CSTE Letter of Support - signed

April 8, 2022

Centers for Disease Control and Preven on
1600 Cli on Road
Atlanta, GA 30329

Dear CDC:
I am wri ng in regard to the spread of highly pathogenic avian in uenza A (HPAI) H5N1 in wild birds,
commercial poultry, and backyard ocks in the United States, and associated human exposures to HPAI
A(H5N1) virus. This urgent and evolving public health threat emerged in the US in January 2022. One
human infec on with a HPAI A(H5N1) virus was detected in an individual in the United Kingdom who
raised domes cated ducks that had been found to be infected with HPAI A(H5N1) virus; it was the same
linage as the viruses currently circula ng in wild birds and poultry in the United States. The poten al for
human infec on with this virus remains unknown, but there are ongoing human exposures to infected
birds. Outbreaks have been reported in poultry or backyard ocks in 25 states, and more states have
conducted symptom monitoring of their residents who traveled to outbreaks to aid in a response.
Therefore, monitoring for HPAI A(H5N1) infec on among exposed individuals will require a coordinated
mul -state and jurisdic onal inves ga on, as well as specialized assistance and resources to adequately
respond. The Council of State and Territorial Epidemiologists (CSTE) strongly supports a centrally
coordinated mul -state and jurisdic onal inves ga on of HPAI A(H5N1) and recommends mul -state
technical assistance from the Centers for Disease Control and Preven on (CDC).
A mul -state coordinated inves ga on to HPAI A(H5N1) will assist each state/local/territory jurisdic on
in making rapid, prac cal decisions for ac ons to prevent and control the public health problem. This
approach will streamline and strengthen the response, as opposed to mul ple state and jurisdic onal
inves ga ons independently addressing HPAI H5N1 monitoring and risk assessment.
Each jurisdic on par cipa ng in the mul -jurisdic onal response would retain ownership of and is
responsible for all data collected within their state.

Sincerely,

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Janet Hamilton, MPH
Executive Director
Council of State and Territorial Epidemiologists