{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:44:01Z","timestamp":1785545041176,"version":"3.56.0"},"reference-count":87,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Highly pathogenic avian influenza (HPAI) A(H5N1) clade 2.3.4.4b, a globally predominant strain, was introduced into poultry in the United States in 2022 via spillover from wild birds, and has since been regularly reported, posing ongoing risks to animal and human health. In 2024, the United States reported the first known HPAI A(H5N1) clade 2.3.4.4b infection in dairy cattle, rapidly evolving into a multispecies outbreak among cattle and poultry, with spillover into humans. Publicly available data remained siloed and fragmented, hindering timely response. Innovative multimodal surveillance methods can enhance situational awareness through comprehensive, standardized data collection, integration, and visualization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to describe observations from the application of enhanced surveillance methods that collect, integrate, and visualize multimodal data for real-time tracking of the 2024\u20102025 HPAI A(H5) outbreak in the United States as an innovative, transparent, repeatable, and scalable approach for open-source public health surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Global.health conducted real-time, multimodal surveillance of the United States 2024\u20102025 HPAI A(H5) outbreak using publicly available data for human cases (Centers for Disease Control and Prevention), animal outbreaks (United States Department of Agriculture), wastewater monitoring (WastewaterSCAN), genomic data (public genomic databases), research updates (scholarly communication), and policy changes and response measures (media and government) for the study period from February 1, 2024 through February 28, 2025. This digital data stream was used to create outbreak resources\u2014an epidemiological linelist, event timeline, and interactive map\u2014using a One Health framework to track emerging hotspots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Global.health curated 70 confirmed human HPAI A(H5) cases across 13 states in a linelist, with exposure for nearly all (n = 65, 92.9%) cases associated with commercial agriculture and related operations. We curated 682 timeline entries across 6 distinct categories: human, cattle, response (eg, research, policy changes, and public health guidance), birds, genome, wastewater, and mammals. The map integrated human cases (n=70) and animal outbreaks (commercial cattle: n=977 and commercial poultry: n=325) into a single view. California was identified as the outbreak epicenter with high numbers of human cases (n=38, 54.3%), commercial cattle outbreaks (n=748, 76.6%), and commercial poultry outbreaks (n=66, 20.3%) during the study period. Wastewater surveillance detected the virus in California, with an unknown source at least 81 days before the first confirmed commercial dairy cattle case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Global.health\u2019s approach for integrating traditional and nontraditional public health surveillance data within a One Health framework enhanced early situational awareness during the United States 2024\u20102025 HPAI A(H5) outbreak, creating open access to resources that improve contextual understanding of the scope and evolution of this emerging zoonotic event. Further research should seek to understand the full potential of multimodal data in outbreak surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/86209","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T10:05:07Z","timestamp":1777284307000},"page":"e86209-e86209","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal Data Approaches for Examining the 2024-2025 Highly Pathogenic Avian Influenza Outbreak in the United States: Descriptive Study"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8080-0270","authenticated-orcid":false,"given":"Juliana","family":"Sopko","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8927-3432","authenticated-orcid":false,"given":"Aimee R","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Powers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5694-8392","authenticated-orcid":false,"given":"Jacquelin A","family":"Sauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8116-476X","authenticated-orcid":false,"given":"Mansi","family":"Avunoori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanislaw","family":"Zakrzewski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1769-7417","authenticated-orcid":false,"given":"Allison","family":"Krugman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Dasgupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2917-0869","authenticated-orcid":false,"given":"Kara","family":"Sewalk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1642-8912","authenticated-orcid":false,"given":"Autumn","family":"Gertz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Rader","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Sheldon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brennan","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica Malaty","family":"Rivera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8838-7147","authenticated-orcid":false,"given":"Moritz U G","family":"Kraemer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel V","family":"Scarpino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8568-5317","authenticated-orcid":false,"given":"John S","family":"Brownstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"issue":"12","key":"R1","doi-asserted-by":"publisher","first-page":"2297","DOI":"10.3201\/eid3112.251118","article-title":"Highly pathogenic avian influenza A(H5N1) Clade 2.3.4.4b virus infection in poultry farm workers, Washington, USA, 2024","volume":"31","author":"Hatta","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","DOI":"10.1038\/s44298-024-00039-z","article-title":"Panzootic HPAIV H5 and risks to novel mammalian hosts","volume":"2","author":"Abdelwhab","journal-title":"Npj Viruses"},{"issue":"8034","key":"R3","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1038\/s41586-024-07849-4","article-title":"Spillover of highly pathogenic avian influenza H5N1 virus to dairy cattle","volume":"634","author":"Caserta","journal-title":"Nature New Biol"},{"key":"R4","unstructured":"Evolution of the influenza A(H5) haemagglutinin: WHO\/OIE\/FAO H5 working group reports a new clade designated 2.3.4.4. 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