Health
‘This Is a Dangerous Virus’
When bird flu first struck dairy cattle a year ago, it seemed possible that it might affect a few isolated herds and disappear as quickly as it had appeared. Instead, the virus has infected more than 900 herds and dozens of people, killing one, and the outbreak shows no signs of abating.
A pandemic is not inevitable even now, more than a dozen experts said in interviews. But a series of developments over the past few weeks indicates that the possibility is no longer remote.
Toothless guidelines, inadequate testing and long delays in releasing data — echoes of the missteps during the Covid-19 pandemic — have squandered opportunities for containing the outbreak, the experts said.
In one example emblematic of the disarray, a few dairy herds in Idaho that were infected in the spring displayed mild symptoms for a second time in the late fall, The New York Times has learned. In mid-January, the Department of Agriculture said that no new infections in Idaho herds had been identified since October. But state officials publicly discussed milder cases in November.
That a second bout of infections would produce milder symptoms in cattle is unsurprising, experts said, and could be welcome news to farmers. But reinfections suggest that the virus, called H5N1, could circulate on farms indefinitely, creating opportunities for it to evolve into a more dangerous form — a “high-risk” scenario, said Louise Moncla, an evolutionary biologist at the University of Pennsylvania.
“You could easily end up with endemically circulating H5 in dairy herds without symptoms, obscuring rapid or easy detection,” Dr. Moncla said.
It’s impossible to predict whether the virus will evolve the ability to spread among people, let alone when, she and others said. But the worry is that if bird flu finds the right combination of genetic mutations, the outbreak could quickly escalate.
“I’m still not pack-my-bags-and-head-to-the-hills worried, but there’s been more signals over the past four to six weeks that this virus has the capacity” to set off a pandemic, said Richard Webby, an influenza expert at St. Jude Children’s Research Hospital.
Federal officials, too, have subtly altered their tone in discussing the outbreak, now emphasizing how quickly the situation might change.
For the general public, H5N1 is “a low risk, relative to the other risks they face today,” said Dr. Nirav Shah, principal deputy director of the Centers for Disease Control and Prevention. But “100 percent, that could change,” he said. “This is a dangerous virus.”
Health experts emphasize that there are precautions Americans can take: Do not touch sick or dead birds or other animals; get tested if you have flulike symptoms; do not consume raw milk or meat, or feed them to your pets.
If a larger outbreak were to erupt, the federal vaccine stockpile holds a few million doses, although that vaccine might first need updating to match the evolved form of the virus. In either case, officials would have to scramble to produce enough for the population.
The C.D.C. recommends treatment with the antiviral Tamiflu, but studies have shown that the drug does very little to ease illness.
Underlining concerns among many experts is that Robert F. Kennedy Jr., who would lead the federal health department if confirmed, was a vocal critic of Covid vaccines and has said the bird flu vaccines “appear to be dangerous.”
Even if the second Trump administration embraces vaccine development, as the first one did when Covid bore down, it’s unclear how many Americans would roll up their sleeves for the shots. Influenza typically affects children and older adults, and pandemic influenza has sometimes hit young adults the hardest. But the mistrust engendered during Covid-19 may make Americans eschew precautions, at least initially.
An evolving threat
Unlike the coronavirus, which caused havoc with its sudden arrival, influenza viruses typically start off in a specific animal species or in certain geographical regions.
When H5N1 emerged in East Asia nearly three decades ago, it mostly sickened birds. In the years that followed, it infected at least 940 people, nearly all of whom had close, sustained contact with infected birds; roughly half of those people died.
But since January 2022, when the virus was detected in wild aquatic birds in the United States, it has affected more than 136 million commercial, backyard and wild birds, helping to send egg prices soaring. It has also struck dozens of mammalian species, including cats both wild and domesticated, raccoons, bears and sea lions.
For at least a year, H5N1 has been infecting dairy cattle, which were not known to be susceptible to this type of influenza. In some cows, it has had lasting effects, reducing milk production and increasing the odds of spontaneous abortions.
And in 2024, the virus infected 67 Americans, compared with just one in the years before, in 2022. The sources of these infections are not all known; one person may have transmitted the virus to someone in their household.
Many of these developments are classic steps toward a pandemic, said Dr. James Lawler, a director at the University of Nebraska’s Global Center for Health Security. But, he noted, “where those were really supposed to trigger accelerated and amplified actions at the federal, state and local level, we’ve just kind of shrugged when each milestone has passed.”
Infections in dairy herds, which first emerged in Texas, appeared to be declining last summer. But in late August, California announced its first case. The state’s figures soon rose sharply, prompting Gov. Gavin Newsom to declare a public health emergency in December.
“That was sort of a flag to me, like, ‘OK, this hasn’t gone away,’” said Dr. Manisha Juthani, commissioner of the Connecticut Department of Public Health. “Over the last couple of months, it has felt like the tempo has increased,” she said.
Several other recent events have raised the level of alarm among experts. In early December, scientists reported that in a lab setting, a single mutation helped the virus infect human cells more efficiently.
And late last year two people, a 13-year-old Canadian girl and a Louisiana resident older than 65, became seriously ill; previously, most people infected with H5N1 had not experienced severe symptoms. The Louisiana patient, who had health conditions and cared for sick and dying birds, died in early January.
The girl was placed on life support because of organ failure, but eventually recovered. Scientists still do not know how she became infected; her only risk factor was obesity.
Both patients had contracted a new version of the virus that is distinct from the one in dairy cattle and is now widespread in birds. In both individuals, the virus gained mutations during the course of infection that might allow it to better infect people.
“We are clearly now getting novel viruses forming in the wild bird reservoir,” Dr. Moncla said. “It’s become challenging to keep a handle on all of the various threats.”
Some experts see it as particularly worrisome that the virus seems to be in food sources like raw milk and raw pet food. Domesticated cats have died in numerous states, prompting the recall of at least one brand of pet food and new federal guidelines on pet food quality.
“The raw-pet-food thing to me is, I think, quite alarming,” said Dr. Jeanne Marrazzo, director of the National Institute of Allergy and Infectious Diseases.
Pasteurization kills live virus, as does cooking meat at high temperatures. Still, neither procedure is perfect, Dr. Marrazzo noted: “There’s no way that you can police production and sterilization in a way that’s going to make sure 100 percent of the time that food supply is going to be safe.”
A flawed response
In the year since the outbreak began, federal officials have announced other measures to prevent or prepare for a pandemic. But each is deeply flawed, experts said.
The U.S. Department of Agriculture was slow to begin testing H5N1 vaccines for cows, leaving interested companies in limbo. Dr. Marrazzo said that the department had released genetic information from virus samples but had not said where or when they were collected — details that would help scientists track the virus’s evolution.
It is also unclear how many herds are reinfected or have been battling monthslong infections. In Idaho, some herds infected in the spring seemed to recover but showed milder symptoms again in November.
“From the data we have to date, we do not see evidence of new infections or reinfections in previously affected herds, but rather a lack of clearance of the original infection,” a spokesman for the U.S.D.A. said in an emailed response. But outside experts said that the trajectory of symptoms suggested a second round of illness.
The U.S.D.A.’s program to test bulk milk began in December — nearly a year after the outbreak began — and still does not include Idaho. Engaging private companies may help the program move faster.
Ginkgo Bioworks, a company that worked with federal agencies during the Covid pandemic, already assesses roughly half the nation’s commercial milk supply for bacteria, antibiotics and other substances.
Adding H5N1 to the list would be straightforward, so “why wouldn’t we just add assays into this infrastructure that we already have?” said Matt McKnight, a manager at the company’s biosecurity division.
Earlier this month, the Biden administration announced $306 million in new funding, about one-third of it for surveillance, testing and outreach to farmworkers.
But farmworkers in some places like the Texas Panhandle are still unaware of what bird flu is, how it spreads and why it should matter to them, said Bethany Alcauter, director of research and public health programs at the National Center for Farmworker Health.
As a result, she said, many workers still do not use protective gear, including in milk parlors where the virus is thought to spread.
Human testing has been voluntary, and infections have been missed. Few farmworkers have opted to be tested, out of fear of immigration officials or their own employers.
“If you don’t look for it, you won’t find it, right?,” said Dr. Deborah Birx, who served as White House Coronavirus Response Coordinator under President Trump. “This is not about lockdowns or restricting activity. It’s about protecting the individual American by empowering them with the information.”
Health
Inside a One-Man Workshop for Ultrapotent Drugs
Last fall, a man who calls himself Chemical Analyst allowed the two of us – New York Times reporters writing about the illegal drug trade – to watch on a secure video call as he packaged ultrapotent synthetic drugs for distribution.
These chemicals now flood the modern drug market. Many have psychoactive effects that are much more intense than those of traditional drugs. One newly emerging drug, cychlorphine, can be 250 to 500 times as strong as heroin and 10 times as strong as fentanyl.
Chemical Analyst is a small-time, independent dealer who supplies powerful drugs without a cartel or gang for support. From an apartment in the northeastern United States, he places online orders for drugs made in a lab in China, repackages them and sells them domestically.
Operations like this represent the frontier of a drug market that is increasingly democratized. Compounds can be made in labs all over the world, ordered online and shipped anywhere. And because these drugs are often entirely new chemical compounds, they are difficult for law enforcement officials to detect.
We interviewed Chemical Analyst over the course of a year, after meeting him through others who use and sell these new, potent drugs.
He allowed The Times to observe his operation on the condition that his identity would remain confidential. He is a felon on probation who fears further prosecution. He is also a functional addict who regularly buys, sells and ingests some of the most potent drugs in the world.
The Times decided to describe parts of his process because they are vital to understanding both the origins of ultrapotent drugs and the difficulties faced by law enforcement in tracking and interdicting these new compounds.
In 2022 and 2023, Chemical Analyst was a street dealer of fentanyl and crack. His setup at an apartment “is so much safer,” he said. “I don’t have to worry about running if a cop rolls up through the alley,” he added. As his own use gravitated to more potent drugs, he developed the connections and expertise to sell them, too.
His latest drugs arrived in mid-October from China in a silver Mylar bag. He paid $4,370 in cryptocurrency for the shipment, which contained several powerful and potentially deadly synthetic compounds.
One bag held a 100-gram slab of MD-PiHP. The drug is a cathinone, a class of stimulants often sold as “bath salts” that can induce psychosis. In markets where these stimulants are particularly popular, like Miami, they are increasingly showing up in toxicology reports from people who suffer fatal overdoses.
On the secure video call, Chemical Analyst measured 100-milligram crystals of the drug into small bags. He sprayed the bags with bleach to remove his DNA, applied labels from an untraceable thermal printer and wore textured latex gloves to keep the bags clean of fingerprints. Because Chemical Analyst is a convicted felon, his prints are already in state databases.
He moved the drugs into smaller baggies and weighed them. He then sealed them into packages for shipment. He wrote a false return address so he could not be traced and drove far from his residence to drop them in the mail.
Chemical Analyst said that people might assume he sold on the “darknet,” a restricted network that requires special software to access. But he has a website on the regular internet, and he takes steps to conceal his whereabouts and identity. He accepts cryptocurrency payments, but he avoids Bitcoin because he worries that it might be trackable.
Drugs like this are hard to police in part because their composition changes all the time. The molecular structure of MD-PiHP is nearly identical to that of MDPV, a potent cathinone that appeared in 2010 and can cause extreme psychosis and death.
Chemical Analyst spoke in detail about the chemistry of these novel drugs. He offered to draw MD-PiHP to show important facets of its structure; shortly after the video call, he texted his illustration.
Chemical Analyst first spotted an online listing for the drug in early 2025. He is familiar enough with drug molecules that the structure alone made him want to try it. He was surprised by its potency and effects. “This is not something humans should be getting high on,” he said, adding an expletive.
He worried that the drug’s potency could produce a high so intense that it “could easily cause anhedonia,” an inability to experience joy when sober. He said that, unlike other suppliers, he did not adulterate his products, so they were predictable and therefore safer. “It’s how I pay the bills,” he said.
His operation also shows just how inexpensive illicit drugs have become in the age of synthetics. In his recent shipment from China, he ordered half a dozen different substances, paying between $6 and $28 for a pure gram, depending on the drug. A standard dose is 50 to 100 milligrams, meaning that the cost of getting high is often less than $1.
He keeps a collection of novel drug samples, as well as a separate stash for his own consumption.
Chemical Analyst plays another important role in the emergence of ultrapotent synthetic drugs. He is part of a small but influential circle of armchair chemists and theorists who discuss ideas for new drugs and scour medical literature for forgotten molecules.
He said that some members of these groups interacted with Chinese manufacturers to discuss new drug ideas. “They get ideas from us,” he said. “We have direct contact with them.”
A source at a Chinese drug manufacturer confirmed to The Times that new drug ideas were introduced first to small dealers and users like Chemical Analyst to test their popularity. If a drug catches on, it might be introduced to the mass market, which continues to rapidly transform.
Health
Simple dinner table habit linked to poor diet and higher health risks in adults over 60
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Reaching for the salt shaker at the kitchen table may seem like second nature for some – but it could reveal troubling details about your health.
Recent Brazilian research, published in the journal Frontiers in Public Health, investigated the impact of adding salt to food with a focus on older adults.
The study used national survey data from more than 8,000 Brazilians over the age of 60, collected between 2017 and 2018.
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Participants were asked the question, “Do you have the habit of adding salt to food at the table?” The researchers then deciphered certain traits that were linked to the habit.
About 10.9% of older adults said they used salt at the table. Men reported this habit more than women – 12.7% compared to 9.4%, according to the published study.
About 10.9% of older adults said they used salt at the table in a recent Brazilian survey. (iStock)
Men not following a diet for high blood pressure were more than twice as likely to add salt compared to men who follow this diet.
Men who reported living alone had a 62% higher likelihood of using salt compared to men who lived with others.
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Women not following a high blood pressure diet had 68% higher likelihood of using extra salt.
Adding salt was also associated with a lower intake of fruits and vegetables among women. The odds of adding salt to food were 81% higher in women who did not eat fruit, and 40% higher in those who did not eat vegetables.
Women who have a high concentration of ultraprocessed foods in their diet were more than twice as likely to add salt to food, as were those living in urban areas.
Women who added salt were less likely to eat fruits and vegetables, the data showed. (iStock)
As this study was cross-sectional, it showed an association but could not prove that one thing caused another, the researchers acknowledged. Some of the information was self-reported, which could also limit the findings.
Diets high in sodium are known to cause an increase in blood pressure, which also raises the risk of heart disease, gastric cancer, obesity, osteoporosis and kidney disease, according to the World Health Organization.
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About 1.89 million deaths each year are associated with consuming too much sodium, the organization reported.
The WHO recommends that adults consume less than 5 grams of salt per day, or just under a teaspoon, for best health outcomes.
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Study co-author Dr. Débora Santos, a titular professor at Rio de Janeiro State University, called for alternative ways to decrease additional use of salt.
“The use of herbs and natural seasonings as alternatives to salt, or culinary techniques such as using the acidity of citrus fruits, may help reduce discretionary salt use while maintaining food palatability,” she wrote in a press release.
“Practical strategies, such as avoiding the routine placement of saltshakers on the table, may also help reduce habitual salt use.”
About 1.89 million deaths each year are associated with consuming too much sodium, the organization reported. (iStock)
Los Angeles-based registered dietitian nutritionist Ilana Muhlstein said adding salt to food before trying it is one of her “biggest pet peeves.”
“It’s interesting that this study found that men were significantly more likely to add salt to their food compared to women, because this is an observation I’ve had as well,” Muhlstein, who was not involved in the study, told Fox News Digital.
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“It could be because women are more bloat-conscious overall and may be more informed on the medical harms of excessive salt, as well as the more superficial ones like making your rings hard to take on or off (when you’re dealing with water retention from increased salt intake).”
For men, Muhlstein suggested that those who live alone are potentially more likely to order takeout – and restaurants “tend to use much more salt than home cooking, which could make someone’s preference for salty food much higher.”
“Public health officials [should] promote nutrition education and the importance of whole foods, less processed foods and reduced salt intake overall,” a nutritionist said. (iStock)
“That is further reflected in the stats showing that the less fruits and vegetables one eats, and the more processed foods consumed, the more likely one was to add salt to their food,” she noted.
The finding that a low blood pressure diet positively influences a person’s salt intake is “promising and intriguing,” according to Muhlstein.
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“This should encourage HHS and public health officials to promote nutrition education and the importance of whole foods, less processed foods and reduced salt intake overall,” she said.
Health
The Fast-Changing Chemistry of New, Dangerous Drugs
Illicit labs are creating new synthetic drugs at breakneck speed. Dangerous, untested compounds are reaching users long before health agencies know they exist. Older drugs are regularly modified to create novel threats. Ecstasy is a prime example.
The party drug MDMA has been illegal since 1985. Its molecular structure can be drawn like this:
But what if you could add one atom to this molecule to change both the experience of taking the drug and its legal status?
You can. A single oxygen atom changes the molecule to methylone, which provides an Ecstasy-like euphoria.
This simple change had a profound consequence. When methylone reached the U.S. market in 2010 the drug could be sold legally in corner stores and smoke shops as “bath salts.”
But methylone wasn’t the end of the story. Illicit chemists now use methylone’s structure as a template for modern-day alchemy. New drug laws push them to invent new variants, which emerge in the illicit drug market with untested potencies and effects — a vicious cycle that has been impossible to contain.
These chemists are located in unregulated labs around the globe, from big enterprises in China and India that produce drugs and their precursor compounds in huge volumes, to single-person and small domestic operations that cut and package drugs for retail sale. Some of the most-used drugs, such as fentanyl, are mixed in Mexico and exported north.
Waves of Bath Salts
Methylone was an early example of a class of drugs known as synthetic cathinones, which continue to proliferate.
Beginning in 2010, emergency rooms began seeing agitated patients who were violent, paranoid and psychotic after ingesting synthetic cathinones sold as bath salts. Poison control centers received a few hundred calls about the drugs in 2010. The following year had over 6,000 calls.
When methylone was finally banned in 2011, unregulated chemists simply tweaked the molecule to evade the ban, creating new drug formulas. The Drug Enforcement Administration noted in 2019 that “as one synthetic cathinone is controlled, another unscheduled synthetic cathinone appears in the recreational drug market.”
Examining the drug on a molecular level shows how illicit chemists try to increase potency and heighten the effect in a user’s brain.
As cathinone molecules become more potent, they also become more addictive. “Because they hijack the dopamine system in the brain — the salience and reward system in the brain — they’re going to be extremely addictive,” said Dr. Michael Baumann, director of the Designer Drug Research Unit of the National Institute on Drug Abuse. “There’s a reason why chemists would design these.”
Experts confirmed that the molecules described in this article are well known among illicit chemists, who have moved on to newer structures. “These are not rudimentary chemists,” Dr. Baumann said. “They’re actually ahead of us.”
Nitazenes, the ‘Frankenstein Opioids’
Another class of drugs has been following a similar pattern. When China banned all variants of fentanyl in 2019, illicit chemists began to research non-fentanyl opioids and rediscovered nitazenes, drugs developed in the 1950s as alternatives to morphine but never approved for medical use. Chemists modify the molecules — which are more complex than cathinones — in similar ways to increase potency.
“This is trial and error,” said Dr. Alex Krotulski, director of the Center for Forensic Science Research and Education, of the efforts. “They’re pushing the envelope to make more and more potent drugs.”
By the end of 2024, at least 22 nitazene molecules had been identified. New variants are prized because of their inexpensive production costs, high potency and vague legal status, according to a 2023 paper.
Ohio’s attorney general was referring to nitazenes when he warned that “Frankenstein opioids are even more lethal than the drugs already responsible for so many overdose deaths.”
China banned nitazenes in July 2025, a move that may cause production to shift to other countries. In the meantime, illicit chemists searching through patents and research papers may stumble on another class of legal molecules to tweak and modify.
“It’s so much more dangerous today, the drugs are so much more potent,” said George W. Hime, assistant director of toxicology at the Miami-Dade Medical Examiner. “Someone out there is playing chemistry.”
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