw poultry-based pet food is to be fed, use a high pressure pasteurized diet; this will be lower (but not zero) risk for pathogens like H5N1 flu.
- If signs of illness occur in a cat that’s eaten a raw poultry-based diet, a veterinarian should be contacted ASAP and the raw diet exposure history should be explained. Fever, lethargy and decreased appetite are probably the most common initial signs. Respiratory disease may not be apparent. Neurological disease is a big concern but typically occurs later. If these signs occur in a cat that has been fed a raw diet, H5N1 should be considered, testing is warranted, and there might be value in providing antiviral therapy (if it can be given early enough).
- We should assume that cats that might have H5N1 are infectious to other pets and possibly people. The risk is probably highest to other cats (since cats are quite susceptible to the virus and cat-to-cat transmission has been shown experimentally) but we can’t rule out the potential for cat-to-human transmission. Keeping the sick cat isolated and using good infection control practices are critical.
The LA County Deptartment of Public Health is monitoring household members and veterinary personnel who were in contact with the cats from this report, and are offering flu testing to anyone who gets sick, but there is no evidence of human disease at this point. That’s great. The risk is probably low, but it’s not zero. When we see a low risk situation over and over again, it eventually ceases being low risk, and then it becomes a bigger problem.
One last thought: Why are we seeing another report of H5N1 in cats from LA County?
- Do they have lots of people? Yes, it’s a huge county.
- Do they have lots of cats? Yes, more people generally means more cats.
- Do they feed raw diets to pets more often? Maybe, but probably not that disproportionately.
The main reason is likely the fact that LA County has an exceptional public health system that does at great job integrating animal health. That raises the concern that more situations like this are likely occurring elsewhere but are going unrecognized. The less robust the local surveillance and communications, the fewer cases are found. I assume there are many more cats that have died from H5N1 flu after eating contaminated food than we know about.








