This study examined how H5N1 clade 2.3.4.4b entered and spread among 42 US dairy farm outbreaks in nine states. Outbreaks from 10 March to 5 May 2024 were analysed by mapping, county case-control comparison and Knox space-time tests. Non-waterfowl abundance was higher in outbreak counties than in high-cattle-density counties without outbreaks (p<0.00001, r=-0.542). Space-time clustering was non-random in 14 of 30 combinations of distance and time thresholds. This fits one Texas introduction, then regional and trade-mediated spread. The analysis covers only the first 42 outbreaks, over about eight weeks.
Why it is interesting: It identifies non-waterfowl bird abundance as a distinguishing feature of the counties with the earliest H5N1 dairy outbreaks. The clustering fits a single Texas introduction with onward spread, with livestock trade among the likely contributing factors.
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