Modeling of H5N1 influenza virus kinetics during dairy cattle infection suggests the timing of infectiousness.

Since early-2024 unprecedented outbreaks of highly pathogenic avian influenza H5N1 clade 2.3.4.4b have been ongoing in dairy cattle in the United States with significant consequences for the dairy industry and public health. Estimation of key epidemiological parameters is required to support outbreak response, including predicting the likely effectiveness of interventions and testing strategies. Here, we pool limited publicly available data from four studies of naturally and experimentally infected dairy cattle. We quantify Ct value trajectories of infected dairy cattle and the relationship between Ct value and the log-titer of infectious virus, a proxy for infectiousness. We estimate that following infection minimum Ct values are rapidly reached within 1-2 days with a population mean Ct value of 15.7 (12.9, 18.4). We identify a threshold Ct value of 21.8 (19.9, 24.6), with values of Ct value above this threshold representing little-to-no infectious viral load. Finally, assuming a direct relationship between Ct value and infectiousness, we estimate the distribution of the duration of infectiousness for dairy cattle (i.e., the duration their Ct value remains below the critical threshold) with a population median of 7.8 (4.1, 13.9) days. Our estimates will be critical inputs to the development of outbreak management guidelines and modeling analyses informing response strategies.