Latest / Healthier Together: Larimer County's Public Health Podcast / Avian Flu Update & A Valentine's Day PSA

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Avian Flu Update & A Valentine's Day PSA · Healthier Together: Larimer County's Public Health Podcast

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  Welcome to Healthier Together, Larimer County's
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  public health podcast, where we come together
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  for healthier lives, connected communities, and
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  real conversations. From your local public health
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  team, I'm your host, Tom. And I'm Joanna. This
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  is your weekly Minnesota where we'll provide
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  a brief update on local public health news. So,
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  Tom, what's up in public health this week? Today,
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  we have Heather Reiter, coordinator for the Avian
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  Health Program at CSU, here to talk about recent
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  cases of avian flu in northern Colorado. Heather,
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  thank you so much for joining us. Yeah, thank
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  you so much for having me. So first off, can
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  you explain what highly pathogenic avian flu
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  is for us? Yeah, for sure. So highly pathogenic
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  avian influenza is usually, it actually is a
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  term that we use with poultry because when it
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  gets into poultry, it's very severe. It's fast
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  moving. It causes a lot of mortality and loss
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  within poultry. And the current strain that's
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  circulating is the H5N1. So a lot of people probably
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  within the news and the media have heard it called
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  bird flu, HPAI, H5N1. And that's all kind of
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  referring to the same kind of strain that's circulating
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  right now, the strain of concern. There's always
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  other flus out there, but this is the one that's
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  kind of causing a lot of havoc in commercial
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  and backyard flocks. So why is HPAI important?
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  And why are you guys paying attention to it so
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  closely? This particular strain especially, like
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  I already kind of mentioned, it really moves
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  fast and it kind of can kill a lot of birds really
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  quickly, like when it gets into a flock. We've
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  also seen kind of major economic impact in the
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  food supply chain, right? We kind of can all
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  think back probably over a year ago when you're
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  going to the market and... There's not as many
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  egg options on the shelf and the prices have
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  gone up. I mean, so sometimes that's what's affecting
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  the consumer directly. But for us, too, because
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  it does get into commercial and backyard flocks
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  and just that huge loss of birds, I think in
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  the U .S. total, we've lost close to 184 hundred
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  and I think we're getting up there to 190 million
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  birds lost. You know, in Colorado alone, since
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  the outbreak, we've lost over 11 million birds.
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  Wow. So and two, there's always this. zoonotic
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  potential. And when we say zoonotic, we mean
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  there's a risk to spill over into humans, right?
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  And we want to prevent that from happening. That
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  raises another question. How is this disease
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  commonly transmitted? This particular one is
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  a wild bird. transmitted disease so really what
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  you're seeing is when you probably a lot of the
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  public now at this point has seen the dead and
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  dying geese when they're taking walks through
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  the park and so we're all kind of familiar with
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  that but they are the spreader of the disease
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  and they're kind of what we consider the natural
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  reservoir of this disease and so they're spreading
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  it through their bird droppings through respiratory
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  means the best way I've kind of heard it described
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  we can all probably Picture what goose poop looks
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  at this point. We've all walked through it. It's
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  everywhere. But if you think about that, if you've
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  got an infected bird and you've got an infected
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  goose poop, right, it has enough viral load to
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  affect over a million birds. So that's how much
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  virus is kind of being put out by geese. And
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  we can all think right now they're all congregating,
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  they're all together, they're kind of eating.
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  you know, and they're in the water systems. And
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  if you've got a backyard flock, you're especially
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  high risk around this, just given how much viral
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  load can come out of these birds. Wow. So what
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  does the avian influenza situation look like
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  then in northern Colorado? So we always are monitoring
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  what's happening in the wild bird population.
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  And we've seen an uptick in positive cases in
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  wild birds. And that correlates with what we're
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  seeing in our commercial flocks and in our backyard
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  flocks. We've had a lot more positive cases recently.
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  In the last 30 days in Colorado, I think we're
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  somewhere between four or five backyard flocks
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  that we've had positive detections in. And then,
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  of course, in Will County, we had a commercial
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  facility that we had a positive detection in.
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  Table egg layer state, we range between 17th
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  and 20th in the nation for table egg layers.
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  Yeah, so I might have already mentioned it, but
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  we've already in Colorado since this outbreak
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  lost close to 11 million birds in Colorado alone.
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  Wow. So what does detection look like then for
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  avian flu? Yeah, for sure. So a lot of times
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  the number one sign that we're seeing in a poultry
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  flock, so that can be turkeys, game birds. chickens
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  is we just get high mortality. That's the most
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  common sign that we see. We get a call that in
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  the last, over the last few days, I've lost,
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  you know, quite a bit, number of birds is usually
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  what we hear. And then when we kind of hear that,
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  we want to get, we'll work with that owner to
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  get their birds tested. So, right, so it's just
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  an oral pharyngeal swab we collect. We get that
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  into our lab. We run that test. And then once
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  we have the results, that'll kind of determine
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  what we do next. Gotcha. So what does a typical
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  outbreak response then look like? Yeah, so if
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  we get a positive flock, and it's going to depend,
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  right? So if it's, we'll talk backyard flocks
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  for a moment. If we get it in a backyard flock,
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  usually a backyard flock, depending on kind of
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  what they do with their birds, kind of has an
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  option. They can usually, quarantining is always
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  a part of that equation, but sometimes you can
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  quarantine and just kind of let the, you know,
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  the virus take its toll on your birds. Or we
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  can help you depopulate. Most people do opt to
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  depopulate just because it is so incredibly hard
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  on the birds. And it is so fast moving and it
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  causes such high mortality that watching the
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  birds suffer is very hard. So yeah, so we work
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  really closely with them to make sure that they,
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  you know, everything, we help them along the
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  entire, every step along the way. Yeah, right.
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  So you've mentioned that this... Primarily, it's
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  impacted larger facilities and also smaller backyard
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  flocks. What can folks who have smaller backyard
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  flocks do to help protect their birds? So, I
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  mean, it's always, you know, we've already talked
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  about transmission. So understanding the risks
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  to your flock is really important. So, like,
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  do you live in an area where there's fields or
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  ponds where you're going to have a lot of waterfowl?
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  You know that's going to put you into a higher
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  risk category. We've had cases where someone
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  in the family, for instance, is a duck hunter
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  and it's come back through duck hunting or waterfowl
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  hunting and they brought it home that way. They
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  didn't clean and disinfect their gear and their
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  clothing and they brought it into their flock.
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  We've had cases where there is spillover events
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  into other animals, like peridomestic animals,
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  like raccoons, skunks, for instance. And so we've
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  had other where we had a detection where we had
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  a sick skunk and we tested it and the skunk was
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  positive for flu. And it wasn't long after that
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  the flock also was positive for flu. So it's
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  a good chance that that's how that got in. And
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  then also little birds. I mean, birds are always
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  a high risk. So just trying to keep your birds
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  indoors and away from wildlife is the biggest
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  thing you can do right now, especially if you've
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  got a lot of waterfowl. There's a couple of flocks
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  too we've worked where, you know, unfortunately
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  they got bird flu and there was a water ditch
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  kind of on their premises. And right on the other
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  side of that gate was a bunch of ducks, right?
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  So just the fact that they're just in the vicinity.
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  these wild birds puts them at risk. Wow. So what
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  are some signs or symptoms that a bird has avian
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  flu? Yeah, like I said, the number one is high
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  mortality. So that's the most common. Sometimes
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  you'll see some neurologic signs before you get
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  the mortality. You can see some pacing, some,
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  you know, the bird's not acting right, kind of
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  ataxic. There are some other like symptoms we
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  can see, sometimes swollen waddles. But I would
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  say with this particular strain, the most common
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  sign we see is just a lot of birds dying in a
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  very short window of time. It's very hard. Yeah,
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  that's got to be hard. So you'd already mentioned
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  this a little bit previously that, you know,
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  there have been transmissions to skunks. Are
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  there other kinds of animals that have the potential
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  to get avian flu then? Yeah, we've seen, actually,
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  if you go USDA website and if you actually search
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  USDA and then, or HPAI, you'll go right to their
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  website and they have a list there. where you
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  can look at what's happening in the poultry industry,
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  what's happening with wildlife and other domestic
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  species. So cats are high risk. We've had lots
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  of spillover events into wildlife, anything from
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  mountain lions. We've had it in dolphins. But
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  then the peridomestic, like skunk, are some of
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  the more common cases that you're usually consuming,
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  like a dead goose. These usually had to consume.
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  carnivores are the ones that are scavenging on
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  the dead geese. Raptors, other raptors have been
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  hit exceptionally hard like vultures and owls
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  and eagles and hawks and stuff like that. So
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  we have had a lot of spillover into other species
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  and then the biggest one was in cattle. So we
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  had kind of a spillover into cattle recently
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  that we've been kind of managing. So which is
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  a unique one. So I guess that begs the question,
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  are humans at risk for avian flu? We do have
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  these spillover events. What we're not having
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  is human to human transmission. But when we do
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  have human cases, it's usually they've come in
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  direct contact with a positive flock, you know,
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  cattle workers, someone that's actually working
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  in the environment where flu is present. So it's
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  still really low risk to humans, but it does
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  happen. We do see. cases of inhumans. And I think
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  in the U .S. we've had one death, but the CDC
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  website kind of keeps that up to date. And what
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  do symptoms then look like when a human gets
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  the avian flu? I'm not a human expert, but my
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  understanding is you'll see conjunctivitis and
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  some other kind of flu -like symptoms. Gotcha.
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  So I guess another follow -up question to that
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  is, do we need to worry about eating eggs or
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  meat? If you handle and cook your food, properly
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  right so like that's the one thing about flu
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  is at any heat so like in the summertime especially
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  when you don't have as much migration you know
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  in the environment because it's so hot it does
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  you know the virus can actually disappear quickly
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  in the environment. But in these colder temperatures,
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  like right now, the virus does pretty well. Of
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  course, we've got spring and fall where the temperatures
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  are cooler, so the virus stays around in the
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  environment a lot longer. So that does translate
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  over to food too, right? And that's for any poultry
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  diseases like salmonella, campylobacteria, E.
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  coli, right? You want to cook your food to temperature.
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  You don't want to eat raw food or undercooked
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  poultry or even raw milk with the cattle cases.
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  That's kind of another risk. And especially with,
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  like, cats, this is what we've seen when it gets
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  into domestic cats. A lot of times it's through
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  one of those pathways, like cats on raw food
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  diets, you know, with a contaminated meat or
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  raw milk. Maybe cats that work in the dairy,
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  that's where we first kind of saw it because
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  they were drinking the raw milk. Yeah, and so
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  really you want to make sure, even for your pets,
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  that you're cooking the food to temperature,
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  not eating raw food. And that does a pretty good
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  job of inactivating it. But also in these commercial
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  facilities, None of the food, like the eggs and
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  stuff at these commercial facilities is entering
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  the supply chain. So if we get flu cases, that's
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  all destroyed. Gotcha. So if people are out in
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  the community and they do see like a group of
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  dead birds, what should they do? Yeah, so if
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  it's wildlife, Colorado Parks and Wildlife, they
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  always encourage you to call them. It doesn't
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  mean they always have the capacity to respond,
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  but they do like to be made aware of what's happening,
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  and that leaves the choice kind of how they manage
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  it. We do not recommend people necessarily, you
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  know, picking up animals, right? Stay clear of
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  them. But sometimes there are circumstances where
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  maybe it's in an area where there's a lot of
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  animal or human traffic and they really want
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  to get rid of it. And so what we recommend is
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  obviously wear gloves. Make sure you wash your
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  hands before and after. Wear a face mask. Wear
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  eye protection. And then you double bag the bird
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  in like a trash bag and then spray the exterior
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  with like a disinfectant. Like a household Lysol
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  will work just fine. And then you can dispose
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  of it in the normal trash stream. So if that's
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  something you have to do. then that's kind of
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  the best safe way to do it, but making sure you're
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  not touching your face and your phone and things
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  that you can contaminate with that you're able
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  to kind of wash your hands and stuff afterwards
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  and wear gloves. And you can always call us too,
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  like give us a call. Not that we can always fix
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  it, but we can point people at resources. Yeah,
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  which comes to my next question. If people want
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  to learn more about avian flu and the current
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  situation in northern Colorado, where can they
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  go for more information? Yeah, that's a great
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  question. So there's, like I already mentioned,
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  there's the USDA website. So if you search USDA
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  website and put HPAI in there, you'll go right
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  to their dashboard, which kind of has the cattle,
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  chicken, wildlife. dashboards on it if you want
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  to know what's happening specifically in colorado
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  if you go to the colorado department of agriculture
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  website and you put in again hpai you'll be taking
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  you'll be taken to their site which has the latest
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  updates and what's happening in colorado so those
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  are two really really really good resources gotcha
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  Is there anything else you think our listeners
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  should know about HPAI? Yeah, we actually also
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  have a resource. It's slightly different, but
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  it's for small flocks. And it's www .healthybirds
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  .info. And it's a new site out there for small
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  flock owners. It has everything on poultry basics,
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  lots of information on biosecurity. So if you
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  really want to learn more detail about the stuff
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  I was talking about today, it's got great information
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  on there on biosecurity. And it's got really
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  good information on... diseases too, and just
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  kind of how you can protect your flock. Because
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  I always think of biosecurity, there's no one
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  simple thing you can do, but it's, I always think
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  of biosecurity like an onion, all the different
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  layers that you can add is the best way to keep
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  your flock safe. But again, there's not really
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  a simple one step you can do. It's kind of all
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  the different things that you can do to keep
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  your flock safe. Gotcha. Well, Heather, thank
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  you so much for joining us and thanks for all
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  that you do. We really appreciate you taking
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  the time. Yeah. Thank you so much for having
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  me. Valentine's Day is right around the corner,
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  and it's a great reminder to check in with your
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  sexual and reproductive health. Joining us today
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  to share some guidance and information about
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  the services offered here at our clinic is Meg
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  Vertovec, Senior Nurse Practitioner in our Sexual
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  and Reproductive Health Clinic. Meg, thank you
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  so much for joining us. Thanks so much for having
• 14:36
  me. I'm excited to be here. Sexual and reproductive
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  health is an important part of routine health
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  care this month and every month. What should
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  people remember to think about when it comes
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  to their sexual and reproductive health? Great
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  question, and I'm glad you brought that up. I
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  think just like we go to the dentist a couple
• 14:52
  times a year, our sexual health is an important
• 14:55
  aspect that we should be considering, and it's
• 14:57
  easy to forget. And so I think the first thing
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  I always tell our patients is knowledge is power.
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  High quality information helps us all make good
• 15:06
  decisions and inform decisions about our health
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  and otherwise. And so seeing a sexual and reproductive
• 15:12
  health provider regularly is an opportunity to
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  get that knowledge in a way where you know it's
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  going to be evidence -based, which can be harder
• 15:20
  to do on your own. I also always like to tell
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  our patients that prevention is 100 times easier
• 15:26
  than treatment. And so routinely... Checking
• 15:30
  in with your health, checking in with your health
• 15:31
  care team will allow you to get preventative
• 15:34
  care services as needed. And education can be
• 15:36
  part of prevention. when we can prevent problems
• 15:39
  that is always superior than waiting until those
• 15:42
  problems arise when we need oftentimes more expensive
• 15:45
  or difficult treatment. Finally, I always tell
• 15:47
  our patients that we might have gone to school
• 15:49
  to help treat and care for them, but they are
• 15:51
  always going to be the expert of their own body.
• 15:54
  And so if something just doesn't feel right,
• 15:55
  you have questions or concerns, there's changes,
• 15:58
  that's a great time to come in and talk through
• 16:01
  them with us. How often should you see a healthcare
• 16:03
  provider to talk about things like STI testing
• 16:06
  and birth control? So that will really come down
• 16:09
  to individual risks, and everyone's going to
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  be a little bit different. It's great to have
• 16:13
  that conversation if you're in the practice of
• 16:16
  seeing a provider annually for an annual physical
• 16:18
  or preventative care services, and they can help
• 16:21
  go through step -by -step your unique situation,
• 16:25
  any specific risk factors you have. and formulate
• 16:28
  a plan that is tailored to your needs. Our clinic
• 16:31
  here at the health department provides sexual
• 16:33
  and reproductive health services. What services
• 16:35
  does our clinic offer? So we are not a full spectrum
• 16:39
  primary care clinic, but we do do a great job
• 16:41
  in the avenue where we do work, so sexual and
• 16:44
  reproductive health. So that includes things
• 16:46
  like STI testing and STI treatment for a wide
• 16:50
  variety of STIs. Those are sexually transmitted
• 16:53
  infections. We also provide on -site a diverse
• 16:57
  amount of birth control methods and so that includes
• 17:00
  things like pills birth control rings birth control
• 17:03
  injections we also do procedures to place things
• 17:07
  like intrauterine contraceptive devices both
• 17:09
  hormonal and non -hormonal as well as birth control
• 17:13
  implants we also provide emergency contraception
• 17:16
  we offer pregnancy testing and counseling about
• 17:19
  your options And then we perform regular routine
• 17:22
  reproductive health exams. So that would include
• 17:24
  things like cervical cancer screenings or pap
• 17:26
  smears, as well as vaccines to protect against
• 17:29
  different sexually transmitted infections. Sometimes
• 17:32
  coming in for a sexual and reproductive health
• 17:34
  appointment can cause some anxiety. What happens
• 17:38
  during an appointment? What can people expect
• 17:40
  when they come into our clinic? I'm so glad you
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  brought this up because I think that's a reason
• 17:44
  a lot of people delay or... avoid care, which
• 17:47
  is understandable. It can be intimidating to
• 17:50
  go to any clinic, especially a clinic for sexual
• 17:52
  and reproductive health. So I always tell our
• 17:54
  patients that we provide what we call patient
• 17:56
  -centered care or care that's really guided by
• 17:59
  the individual patient and their needs. And so
• 18:02
  we will talk through with them what they're comfortable
• 18:04
  with, what they're looking for, what symptoms
• 18:07
  they're experiencing before we perform any exams
• 18:10
  or any testing. I always also want patients to
• 18:14
  know that their consent is essential. And so
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  if there's things that we might recommend based
• 18:18
  on their risk factors or the stories they're
• 18:21
  telling us, that doesn't mean that they need
• 18:23
  to agree to an exam or certain testing. It's
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  always going to be guided by their needs, their
• 18:28
  desires, and their choices. And so we want them
• 18:30
  to feel empowered and comfortable seeking care
• 18:33
  here and know that we're going to work together
• 18:35
  as a team to figure out what's best for them
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  and for their health. And so oftentimes patients
• 18:41
  get nervous, specifically about the exam portion.
• 18:44
  And so I tell patients things have changed a
• 18:46
  lot. You don't routinely need an exam if you're
• 18:50
  not having symptoms. And so if you're interested
• 18:52
  in starting a birth control method, oftentimes
• 18:55
  we can talk through all the methods and you don't
• 19:00
  even need to have an exam to start things like
• 19:02
  birth control pills or birth control rings or
• 19:03
  birth control shots. Also for testing, if you're
• 19:07
  not having symptoms that you're concerned or
• 19:09
  you want us to examine, you can collect your
• 19:11
  own test swabs, which is really empowering for
• 19:14
  patients who might be intimidated by having to
• 19:16
  have that exam. And so I hope that patients can
• 19:19
  learn that it doesn't have to be such a scary
• 19:21
  place to come. Who can use these services? Who
• 19:23
  can come to our clinic? So the health department
• 19:26
  is unique. Our clinic is unique in that we don't
• 19:28
  accept private insurance at this time. And so
• 19:31
  we only bill Medicaid, and then the rest of our
• 19:36
  patients are considered self -pay. That means
• 19:38
  we're also always happy to see any patients who
• 19:41
  don't have insurance. All of our patients with
• 19:44
  private insurance or who don't have insurance
• 19:46
  will be placed on a sliding fee scale, and that's
• 19:49
  based on their self -reported income. And we
• 19:52
  never turn anyone away because of inability to
• 19:54
  pay. We don't want people to be intimidated to
• 19:57
  seek services or to... delay services because
• 20:00
  of fear of cost. And so I would encourage them
• 20:03
  to give us a call and we can walk through where
• 20:05
  they would fall on that sliding fee scale. And
• 20:08
  we always work with patients to get the care
• 20:10
  they need, regardless of their ability to pay.
• 20:12
  Also, it's important to know in the state of
• 20:15
  Colorado, patients of all ages can seek sexual
• 20:17
  and reproductive health care without parental
• 20:19
  consent. So we can provide care to minors in
• 20:22
  our sexual and reproductive health clinic. We
• 20:24
  always encourage having a trusted adult involved,
• 20:26
  but not everyone has that. And so we do provide
• 20:29
  care for patients of all ages that is confidential.
• 20:32
  And how can listeners request an appointment?
• 20:34
  So patients can call our health department directly
• 20:36
  at 970 -498 -6700. They can also go to larimer
• 20:41
  .gov backslash health, click on the clinical
• 20:44
  services page, and there is a spot where you
• 20:46
  can request an appointment online. And one of
• 20:48
  our clerical team members will call them back
• 20:50
  to get that scheduled. Meg, thanks so much for
• 20:52
  joining us today. Thank you. Thanks for listening,
• 20:55
  Larimer County. Until next week, stay well, stay
• 20:58
  connected, and remember, we really are healthier
• 21:00
  together.