Like avian influenza raged through poultry and dairy cattle across the United States, Georgia became the latest state to detect the virus in a commercial poultry flock, and on Friday, it halted all sales of poultry to further spread of the disease will be minimized. Nationally, egg prices are on the rise — if you can find them at your local grocery store.

The ongoing animal outbreak has also led to at least 67 cases of bird flu in humanswith all but one causing mild disease. Earlier this month, a man in Louisiana died after being hospitalized with severe bird flu in December. This is the first recorded death in the country due to H5N1.

The US has previously licensed three H5N1 vaccines for humans, but they are not commercially available. The government is buying millions of doses for the national stockpile when needed. But even as the epidemic spreads, federal health officials under President Joe Biden have been reluctant to deploy them. Experts say the decision stems from risk, and for now, the risk of H5N1 remains low. Launching a vaccine among farm workers and others at higher risk of infection may be a more targeted tactic, but even that step may be premature. Now, with a change in federal health leadership about to begin President Donald Trump’s second term, the decision rests with the new administration.

“Right now, from the point of view of severity and speed of transmission, it doesn’t seem like a necessity to get a vaccine to protect people,” said William Schaffner, a physician and professor of preventive medicine at Vanderbilt University. in Tennessee.

So far, there is no known human-to-human spread of H5N1, but health officials are monitoring the virus for any genetic changes that could make it more contagious. you are possible. Most bird flu infections are associated with exposure to animals. Of the 67 known human cases in the US, 40 have been linked to sick dairy cows and 23 have been associated with poultry farms and culling operations. In the other four cases, the exact source is unknown.

In the US, human cases are mild, with most causing only conjunctivitis. In some cases, people have mild respiratory symptoms. Except for the Louisiana patient, all individuals who tested positive for H5N1 recovered quickly and did not require hospitalization. Historically though, H5N1 has killed about 50 percent of cases. Since 2003, there have been a total of 954 cases of human H5N1 reported by the World Health Organization, and about half of them died. Egypt, Indonesia, Vietnam, Cambodia, and China reported the highest number of deaths from human bird flu.

Those numbers come with some caveats. For one, most of the deaths occurred in areas where people lived in close proximity to sick chickens. “In those circumstances, the thinking is that they probably got a large dose of the virus,” Schaffner said.

Additionally, the case fatality rate—the proportion of infected people who die from the disease—considers only known cases, and some cases of H5N1 will undoubtedly go undetected in part because the bird’s symptoms flu is similar to other respiratory viruses. In the US, language barriers among farm workers, lack of testing, and workers’ reluctance to report that they are sick are also factors. “We’re probably missing more cases than we’re noticing, and we’re more likely to find a serious case,” said Shira Doron, chief infection control officer at Tufts Medicine in Boston and an epidemiologist at Tufts Medical Center hospital.