Infectious Disease

Should I be worried about bird flu? Everything you need to know

Mary Cunningham — Wed, 22 May 2024 15:13:12 +0000

Should I be worried about bird flu? Everything you need to know Mary Cunningham Wed, 05/22/2024 - 11:13

Professor Amira Roess

In April, the World Health Organization confirmed a case of Avian influenza A (H5N1), commonly known as bird flu, in a human in Texas. The individual contracted the disease while working on a commercial dairy cattle farm where the cows are believed to have been infected. The individual reported only minor symptoms and is the first confirmed human case in 2024. A second case of bird flu was reported in a human in May 2024. Cases of bird flu in cattle and other animals have now been found in Idaho, Kansas, Michigan, New Mexico, Ohio, Texas, and other states.

Reports have emerged that virus particles have been found in milk, but it is important to note that the virus particles are not infectious in pasteurized milk. Global organizations continue to monitor the situation as it evolves.

Amira Roess, professor of global health and epidemiology, offers insight and clarity on the uncertainties of this early disease outbreak. Roess is an epidemiologist who studies emerging zoonotic infectious diseases and their risk factors. Her research is interdisciplinary and includes complex longitudinal studies throughout the world. She served as the science director of the Pew policy commission on Industrial Food Animal Production and also served as a consultant on preparedness and response to H5N1 in 2007.

Should I be worried about bird flu right now?

Right now, most individuals do not need to be particularly worried about this strain of influenza because it is not affecting large numbers of people. There are many actions being taken to protect humans and to limit the impact of this virus on both our food supply and on people. For example, surveillance of animals has ramped up in response to the growing epidemic in animals. As infected animals are being identified, they are removed from the food supply before they can spread the virus.

Should we be worried that the current outbreak will spread?

Several agencies are closely monitoring the situation. So far this year, cows, birds, and one person in the U.S. have been infected with the virus. Influenza viruses are notorious for their ability to mutate. We have limited knowledge of cow viruses adapting to humans so the mutations must be monitored closely for any changes that may occur that make the virus more transmissible or more dangerous to humans. If changes occur, early interventions can be put in place, including the development of tailored, vaccines.

We have decades of experience monitoring influenza and H5N1 in particular. What we have seen time and time again is that surveillance of human, animal, and environmental samples is extremely important. Surveillance allows us to identify new viral strains that may have public health importance before they cause large numbers of severe illness and death in both people and animals.

Is milk safe to drink even though the virus has been found in milk?

Here I will emphasize the pasteurized milk is safe for consumption. There have been reports of cats being fatally infected with this strain of influenza after consuming contaminated raw milk.

Testing by the FDA and USDA has not detected any live viruses in retail pasteurized dairy products like cheese, sour cream, or milk powders. Essentially, this means that while viral particles have been detected in pasteurized dairy products, including milk, these are not infectious. The bottom line is that pasteurization is effective in inactivating potentially live strains of bird flu.

To speak to Amira Roess about bird flu or other emerging diseases, please contact Michelle Thompson at mthomp7@gmu.edu

Amira Roess is a professor of global health and epidemiology at ��AV's College of Public Health, Department of Global and Community Health. She is an epidemiologist with expertise in infectious diseases epidemiology, multidisciplinary and multi-species field research and evaluating interventions to reduce the transmission and impact of infectious diseases. Roess currently oversees several longitudinal studies to understand emergence and transmission of zoonotic infectious diseases globally, including the emergence and transmission of Campylobacter (with support from The Bill and Melinda Gates Foundation), MERS-CoV (with support from the U.S. National Science Foundation), and the development of the microbiome during the first year of life. She studies links between food animal production and emerging infectious and zoonotic diseases emergence globally, and mHealth (especially apps) technology integration and evaluations to reduce the impact of infectious disease outbreaks, promote health care, and help reduce disparities.

About George Mason University

��AV is Virginia’s largest public research university. Located near Washington, D.C., Mason enrolls more than 40,000 students from 130 countries and all 50 states. Mason has grown rapidly over the past half-century and is recognized for its innovation and entrepreneurship, remarkable diversity, and commitment to accessibility. In 2023, the university launched Mason Now: Power the Possible, a one-billion-dollar comprehensive campaign to support student success, research, innovation, community, and stewardship. Learn more at gmu.edu.

About College of Public Health at ��AV

The College of Public Health at ��AV is the first and only College of Public Health in Virginia combining public health transdisciplinary research, education, and practice in the Commonwealth as a national exemplar. The College enrolls more than 1,900 undergraduate and 1,300 graduate students in our nationally recognized programs, including six undergraduate degrees, eight master’s degrees, five doctoral degrees, and six professional certificate programs. The College is comprised of the School of Nursing and the Departments of Global and Community Health, Health Administration and Policy, Nutrition and Food Studies, and Social Work.

In This Story

Amira Roess, PhD, MPH

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Should you be worried about ‘zombie deer’?

Mary Cunningham — Wed, 20 Mar 2024 17:28:05 +0000

Should you be worried about ‘zombie deer’? Mary Cunningham Wed, 03/20/2024 - 13:28

Attention Media: To speak to Amira Roess about chronic wasting disease, please contact Director of Marketing and Communications, Michelle Thompson at mthomp7@gmu.edu

��AV researcher Amira Roess discusses deer with chronic wasting disease, nicknamed "zombie deer," and what the risk to humans is.

Photo by Getty Images

Zombies have been found in a northern Maryland state park—zombie deer that is. The sick deer are not after human brains, but they could be harmful to humans who have contact with them.

We spoke with Amira Roess, professor of global health and epidemiology at ��AV's College of Public Health, to learn about zombie deer. Roess worked on deer-related illness while she was an epidemic intelligence service officer (i.e., an outbreak investigator) at the Centers for Disease Control. She is one of the principal investigators, along with Taylor M. Anderson of the College of Science on a study funded by the USDA examining the nature of human and deer contact in urban areas, specifically in the Washington, D.C., metropolitan area.

What are zombie deer?

What is referred to as "zombie deer" are actually deer infected with chronic wasting disease (CWD), which is a prion disease. Deer with CWD can appear very unsteady, stumbling a lot, and are often very thin. They may also show other symptoms related to neurological damage.

Prions are proteins that cause other proteins to unfold. Some describe them as virus-like proteins. When they infect a person or an animal they cause severe neurological damage. This leads to serious symptoms that get worse over time including unsteadiness, loss of the ability to speak or walk or swallow, and weight loss.

How worried should people be about getting prion disease?

Fortunately, the risk of prion disease from deer appears low if humans limit their contact with deer, especially their blood and nervous tissue. But this means that we must be very careful and vigilant.

Why haven’t we heard of prions before?

You may not remember hearing the word "prion,” but you might remember hearing about a prion called bovine spongiform encephalopathy (BSE), which was commonly called “mad cow disease” by many. That experience showed the world just how deadly prion diseases can be for humans.

During the BSE outbreak in England in the 1990s, humans became infected after eating beef products that had come from cattle infected with prions. Infected people lost their ability to walk, talk, and had very agonizing slow deaths that could only be diagnosed after death upon autopsy. That was the largest prion outbreak ever documented. What is very concerning is that in the U.S. when we test deer for chronic wasting disease, we increasingly find it.

Are you worried about outbreaks?

I am concerned that it is a matter of time before we find prion disease among people whose only exposure was through direct contact with deer. In the case of BSE, it was hypothesized that many infected individuals had first gotten exposed 10 or more years prior to their deaths. We believe that during those 10 or more years the prion slowly caused damage and went undetected until the damage got so extensive, that symptoms appeared.

How can we reduce our risk of contracting CWD?

Deer are wildlife, and as with all wildlife, we need to limit our contact with them. In many parts of the U.S., white-tailed deer are becoming habituated or accustomed to humans. They know that we generally don't hurt them, and increasingly we do things like feed them. But remember, deer are not pets—they have not evolved to be in such close contact with humans. They are still wildlife and deserve our respect and distance.

Do not approach deer and train your pets not to approach them either. If you have children or take care of children, make sure to teach them to be respectful of wildlife and to never approach deer or other wildlife. This is especially important if the animal appears hurt, sick, or disoriented. In that case, call 311 or your local wildlife office immediately to get a professional involved to help the animal.

Is there a group that is more at risk for chronic wasting disease?

Deer hunters are at an increased risk because of their close contact with the blood and nervous tissue of deer that they have hunted. Numerous educational resources about how to protect yourself from the risk of prions and other pathogens when hunting are now available. The best advice is to use personal protective equipment (PPE). If a deer appears sick, do not hunt it. Hunters can access information from their local games departments and in the USDA chronic wasting disease website.

Are there other animals that carry prions?

So far there have been reports of prion disease in humans, sheep, goats, cattle, mink, cats, and lemurs, among other mammals. Our knowledge about which other animals can be infected is limited by the fact that we don't have active surveillance for prion disease and most other diseases. What we know is very limited and confined to our experiences with cattle, deer, and other animals that have been found infected because of symptoms. Prions can remain in the environment for long periods of time, and they are very difficult to destroy.

What can we do to protect deer?

Remember that all wildlife deserve our respect and deserve to be left alone. Do not feed deer or other wildlife and remove all food sources (such as trash) to protect deer, raccoons, squirrels, birds and other animals.

When people approach an injured or sick animal, we often cause stress to the animal which then can make the animal sicker. If a deer looks sick, you should exercise extreme caution and not approach it. Instead, call 311 and report the deer so that it can be tested.

Studies have found that wildlife are losing their fear of humans, and this is linked to an increase in illness in these animals and also in people. Remember that wildlife carry numerous diseases that can harm people, including deer ticks that spread Lyme disease, and raccoons, coyotes, and foxes that spread rabies.

To speak to Amira Roess about chronic wasting disease, please contact Michelle Thompson at mthomp7@gmu.edu

Amira Roess is a professor of global health and epidemiology at ��AV's College of Public Health, Department of Global and Community Health. She is an epidemiologist with expertise in infectious diseases epidemiology, multidisciplinary and multi-species field research and evaluating interventions to reduce the transmission and impact of infectious diseases. Roess currently oversees several longitudinal studies to understand emergence and transmission of zoonotic infectious diseases globally, including the emergence and transmission of Campylobacter (with support from The Bill and Melinda Gates Foundation), MERS-CoV (with support from the US National Science Foundation), and the development of the microbiome during the first year of life. She studies links between food animal production and emerging infectious and zoonotic disease emergence globally, and mHealth (especially apps) technology integration and evaluations to reduce the impact of infectious diseases outbreaks, promote health care and health reduce disparities.

Some of her deer-related work appears in these journal articles:

More resources about chronic wasting disease can be found here:

In This Story

Amira Roess, PhD, MPH

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New bivalent vaccine is a consequential next step to preemptively address colder month COVID peaks

Taylor Thomas — Fri, 04 Nov 2022 13:10:35 +0000

New bivalent vaccine is a consequential next step to preemptively address colder month COVID peaks Taylor Thomas Fri, 11/04/2022 - 09:10

In This Story

Amira Roess, PhD, MPH

Professor of public health Dr. Amira Roess shares why it is imperative we all get the latest COVID vaccine

The decreasing temperatures usher in our third fall and winter with the addition of COVID to cold and flu season. Despite feelings of normalcy returning, health professionals are still wary and continue to stress the crucial nature of preventative measures to protect against the illnesses that rise during this time of year. In addition, the country has seen a spike in RSV cases and the region is reporting a strain on the local pediatric hospitals, with several reporting they are nearing capacity.

Amira Roess, epidemiologist and professor in the Department of Global and Community Health, recently shared all the need to knows regarding the bivalent vaccine. Currently, only about seven percent of individuals ages five years and older are vaccinated with the updated booster, and she was quoted in Teen Vogue and AFAR Magazine to provide her expertise and comment about the importance of COVID-19 vaccination.

As Dr. Roess remains a foremost expert on infectious diseases, she provides further detail about the importance of remaining updated on vaccinations and is available for further comment.

How is the bivalent booster different from other COVID vaccines?

The new bivalent booster is expected to be even better at reducing the chance of infection and, if you do get infected, reducing the duration and severity of COVID-19. Bivalent refers to the booster having an mRNA component from the original strain of COVID in addition to the omicron variant BA.4 and BA.5. These are two of the variants currently circulating as well as one of the older variants. The new booster is anticipated to provide greater protection against variants that are closely related to those that the booster is formulated from and protect against future strains.

Why should those who are eligible get the new booster?

COVID-19 vaccines have consistently shown that they reduce the chance of severe infection and death. We now have a vaccine that is tailored to target the newer variants. Stay up to date on your vaccines. Vaccinated individuals have a much lower chance of severe illness. Once you are eligible to get the new booster then get it. Getting the booster will give your body a chance to develop antibodies and increase your protection against infection and severe disease.

The FDA has also recently approved the booster vaccine for people five years and older. Those who are eligible are recommended to receive one bivalent mRNA booster dose after completion of any FDA-approved or FDA-authorized monovalent primary series or previously received monovalent booster dose(s).

For this year, our models cannot adequately predict when the peaks of COVID will be or how bad they will be, but the last two and a half years have shown us that we should expect peaks.

If we wish to avoid severe rises in cases, it is imperative for more people to receive the newest dose.

Should we still mask even if we are vaccinated with the booster?

It is a good idea to wear a mask when you are in crowded indoor settings with people you don't know, especially if you are vulnerable to severe infection. During periods of high transmission in your community consider wearing a mask when you're in crowded areas. And if you are symptomatic wear a mask and limit your interaction with others while you are infected, especially members of your community who are immune compromised or elderly. Wear the best quality mask that you have access to. The more effective masks are the N-95 or K-95 (or equivalents).

Is COVID still considered worse than the flu?

Overall, more than four times as many individuals are infected with the COVID-19 virus than with the flu virus. Flu did not disrupt life, businesses, health care, school, and other aspects of life the way COVID-19 does. The sheer number of individuals who test positive for COVID-19 and have to isolate is many times more than that due to flu. I think these are reasons why it's hard to say that the pandemic is over. It's still infecting and killing more people than other infectious diseases in this country.

The disparities in health care access are also still very troubling and will continue to lead to higher rates of severe illness and death among minoritized and low-income populations. Effective treatments will continue to be out of reach for poor individuals and those who are ignored by the medical system furthering the difference in severe illness and mortality rates.

Is the pandemic over?

For segments of our population the pandemic is over. For healthy young adults and healthy children, the pandemic has been over for quite some time. They have the lowest COVID-19 disease severity and death rates compared to other groups.

For others, the pandemic is still disrupting day-to-day life. Older individuals and people with underlying conditions remain the most vulnerable to COVID-19 and to them the pandemic will never be over. For those who live with vulnerable individuals the pandemic is still very real. We are continuing to see about 400 COVID-19 deaths per day. We are continuing to have at least 50,000 cases a day, and we know we are severely undercounting cases.

The end of the pandemic would mean that we would evenly distribute therapeutics and high-quality health care to infected individuals no matter what their race or ethnicity or income level. The end of the pandemic would mean that we would have a functioning public health infrastructure that has resources uniformly distributed across the country, across the world, regardless of the income status of the population it serves. That had never been our past. It's certainly not our present, but I do hope it becomes our future.

Dr. Amira Roess specializes in infectious diseases, especially reducing the transmission of diseases that spread between animals and humans, including coronaviruses like MERS-CoV and SAR-CoV-2, the latter of which causes COVID-19. She has expertise in emerging zoonotic infectious diseases and interventions to reduce the transmission and impact of infectious diseases.

She is a professor of Global Health and Epidemiology at ��AV's College of Public Health Department of Global and Community Health. Prior to joining academia, Dr. Roess served as the Science Director for the Pew Commission on Industrial Food Animal Production at Johns Hopkins and was an Epidemic Intelligence Service (EIS) officer at the CDC. She has served as a consultant for the United States Agency for International Development, the World Bank, and Westat Inc.

For more information, contact Michelle Thompson at 703-993-3485 or mthomp7@gmu.edu.

About Mason

��AV, Virginia’s largest public research university, enrolls 39,000 students from 130 countries and all 50 states. Located near Washington, D.C., Mason has grown rapidly over the last half-century and is recognized for its innovation and entrepreneurship, remarkable diversity, and commitment to accessibility. In 2022, Mason celebrates 50 years as an independent institution. Learn more at http://www.gmu.edu.

About College of Public Health at ��AV

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7 frequently asked questions about Monkeypox

Mary Cunningham — Mon, 12 Sep 2022 00:58:34 +0000

7 frequently asked questions about Monkeypox Mary Cunningham Sun, 09/11/2022 - 20:58

In This Story

Amira Roess, PhD, MPH

Epidemiologist and professor Amira Roess answers the most frequently asked questions about monkeypox.

In July 2022, the World Health Organization declared that the global monkeypox outbreak was a public health emergency of international concern, and in August 2022, monkeypox was declared a public health emergency in the United States. The monkeypox outbreak is still spreading at unacceptable levels globally and nationally. With colleges and schools back in session, monkeypox has a new opportunity to potentially infect more people.

Epidemiologist and professor at ��AV Dr. Amira Roess specializes in infectious diseases, especially reducing the transmission of diseases that originate through animal-human contact, including monkeypox. Roess first studied monkeypox on while serving as an Epidemic Intelligence Service officer at the CDC in 2008.

Here Roess answers the most frequently asked questions about monkeypox and she is available for further comment.

Information about monkeypox is always evolving as researchers learn more. This information is accurate as of September 8, 2022.

Is Monkeypox a sexually transmitted infection (STI)? Can only men who have sex with men can get monkeypox?
No, monkeypox is not considered a sexually transmitted infection, meaning that sex is not the only way that you can get monkeypox. The virus spreads through close skin-to-skin close physical contact and through contact with bodily fluids from an infectious person. This type of contact is not limited to sexual activity.

Anyone can get monkeypox. In the United States, we're seeing that there are a lot of cases and transmission among men who have sex with men. Though we're not seeing significant transmission outside of that group, we are seeing cases in nonsexual contacts and in children. It is important to remember that anyone can get monkeypox. In the United States, we have seen over 30 cases in children

How does monkeypox spread?
Monkeypox spreads through close physical contact with someone who is infected, their bodily fluids, or contact with bedding, linens, towels, or similar material that has come in contact with the infected individual. Sex is one way to have close physical contact with someone, but the virus can also spread from close dancing, hugging, or any other contact that leads to close skin-to-skin contact.

How can I prevent the spread of monkeypox?
You can reduce your chances of catching or spreading monkeypox by reducing the number of individuals that you have close personal contact. Think through what exposures you might have in your everyday life. Have you had close physical contact with someone who is at risk of monkeypox or who has been recently exposed? If so consider getting the monkeypox vaccine.

If you get monkeypox, you can reduce the chance of spreading it by isolating and immediately notifying anyone you might have close contact with so that they can also take precautions (see below).

What are the signs and symptoms of monkeypox?
The symptoms can vary. Within three weeks of exposure, many people have a fever, headaches, and/or body aches. Often, they'll have swollen lymph nodes. Typically, individuals with monkeypox will also develop a rash that looks like pimples or pox lesions, and it is often found in the areas where that initial skin-to-skin contact or exposure may have occurred. View all the symptoms on the CDC website here.

How painful, dangerous, or deadly is monkeypox?
The strain of monkeypox that is circulating right now is not very deadly. Only a fraction of a percentage of people have died so far from the virus, and most of those deaths are reported to have been among people who have severe underlying immune compromising conditions. However, monkeypox can be very painful and there is concern about scarring from the rash.

What do I do if I’ve been exposed?
If you've already been exposed, immediately speak to a health care provider and get the vaccine as soon as you can. There is some confusion out there about the timing of the vaccine following an exposure. If you get that vaccine within two weeks of a known exposure you could significantly cut down the chances of you getting infected and of having a severe case of monkeypox. Also, let your close contacts know so they can get the vaccine. Together, we can cut down this cycle of transmission.

Can children get monkeypox?
Yes, children can get monkeypox. Children can get the virus the same way adults do—though contact with someone who has the virus. Currently, we are seeing an increase in cases among children.

To learn more monkeypox, read Dr. Roess’s other tip sheets below or visit the CDC’s monkeypox page:

What to Know About Monkeypox and the Potential for an Outbreak in the U.S. Updated May 23, 2022
Is Monkeypox the Next Pandemic? June 3, 2022
Monkeypox Background: Origins, Globalization, and Public Health June 6, 2022

For more information, contact Michelle Thompson at 703-993-3485 or mthomp7@gmu.edu.

Dr. Amira Roess specializes in infectious diseases, especially reducing the transmission of diseases that spread between animals and humans, including coronaviruses like MERS-CoV and SAR-CoV-2, the latter of which causes COVID-19. She studied monkeypox and other viruses when she served as an Epidemic Intelligence Service Officer at the CDC’s Poxvirus and Rabies Branch.

She is a professor of Global Health and Epidemiology at ��AV's College of Health and Human Services, Department of Global and Community Health. Prior to joining academia, Dr. Roess served as the Science Director for the Pew Commission on Industrial Food Animal Production at Johns Hopkins, and was an Epidemic Intelligence Service (EIS) officer at the CDC. She has served as consultant for the United States Agency for International Development, the World Bank, and Westat Inc.

About Mason
��AV, Virginia’s largest public research university, enrolls 39,000 students from 130 countries and all 50 states. Located near Washington, D.C., Mason has grown rapidly over the last half-century and is recognized for its innovation and entrepreneurship, remarkable diversity, and commitment to accessibility. In 2022, Mason celebrates 50 years as an independent institution. Learn more at http://www.gmu.edu.

About the College of Health and Human Services
The College of Health and Human Services prepares students to become leaders and to shape the public's health through academic excellence, research of consequence, community outreach, and interprofessional clinical practice. The College enrolls more than 1,900 undergraduate and 1,300 graduate students in its nationally-recognized offerings, including 6 undergraduate degrees, 13 graduate degrees, and 6 certificate programs. The college is transitioning to a college of public health in the near future. For more information, visit https://chhs.gmu.edu/.