You’ve probably heard about it on the news: The bird flu is causing concern.

While the current public health risk is low, the U.S. Centers for Disease Control and Prevention (CDC) is working with local health experts and watching the situation carefully.

Nicholas R. Sells, MD, FACP, FIDSA

“The key message is that people should not be worried. We believe the risk to the population is low,” says Nicholas R. Sells, MD, FACP, FIDSA, Medical Director of Infection Prevention, Mount Sinai Morningside, and Associate Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai.

New York Gov. Kathy Hochul delivered the same message—that there was no public health threat—when she recently ordered the temporary closure of bird poultry markets in New York City to allow for special cleaning and inspections.

Here are five key takeaways to keep you updated on the bird flu, also known as avian influenza.

Why the risk to the public is low: Bird flu, which has circulated for decades, is now widespread in wild birds worldwide and is causing outbreaks in poultry and dairy cows in the United States. There have been several recent human cases among dairy and poultry workers. The risk to the general public is low because the current strain of this virus cannot easily spread from person to person, experts say.

Eggs, chicken, and milk: News about the bird flu has prompted some questions among the general public, and experts like Dr. Sells are emphasizing that it is safe to eat eggs and chicken, and drink pasteurized milk that you buy in the store. That’s because the bird flu is not transmissible by eating properly prepared and cooked poultry and eggs. Proper cooking and pasteurization kills the bird flu virus and other dangerous microbes. Milk and infant formula you buy in the store are also safe for infants and children, according to the American Academy of Pediatrics.

What the experts are doing: The CDC is using its flu surveillance systems to monitor for bird flu activity in people. According to the CDC, flu viruses change over time, so there is a risk the virus could be become more easily spread among people. At Mount Sinai, epidemiologists have been in touch with the CDC and the New York State and New York City health departments and have alerted health care providers through the Health System to be on the lookout for patients who may show signs of infection and to review their protocols for testing if needed. The reported signs and symptoms of bird flu virus infections in humans have ranged from no symptoms or mild to severe and include eye redness, fever, cough, and sore throat.

Here’s what you can do: Avoid contact with sick or dead wild birds, poultry and other animals, including dairy cows. Do not touch or consume raw milk or raw milk products or feed them to pets. Cook poultry, eggs and beef to the appropriate internal temperatures.

What about my pets? Bird flu viruses mainly infect wild migratory water birds and domestic poultry. Some bird flu viruses can spread to other animals. Cats and dogs could potentially eat or be exposed to sick or dead birds infected with bird flu viruses, and they could become infected. If your pet is showing signs of illness of a bird flu infection and has been exposed to infected (sick or dead) wild birds/poultry, you should monitor your health for signs of fever or infection.  According to the CDC, it is unlikely you can get sick with bird flu from your infected pet, but it is possible.

Did you know that some of the symptoms of the common respiratory illnesses that typically spread during the winter months mimic the symptoms of cardiovascular disease?

For example, if you are feeling short of breath or having chest pain, you may think it’s the flu. But it may be something else, especially if you have heart disease or are at risk for it.

That’s why the experts at Mount Sinai Fuster Heart Hospital are warning about the risk of heart problems during the time that respiratory illnesses typically surge, which also coincides with American Heart Month in February.

With a recent surge in influenza, COVID-19, norovirus, respiratory syncytial virus (RSV), and other respiratory viruses, it’s critical to pay close attention to your heart and symptoms—especially if you have heart disease or the risk factors for it, according to the experts. The combination of these four viruses has been termed a “quad-demic” as they are circulating at elevated levels this winter, according to the Centers for Disease Control and Prevention.

Symptoms of respiratory illness can mimic those of cardiovascular disease or cardiac events in high-risk groups. Some patients may think that symptoms such as being short of breath, weak, cold, or feverish, or having dizziness or chest pain may be solely a result of these winter viruses, but these symptoms could also be associated with, and masking, dangerous cardiovascular complications such as heart attack, pulmonary embolism, viral myocarditis, pericarditis, or even heart failure.

“We have seen people mistaking virus symptoms for serious heart complications. For example, some patients have shortness of breath, wheezing, coughing, swelling, and palpitations, and assume their symptoms are linked to a cold, when in fact they were actually in heart failure. Other patients who have had persistent chest pain and palpitations after acute viral illness may need to consider that, in fact, this could be myocarditis,” says Johanna Contreras, MD, a cardiologist at Mount Sinai Fuster Heart Hospital.

“Don’t ignore these symptoms thinking they are just a long-lasting viral infection, especially if you’re at high risk of heart disease, as this disease can be treated promptly and avoid long-term complications,” says Dr. Contreras. “Make sure to consult your doctor or call 911 if you have worsening chest pain, dizziness, or shortness of breath—a serious cardiac condition can progress quickly and it’s key to catch complications early, before they become life-threatening.”

The recent surge in viruses can also trigger cardiovascular complications among those with established heart conditions, including fever, dehydration, and increased inflammation, and Mount Sinai cardiologists are seeing a rise in these cases across all age groups.

Patients with underlying cardiovascular disease and the associated risk factors are at increased risk. Inflammation can trigger heart attacks in people with coronary artery disease. It can also exacerbate heart failure symptoms and irregular or rapid heartbeats, leading to hospitalization. Doctors have also seen post-viral myocarditis—inflammation around the heart that can progress to complications such as heart failure and cardiogenic shock—in otherwise healthy patients.

“In fact, anyone is susceptible, even health care providers themselves are susceptible, and anyone who is not paying attention to their symptoms may get sick with potentially life threatening complications,” says Icilma Fergus, MD, Director of Cardiovascular Disparities for the Mount Sinai Health System. “A recent patient had severe shortness of breath, weakness, palpitations and fatigue, fearing they had heart failure. After they had bloodwork taken, there was a frantic moment when we could not reach the patient to share results that revealed a significantly elevated troponin level which can be linked to a heart attack. Although we suspected the worst, we eventually reached the patient and they were hospitalized with Influenza A and severe viral myocarditis. They were treated appropriately and luckily there was a good outcome.”

“If you get sick and have chest pain or are out of breath, or have swelling of the legs, and it’s getting worse—especially if you have an underlying heart condition or risk factors such as obesity, diabetes, or a family history of heart disease—your symptoms of a viral infection may in fact represent cardiac symptoms,” says Anuradha Lala, MD, a cardiologist at Mount Sinai Fuster Heart Hospital. “While the immune system’s primary job is to eliminate the virus, the inflammatory response can inadvertently harm cardiac tissue. Thus, if you have a known heart condition, viral infections can bring on exacerbations—or a worsening of the underlying issue—whether it is atrial fibrillation, coronary heart disease, or heart failure.”

Heart Disease Statistics

Heart disease is the leading cause of death among men and women in the United States. Nearly half of adults—more than 121 million people—have some type of cardiovascular disease. According to the Centers for Disease Control and Prevention, more than 700,000 people die of heart disease annually, and 80 percent of these cases are preventable.

High-Risk Groups

Anyone can get heart disease, but people are more susceptible if they have cardiovascular risk factors such as high cholesterol, high blood pressure, diabetes, being overweight, or using tobacco. Age is also a factor, specifically for menopausal women (between 45 and 55) and men older than 55, and men with a family history also are at higher risk. Getting less than six hours of sleep a night may also contribute to poor outcomes.

Certain groups, including African American and Hispanic/Latino people as well as new immigrants, may also be at higher risk of complications from untreated viral illnesses. However, risk for cardiovascular disease in any population can be decreased by taking simple steps toward a healthier lifestyle.

Tips for Lowering Risk of Heart Disease

• Know your family history
• Be aware of five key numbers cited by the American Heart Association: blood pressure, total cholesterol, HDL (or “good”) cholesterol, body mass index, and fasting glucose levels
• Maintain a healthy diet, eating nutrient-rich food and eliminating sweets
• Limit alcohol consumption to no more than one drink per day for women and men
• Quit using tobacco or other inhaled substances, including both smoking and electronic cigarettes/vapes
• Watch your weight and exercise regularly
• Learn the warning signs of heart attack and stroke, including chest discomfort; shortness of breath; pain in the arms, back, neck, or jaw; breaking out in a cold sweat; and lightheadedness
• Find practical ways to eliminate stress and focus on mental health