A study on sustained mammal-to-mammal transmission of bird flu across various species reveals that global control measures are falling short. Published in Nature, the research examined outbreaks in European fur farms, South American marine mammals, and U.S. dairy cattle, raising concerns about the potential risk to humans. Zoonotic influenza expert Dr. Thomas Peacock and his team assessed how recent shifts in the ecology and molecular evolution of H5N1 in wild and domestic birds have heightened the chances of spillover to mammals. They also weighed various evolutionary pathways that could turn the global H5N1 influenza panzootic into a human pandemic virus.
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H5N1’s Evolving Threat
“Influenza A viruses (IAV) have caused more documented global pandemics in human history than any other pathogen. Historically, swine are considered optimal intermediary hosts that help avian influenza viruses adapt to mammals before jumping to humans,” said Dr. Peacock, who investigates the drivers of the current H5N1 avian influenza panzootic. “However, the altered ecology of H5N1 has opened the door to new evolutionary pathways.”The review highlights potential gaps in control mechanisms, including a reluctance to engage with modern vaccine and surveillance technologies and a dearth of data collection around the transmission of H5N1 between cows and to humans on US dairy farms.
Whilst previous generations of US cattle producers had eradicated foot-and-mouth disease by rapidly sharing epidemiological data, the authors say months of missing data is leaving researchers, veterinarians, and policy makers in the dark.
“H5N1 is a reportable disease in poultry, but not mammals, in the US. The US Department of Agriculture requires H5N1 testing only in lactating cattle prior to interstate movement,” said Dr. Peacock.
Current practices for H5N1 testing in wildlife focus on carcasses, not monitoring animals whilst alive, the paper notes, providing opportunities for variants of H5N1 to spread silently undetected.
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An evolutionary process of “genomic reassortment” in viruses with segmented genomes is driving the global panzootic outbreak. When two or more viruses co-infect a single host, they can swap entire segments during genome replication to create novel hybrids.
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The writers say the prospect of H5N1 becoming continually present in Europe and the Americas is a turning point for High Pathogenicity Avian Influenza (HPAI).
“New control strategies are needed, including vaccination. Influenza vaccines are licensed for poultry that reduce disease burden, but do not prevent infection and have varying degrees of success.”
Stocks of H5 vaccine that are antigenically related to circulating viruses are available and could be produced at scale using mRNA platforms if H5N1 begins spreading in humans, the authors note.
“The severity of a future H5N1 pandemic remains unclear. Recent human infections with H5N1 have a substantially lower case fatality rate compared to prior H5N1 outbreak in Asia, where half of people with reported infections died. The lack of severity in US cases may be due to infection through the eye, rather than through viral pneumonia in the lung.”
Older people appear to have partial immunity to H5N1 due to childhood exposure, whereas younger people born since the 1968 H3N2 pandemic may be more susceptible to severe disease in a H5N1 pandemic.
Source-Eurekalert