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Health officials in the most populous state in the country have seen where the bird flu story appears to be heading, and they’re determined to stay ahead of it. Whether the rest of the nation is willing to follow suit remains to be seen.

On the same day that the first severe case of the avian virus in the U.S. was disclosed in Louisiana, halfway across the country, California Gov. Gavin Newsom declared a State of Emergency designed to expedite the state’s response to further outbreaks of H5N1, commonly known as bird flu.

Newsom described the measure as “targeted action” to give government agencies the resources they need to respond quickly, particularly in the areas of testing, monitoring and distributing protective gear to at-risk workers.

“While the risk to the public remains low, we will continue to take all necessary steps to prevent the spread of the virus,” the governor added.

The possibility of H5N1’s spread to humans on a large scale has been feared for some time by research experts, but to date, no human-to-human transmission of the virus has been documented. According to the federal Centers for Disease Control and Prevention (CDC), 61 people in the U.S. have been confirmed with the virus, most of them either infected via dairy herds or commercial poultry flocks. California has confirmed 34 cases in humans.

The CDC on Wednesday announced that a person in Louisiana had been hospitalized with a severe case of bird flu infection, the first of its kind after other patients experienced mostly mild symptoms. A spokesperson for the Louisiana Department of Health tells Fortune that the patient “is experiencing severe respiratory illness related to H5N1 infection,” and is in critical condition.

According to the spokeswoman, the patient is reported to have underlying medical conditions and is over 65 years old. The infection is attributed to “a combination of a backyard, non-commercial flock, and wild birds,” she says.

The disclosure of a severe case of H5N1 renewed calls by experts for a dramatic increase in testing and reporting in the U.S. For months, researchers have warned that the bird flu outbreak was going to become a national issue, and they’ve worried that the virus could mutate in ways that eventually make human-to-human transmission possible.

Scott Hensley, a viral immunologist at the University of Pennsylvania Perelman School of Medicine, noted that the Louisiana patient was infected with the same H5N1 genotype as a previous patient in British Columbia.

“It is possible that this particular virus has a greater potential to adapt and cause severe disease in humans,” Hensley says. The immunologist says he is “anxiously awaiting the sequence data from the Louisiana patient to see if there are genetic signatures of human adaptation.”

In the meantime, some experts want other states to follow California’s lead.

“Gov. Newsom’s emergency declaration is exactly the right move,” Rick Bright, an international expert on infectious diseases and pandemic preparedness,” tells Fortune. “It will provide greater priority and resources to improve the response to the H5N1 virus that appears to be spreading without much constraint across the state’s dairy farms.”

The emergency declaration should supercharge California’s attempts to contain the spread of the virus. State and local agencies have worked for months to keep the public updated and reach out to farmworkers, including those for whom English isn’t a first language, with tips on how to stay protected and limit potential exposure to H5N1 from commercial herds and flocks.

Newsom’s office said the state has also distributed “millions of pieces” of personal protective equipment, or PPE, to high-risk workers at dairy farms. California officials have documented bird flu in 645 dairy herds—311 dairies in just the last 30 days.

The virus has killed more than 123 million birds in the U.S. since 2022, most of them in commercial poultry operations.

The Louisiana case serves as a reminder of the strong reach of the H5N1 virus—including, Bright says, the ability to mutate. “This virus has changed in ways that are allowing it to be more prevalent in a greater variety of animal species, including mammals,” he says. “The more this virus is present around people, the much higher the risk becomes for human exposure, infection, and severe illness.”

Bright and many other researchers have long sounded the alarm, beseeching the federal government to exert whatever pressure it can on state and local agencies to ask farms to test their workers for virus, take protective measures, and test their flocks or herds. Much of that, though, can only be requested, not demanded.

Earlier this month, the U.S. Department of Agriculture announced that it would begin testing the national milk supply. The USDA has issued a federal order requiring that raw, unpasteurized milk be collected and given to the USDA upon request, officials said at a press briefing this week.

All of this makes California’s move on Wednesday more notable. The emergency declaration frees up more funds to provide local agencies with the means to hire additional staff and enter into contracts to expand testing and other resources to farms.

“We need much stronger efforts in terms of reducing the risk of infection between animals to new species and to humans,” Maria Van Kerkhove of the World Health Organization (WHO) said at a conference on global health issues last month. “To do that, we need to protect people who are at risk, people who are exposed.”

Bright is among those who’ve long worried that the highly pathogenic virus would make the jump to human-to-human transmission, one reason he consistently lobbied for more aggressive testing and reporting of cases when the bird flu was beginning to become widely reported across America’s dairies and chicken farms.

Others are circumspect. “Right now, we certainly don’t have any evidence the virus is getting hotter for humans,” the WHO’s Richard Webby, who studies infectious diseases at the St. Jude Children’s Research Hospital, tells Fortune. “Fingers crossed [that it won’t].”

This article originally appeared on https://fortune.com/well/2024/12/18/bird-flu-severe-california-state-of-emergency/