Florida is evacuating and preparing for Hurricane Milton that is projected to make landfall as a Category 3 hurricane on Wednesday evening. The state continues to recover from Hurricane Helene, which made landfall in the Big Bend region of Florida less than two weeks ago.

On Monday, Hurricane Milton quickly strengthened into a Category 5 hurricane, triggering storm surge warnings higher than Helene’s for Florida’s Gulf Coast. In preparation, widespread evacuation orders were issued along the coast, and as many as 15 million people are under flood watches across the Florida peninsula. Areas just north of where Milton makes landfall could see more than a foot of rain. Starting today and Wednesday, 11 million people are also at risk for tropical tornados.

Crews in Florida have been working around the clock to remove debris from Helene before Milton’s impact occurs. Florida Governor Ron DeSantis said up to 4,000 National Guard personnel will be deployed to continue Helene cleanup on the state, CNN reported.

As the second most deadly storm in U.S. history, Helene created a 500-mile path of destruction with more than 230 deaths reported across six states. North Carolina particularly was hit with catastrophic flooding, resulting in more than 100 deaths in that state alone so far. In turn, the Federal Emergency Management Agency (FEMA) has provided more than US$26 million in housing and other types of assistance to over 25,000 households. More than 1,200 urban search and rescue personnel are in North Carolina and the teams have rescued or supported more than 3,200 survivors as of Saturday. More than 700 FEMA staff are on the ground as well. Over 74% of originally reported power outages also have been restored.

FEMA also has provided more than $40 million to more than 8,000 households in Florida, $4.7 million to over 5,700 households in South Carolina, $29 million to over 35,000 survivors in Georgia, and more than $230,000 to over 50 households in Virginia. FEMA has received more than 2,300 applications for disaster assistance in Tennessee.

On Oct. 3, the U.S. Centers for Disease Control and Prevention (CDC) confirmed two human cases of bird flu among workers who were exposed to infected dairy cows. On Saturday, the California Department of Public Health identified a third possible human case of bird flu and is awaiting confirmation from the CDC. The identification of bird flu in people with exposure to infected animals is not unexpected and does not change CDC’s risk assessment for the public, which continues to be low. 

At this time, the two confirmed and one unconfirmed cases in California have no known link, as the people worked on different dairy farms in California’s Central Valley. This suggests the three cases are separate instances of animal-to-human spread of the virus. All three humans have experienced mild symptoms, including eye redness or discharge (conjunctivitis). None of the individuals have been hospitalized. 

Including these most recent cases, 17 human cases of bird flu have been reported in the U.S. during 2024, bringing the total to 18 cases since 2022. Cases during 2024 have been reported in Texas (1), Michigan (2), Colorado (10), Missouri (1), and California (3). Six of the 17 reported human cases have been linked to exposure to sick or infected dairy cows. Nine cases had exposure to infected poultry. The source of infection for the one case in Missouri has not yet been determined.

While these are the first human cases of bird flu in California, bird flu outbreaks among dairy herds were first reported in the state in August 2024. Bird flu was detected for the first time in cows this year in the U.S., as CMM previously reported. The virus is widespread in wild birds and has caused ongoing outbreaks among poultry in the United States since 2022.

CDC has recommendations to protect people against bird flu. These include avoiding contact with wild birds and sick or dead animals and not preparing or eating unpasteurized (raw) milk or raw cheese. If you work with dairy cows or other animals that could be infected with bird flu, wear personal protective equipment (PPE) when in contact with (or around) dairy cows, raw milk, other animals, or surfaces and other items that might be contaminated with virus. CDC recently issued updated PPE to prevent bird flu infection. 

As CMM previously reported, the World Health Organization said an Argentinian bird flu vaccine developer will share its data with manufacturers in low- and middle-income countries to accelerate a vaccine rollout if a bird flu pandemic occurs.