Zoonotic Bird Flu News since 4 Jan till 23 Jan 2023

Bird Flu Warning: Its Spreading, Mutating, and Infecting Mammals Infection Control Today, 23 Jan 2023]

By Kevin Kavanagh

As many of us remain focused on COVID-19 and its immunosuppressive augmentation of other infectious diseases, mother nature is not sitting still. I was again reminded of this fact when I attempted to purchase a dozen eggs for over $6. The average price in the United States was over $4 in December 2022. In January 2023, the New York Times reported a cost of over $7. This consumer price gouge is not the grocery store's fault, the COVID-19 bailout, or even our bloated federal deficit. It is the result of mother nature and the H5N1 bird flu pandemic.

Along with RSV, SARS-CoV-2, and Seasonal influenza, the bird flu is spreading rapidly in the United States at epidemic proportions. According to the New York Times, 60 million birds have been infected or killed (culled) in 47 states. So far, this has surpassed the second-largest outbreak in 2015, when 50.1 million birds died in 21 states. The number of states affected has more than doubled.

Bird flu has rarely affected humans; when it does, it is from directly handling birds. The virus rarely spreads from human to human. The concern is that when it infects humans, according to the Centers for Disease Control and Prevention (CDC), there is an approximately. From 2003 to 2006, H5N1 infected 232 people and killed 134.

But the one thing we have all learned from COVID-19 is that when RNA viruses spread rapidly, they mutate. This is what appears to have happened with H5N1. A new strain that is “highly pathogenic” has emerged and killed 1,600 snow geese in Colorado. To make matters worse, 3 Montana grizzly bears had to be euthanized after they caught the virus. This outbreak was described as the most significant foreign animal outbreak in US history and raises fears that the virus has mutated to promote the infection of mammals. A capability that could have profound consequences for the mammalian species, homo sapiens.

Unfortunately, this outbreak appears not to be a single occurrence. In Spain, a highly pathogenic H5N1 virus has infected the mink population. As of early October 2022, 52,000 minks were placed in cages, and the expected overall mortality of 0.2% to 0.4% rose to a mortality rate of 4%. Samples from the minks that died revealed the H5N1 virus. This virus was also found in 27 birds in the province and a neighboring province. The authors report that mink-to-mink transmission has occurred.

The virus which affected the mink population was a new strain, having the “uncommon mutation (T271A) in the PB2 gene.” Zhang Y et al (2012) have observed, “that amino acid 271A of PB2 plays a key role in virus acquisition of the mutation at position 226 of HA that confers human receptor recognition.” In other words, the strain which infected the mink population may be one step away from being able to spread in humans efficiently.

There have also been several gain-of-function laboratory experiments which, as dangerous as these experiments are, have shown the potential for the avian flu virus to take on characteristics of seasonal influenza. In 2006, CDC made 2 hybrid viruses (avian flu and human influenza) and infected ferrets, but the infection failed to spread. But research reported in 2010 by Dr. Yoshihiro Kawaoka from the University of Wisconsin produced a highly pathogenic hybrid with the pandemic ability of H1N1 (human influenza). The report states, “the new findings raise concerns that H5N1 and pandemic H1N1 viruses could reassort in individuals exposed to both viruses and generate an influenza strain that is both highly virulent and contagious.” The published research in the Proceedings of the National Academy of Sciences also stressed the importance of monitoring the emergence of avian flu viruses with mutations in the PB2 segment.

“…that the human virus PB2 segment functions in the background of an avian H5N1 virus, enhancing its virulence. Our findings highlight the importance of surveillance programs to monitor the emergence of human H5 reassortant viruses, especially those containing a PB2 segment of human origin.”

I’m starting to experience dé·jà Vu. Gain-of-Function experiments performed on a hazardous virus, viral spread from birds to mammals, spread between mammals, and mutations beginning to arise, which may be the first step in conferring the ability to transmit in humans.

I do not want to go through this again, especially since our current pandemic is not under control. We need to aggressively contain the spread of bird flu and increase our genomic surveillance for this disease. This is not a certainty since our current genomic surveillance for COVID-19 needs to be strengthened at a time when mutations are flourishing, and the dangers of long COVID are becoming more ominous.

Three Grizzly Bears Tested Positive for Avian Flu in Montana [Smithsonian Magazine, 23 Jan 2023]

BY Margaret Osborne

The current outbreak has led to the deaths of more than 52 million birds in the United States
Amid an avian flu outbreak that’s decimating wild and domestic bird populations, scientists have documented the first cases in wild grizzly bears. The three bears, which were euthanized last fall in Montana, later tested positive for the virus, the state’s Fish, Wildlife and Parks department announced in a statement last week.

The highly pathogenic avian influenza (HPAI) virus has previously been found in a fox and a skunk in Montana, as well as in other mammals such as raccoons, black bears and coyotes in other areas of the country. These are the first recorded cases among wild grizzlies, per the department.

The three infected bears were “in poor condition and exhibited disorientation and partial blindness, among other neurological issues,” per the statement. They were observed in three different locations in the northwestern part of the state. Originally, officials suspected the animals had rabies, but when those tests came back negative and reports came in of bird flu in mammals elsewhere, officials decided to test for the virus, writes Isabel Hicks for the Bozeman Daily Chronicle.

“We thought, let’s test these just to be safe, thinking they would probably be negative,” Jennifer Ramsey, the department’s wildlife veterinarian, tells the publication. “Lo and behold, they were not.”

The current outbreak of avian flu has been the largest in U.S. history, with more than 52 million birds either killed by or culled to contain the virus. Unlike the last large surge in 2014 to 2015, this outbreak did not die out over the summer, and it seems to be driven by wild birds rather than domesticated ones.

“We don’t know exactly what it is about it, but it does seem just to be able to grow and transmit better in wild birds,” Richard Webby, director of the World Health Organization’s Collaborating Center for Studies on the Ecology of Influenza in Animals and Birds, tells NPR’s Bill Chappell. “Wild birds are the perfect mechanism to spread a virus because they, of course, fly everywhere.”

Birds infected with avian flu shed the virus in their feces, saliva, feathers and mucus, and the virus spreads when other birds come in contact with it directly or on contaminated surfaces. In chickens, the mortality rate is up to 90 to 100 percent, with birds often dying within 48 hours.

The general human population has a very low risk of infection. Only one case of this subtype of avian influenza has been reported in humans in the U.S., when a man who was involved in culling poultry was exposed on a commercial farm in Colorado last April. His only symptom was fatigue, and he recovered and was treated with an antiviral drug, per the Centers for Disease Control and Prevention. Still, the agency recommends avoiding direct contact with domestic birds or any surfaces that sick birds, wild or domestic, may have contaminated. And while wild mammals seem to be picking up the virus, they are also unlikely to transmit it to humans.

“These mammals likely got infected from consuming carcasses of HPAI-infected birds,” Ramsey tells CNN’s Amanda Watts and Theresa Waldrop via email. “Fortunately, unlike avian cases, generally small numbers of mammal cases have been reported in North America … For now, we are continuing to test any bears that demonstrate neurologic symptoms or for which a cause of death is unknown.”

First known epidemic of highly pathogenic avian influenza H5N1 in farmed mink [News-Medical.Net, 22 Jan 2023]

By Liji Thomas

Highly pathogenic avian influenza (HPAI) A(H5N1) is a strain of the avian influenza virus that primarily affects birds, particularly poultry. HPAI A(H5N1) is a highly contagious and deadly virus that can cause severe illness and death in birds, including chickens, ducks, geese, and turkeys. It has made a resurgence after many months of extremely low prevalence during the coronavirus disease 2019 pandemic (COVID-19). A recent report in the journal Eurosurveillance describes an outbreak from a mink farm in Spain caused by clade 2.3.4.4b.

The outbreak
The mink farm described here is in Galicia, northwest Spain. The initial signs of the outbreak came with a sudden rise in the number of deaths in proportion to the total number of minks, with the mortality rate increasing to 0.77% from the expected rate of 0.2-0.3%. This occurred in early October 2022 and led to the collection of oropharyngeal swabs from two sick animals.

These were tested at the Central Veterinary Laboratory (LCV) of Algete (Ministry of Agriculture, Fisheries and Food (MAPA)). While the mink samples showed no trace of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the polymerase chain reaction (PCR) test, they were positive for the HPAI virus. This was supported by the identification of pneumonia in the affected animals, which led to bleeding into the lungs.

The sick animals showed signs such as anorexia, dribbling, drooling of saliva, low energy, bleeding from the snout, and tremors or loss of balance and coordination, indicating the involvement of the nervous system.

The deaths increased week by week, reaching a peak by the third week of October when over 4% of animals were dying. Initially, mortality was observed among animals living near the manure storage barn. These barns displayed several hotspots of mortality, i.e., clusters of 2-4 pens with 100% mortality within a week or two.

The deaths spread to adjacent barns until they were occurring in every place there were minks. As more and more samples were taken from those barns where the most significant number of animals appeared to be dying, high levels of H5N1 were detected, as assessed by a low cycle threshold (Ct) in rectal, oropharyngeal, or lung samples.

In the second week of October that year, the animal health services census showed over 51,000 minks in wire cages within roofed but not completely walled-in barns. The animals were fed raw fish, poultry by-products, blood meals, and cereals. The poultry waste came from farms and abattoirs in Galicia.

How was it detected?
Interestingly, no outbreaks of avian flu among farmed birds were known to have occurred so far in this region, as late as January 10, 2023. However, in the weeks before the mink outbreak, multiple wild birds were found to be sick or dead from HPAI infection, including a few seagulls and several gannets. This was a red flag for public health experts to suspect that the mink deaths were related to this virus.

Omics eBook
Along with PCR testing to rule out SARS-CoV-2 infection, this led to specific testing for HPAI, which was confirmed to be the culprit.

The virus
Genomic testing in the European Reference Laboratory revealed the strains belonged to clade 2.3.4.4b. This has been noted to infect wild birds, especially herring gulls, in Belgium, the Netherlands, and France, both in the past and for some weeks before the Spanish outbreak. However, it has not been reported in Spain prior to this outbreak.

Clade 2.3.4.4b appears to be the result of reassortment events of several genes of H5N1 with the gull-adapted H13 subtype. The strains genotyped from the minks differed at 8-9 amino acids from the nearest genetically related H5N1 variants. Especially remarkable is the alanine substitution in the PB2 gene that causes increased viral polymerase activity following its infection of mammalian cells.

So far, this substitution has been observed just once in a European polecat from the Netherlands, in March 2022. The other mutations in this clade have not yet been found anywhere else, and studies are awaited to unravel their role in the virus lifecycle.

Averting further spread
Following the virus's identification, mink culling began on October 18, 2022, clearing all animals on the farm's premises by November 17 of that year. The farm was cleaned up with the destruction of all the waste and carcasses. Most of the farm's 12 workers took part in the culling, having already been in contact with the animals prior to this step. They were tested on the 13th and 14th of October by nasopharyngeal swab while asymptomatic, and all tested negative for the virus.

Out of caution, they were required to stay away from people for ten days from the last contact with the farm or the mink. They also self-monitored for flu-like symptoms. Only one showed symptoms on November 2 but tested negative for the virus.

Notably, workers on mink farms have been required to wear face masks since April 2020, when farmed mink were found to be infected with SARS-CoV-2. Later, more protective gear was added, along with handwashing several times a day, while work clothes were laundered and showers were taken as frequently at the farm. The workers also spent less time off-duty at the farms, reducing their period of contact.

What are the implications?
Mink appears to allow infection by influenza viruses, both human and avian. "This species could serve as a potential mixing vessel for the interspecies transmission among birds, mammals and human." With H5N1 being reported in birds worldwide, care must be taken to prevent mink infection on farms like this one. Importantly, though rare, human infection with avian flu has a very high mortality rate of 50-60%.

Earlier concerns were raised as mink were found to be susceptible to SARS-CoV-2, with transmission occurring bidirectionally between humans and mink. Such events could cause similar pathogens to spread from or to wild animals through farmed mink, posing a threat to human health.

This underlines the need to "strengthen the culture of biosafety and biosecurity in this farming system and promote the implementation of ad hoc surveillance programs for influenza A viruses and other zoonotic pathogens at a global level."

Journal reference:
• Aguero, M. et al. (2023). Highly pathogenic avian influenza A(H5N1) virus infection in farmed minks, Spain, October 2022. Eurosurveillance. https://doi.org/10.2807/1560-7917.ES.2023.28.3.2300001, https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2023.28.3.2300001

Researchers detail H5N1 avian flu outbreak at mink farm in Spain [CIDRAP, 21 Jan 2023]

By Lisa Schnirring

Several countries have reported instances of H5N1 avian flu infections in mammals, but now Spanish researchers have reported the first known outbreak in farmed mink. They described their investigation yesterday in Eurosurveillance.

The outbreak began in early October 2022 at a farm housing nearly 52,000 mink in Galicia region in northwest Spain. Farm workers noted a sharp increase in deaths, and nasopharyngeal swabbing of the mink revealed H5N1 avian influenza. The mortality rate increased each week, spreading from hot spots to the rest of the barns, peaking toward the end of October.

The mink were housed in partially open barns and were fed raw fish, poultry byproducts sourced from the same region, and other items.

Potential public health implications
A more detailed genetic analysis of the H5N1 virus found that it belonged to the current clade circulating in wild birds and poultry on multiple continents and is most closely related to a strain found in seabirds across Europe.

The scientists found that the H5N1 virus has an uncommon mutation that was seen only once before in a European polecat and that it could have arisen on its own in the mink. They said the mutation in the PB2 gene may have public health implications, given that it is present in the avian-like PB2 gene of the 2009 H1N1 pandemic flu virus and has characteristics that enable recognition by human airway receptor cells.

The virus was involved in wild bird deaths in Galicia in the weeks leading up to the mink farm outbreak, and the birds could have introduced the virus to the farm, given that the barns were partially open. The researchers said, however, that more sequencing is needed to confirm the connection. They added that no avian flu outbreaks had been reported at poultry farms that supplied byproducts to the mink farm.

No related human infections were found at the farm. Spanish mink farm workers are required to wear masks because of the risks of SARS-CoV-2 in those setting. The authors said more studies are under way to look at virulence and transmissibility of the virus. Since mink have been suggested as a possible mixing vessel for respiratory viruses, the group emphasized that interventions are needed to prevent contact between mink and wild animals and to control transmission between farm works and mink.

New bird flu pandemic fears as top virologists sound alarm over 'worrisome' spread of killer virus in mink - and say it raises chilling prospect that H5N1 could jump to humans and sweep planet [Daily Mail, 20 Jan 2023]

By By STEPHEN MATTHEWS & EMILY CRAIG

• Top virologists alarmed after bird flu strain H5N1 spreads between mammals
• Outbreak occurred in a farm in Spain in October which housed 52,000 mink
• It raises prospect it could acquire mutations to spread easier among humans

Fears of a potentially devastating bird flu pandemic were heightened today after a 'worrisome' outbreak among mink.

Top virologists from across the world have sounded the alarm after tests confirmed the H5N1 strain was spreading between mammals.

It raises the prospect that the pathogen could acquire troublesome mutations that allow it to spread much easier between humans, helping it clear the biggest hurdle that has stopped it from sweeping the world.

One virus-tracking scientist described the H5N1 strain, detected in Spain, as being similar to one purposely engineered to better infect humans in controversial 'gain of function' lab experiments.

Top virologists from across the world have sounded the alarm after tests confirmed the H5N1 strain was spreading between mink (pictured). The outbreak occurred in a farm in Galicia, north west Spain, in October which housed 52,000 of the animals

Alan Gosling, a retired engineer in Devon, caught the virus after his ducks, some of which lived inside his home, became infected. No one else caught the virus

Professor Rupert Beale, an immunology expert at the world-renowned Francis Crick Institute in London, said: 'We should have vaccine contingency plans already.'

And Professor Isabella Eckerle, a virologist at the University of Geneva's Centre for Emerging Viral Diseases, called the findings 'really worrisome'.

Other experts warned that outbreaks among mink could lead to a recombination event — when two viruses switch genetic material to make a new hybrid.

A similar process is thought to have caused the global 2009 swine flu crisis that infected millions across the planet.

The same biological phenomenon was also seen during the Covid pandemic, such as so-called Deltacron — a recombination of Delta and Omicron, first detected in France last February.

For decades, scientists have warned that bird flu is the most likely contender for triggering the next pandemic.

Experts say this is because of the threat of recombination — with high levels of human flu strains raising the risk of a human becoming co-infected with avian flu as well.

This could see a deadly strain of bird flu merge with a transmissible seasonal flu.

The mink outbreak occurred in a farm in Galicia, north west Spain, in October which housed 52,000 of the animals.

It was only spotted after a sudden surge in the animals dying. Up to four per cent died in one week during the course of the outbreak, which was declared over by mid-November.

Farm vets swabbed the minks and the samples were analysed at a Government lab, where they tested positive for H5N1.

It led to all of the animals being culled, farm workers isolating for 10 days and heightened security measures in farms across the country.

These included wearing face masks and disposable overalls and showering before leaving the premises.

Analysis of samples taken, which were published yesterday in the infectious disease journal Eurosurveillance, show the virus had gained nearly a dozen mutations — most of which had never or rarely been seen before in bird flu strains.

One was previously seen on the virus behind the 2009 global swine flu pandemic.

Scientists probing the samples believe it was triggered by a H5N1 outbreak among seabirds in a nearby province.

The UK has logged a record number of bird flu cases last winter. Levels usually fall in the spring and summer, but the outbreak rumbled on past its usual end point. Nearly 300 confirmed cases of H5N1 have been detected among birds in England since the current outbreak began in October 2021. However, the true toll is thought to be much higher
The report, from experts at Spain's Ministry of Agriculture, Fisheries and Food, along with some from the Counsel of Rural Affairs, states that this is the first time H5N1 has spread among mink in Europe.

They warned minks could act as a 'potential mixing vessel' for H5N1 transmission among birds, mammals and humans — such as by recombining the strain with human flu viruses, which can infect people.

Increased biosecurity measures at mink farms and increased surveillance are needed to limit any risk of transmission to people, the report warned.

Professor Francois Balloux, an infectious disease expert based at University College London, said: 'The sequenced genomes carry several rare or previously unreported mutations, likely acquired after mink-to-mink transmission.

'Avian flu AH5N1 can infect a range of carnivores and also sometimes humans. Small clusters in humans have been reported but human-to-human transmission remains ineffective.

'Such outbreaks of avian flu in mink farms are highly suboptimal as they create natural "passaging experiments" in a mammalian host, which could lead the virus to evolve higher transmissibility in mammals.'

Dr Jeremy Ratcliff, a senior scientist at Johns Hopkins University Applied Physics Laboratory in Maryland, said there is no need to panic over the outbreak because it ended two months ago.

'However, that H5N1 can successfully adapt to mammal-mammal transmission is worrisome in general,' he added.

Other virologists online warned that the mutated version of H5N1 was similar to one made in a lab to better infect mammals.

They pointed to one controversial experiment, by Dutch scientist Ron Fouchier, which involved tweaking H5N1 so it could better infect ferrets.

The results sparked controversy among the scientific community and security agencies over concerns they could be used to create a bioweapon.

Findings showed a version that could infect mammals can be achieved with just a few tweaks to the virus.

The US National Science Advisory Board for Biosecurity asked for some parts of the findings not to be published — but eventually permitted the findings to be published in the journals Nature and Science.

Advocates of these so-called 'gain of function' tests claim they can help pandemic preparedness by revealing how viruses can mutate, allowing scientists to develop drugs and vaccines that work against them.

But critics argue the experiments could trigger an outbreak if the virus accidentally leaked from a lab, which is how some scientists believe the Covid pandemic started.

The UK has logged a record number of bird flu cases last winter. Levels usually fall in the spring and summer, but the outbreak rumbled on past its usual end point.

Nearly 300 confirmed cases of H5N1 have been detected among birds in England since the current outbreak began in October 2021. However, the true toll is thought to be much higher.

One year ago, the UK's logged its first case of H5N1 in a person.

Alan Gosling, a retired engineer in Devon, caught the virus after his ducks, some of which lived inside his home, became infected. No one else caught the virus.

The virus struggles to latch onto human cells, unlike seasonal flu, scientists say. As a result, it is usually unable to penetrate them and cause and infection.

Three Montana Grizzly Bears Euthanized Last Fall Tested Positive for Avian Flu [The New York Times, 20 Jan 2023]

By Maya King

Three Montana Grizzly Bears Euthanized Last Fall Tested Positive for Avian Flu The bears are believed to have contracted the virus from diseased birds, amid what a U.S.D.A. spokesman called the “largest foreign animal disease outbreak in U.S. history.”

Three young grizzly bears in Montana that were euthanized last fall later tested positive for the highly contagious avian influenza, the state’s Fish, Wildlife and Parks service announced this week, fueling fears that the virus that has killed millions of poultry in the last year is rapidly spreading to other animal groups.

The bears were disoriented, had begun to go blind and were euthanized as a result of their poor condition, the parks service said in a news release on Tuesday. They tested positive for the virus in January, said Dr. Jennifer Ramsey, the veterinarian for Fish, Wildlife and Parks. She said the bears had most likely contracted the virus from consuming diseased birds with high levels of the virus.

The outbreak of the current strain of the bird flu known as H5N1 is “the largest foreign animal disease outbreak in U.S. history,” according to a spokesman for the U.S. Agriculture Department. It has infected nearly 60 million commercial and backyard flocks of birds in 47 states, and its near ubiquity has driven up poultry prices and caused egg shortages in supermarkets across the country, as consumers jostle for cartons topping $7 or more.

Most of the infections are found in wild birds, and some of those spread to other animals that prey on them. The Agriculture Department has recorded avian flu infections in 110 mammals since May 2022, including raccoons, foxes and skunks. The grizzly bears’ positive tests mark the first time that Montana has recorded bird flu in a mammal species.

“It’s disappointing,” Dr. Ramsey said in an interview. “I think in the spring we had a really high peak of wild bird mortality and we all had a hope that this thing would kind of fade out over the summer, and then we wouldn’t have a lot of cases this winter. But that hasn’t been the case.”

Vaccines against the bird flu exist but are not yet widely available for the H5N1 strain in the United States. Only a handful of cases have been recorded in humans. Dr. Ramsey said she recommended that humans keep their pets away from dead birds and wear gloves when handling any dead wildlife.

Wild bird populations tend to migrate across hundreds of miles and are often asymptomatic when infected, making it difficult for wildlife experts to track and contain the virus. Should it continue to spread during the spring and summer when temperatures warm and mammals emerge from hibernation, infectious disease experts say, the virus is likely to become more widespread among other animal groups, including mammals and aquatic animals.

Still, the extent of infection in birds is enough cause for concern for the experts tracking its spread.

“We have not had this virus in our part of the world on this scale before,” said Richard Webby, a director in the Department of Infectious Diseases at St. Jude Children’s Research Hospital. “In the world of flu, this is a pretty major event.”

Human infection caused by avian influenza A(H5) - Ecuador [World Health Organization, 18 Jan 2023]

Situation at a glance
On 9 January 2023, WHO was notified of a human infection caused by an avian influenza A(H5) virus. The case, a nine-year-old girl, living in a rural area in the province of Bolívar, Ecuador, was in contact with backyard poultry, which was acquired a week before the onset of her symptoms. She is currently hospitalized, in isolation, and is being treated with antivirals.

This is the first reported case of human infection caused by avian influenza A(H5) virus in the Latin America and the Caribbean region. Work is ongoing to further characterize the virus.

Currently, available epidemiological and virological evidence suggests that influenza A(H5) viruses have not acquired the ability for sustained transmission among humans, thus the likelihood of human-to-human spread is low.

Description of the situation
On 9 January 2023, the Ecuador IHR National Focal Point (NFP) informed WHO of a human case of infection with an avian influenza A(H5) virus. The case was detected as part of severe acute respiratory infection (SARI) sentinel surveillance and was confirmed by the National Influenza Centre (NIC), the National Institute of Public Health Research (INSPI per its acronym in Spanish).

The case is a nine-year-old girl, with no known comorbidities, from Bolívar Province, Ecuador.

She developed symptoms of conjunctival pruritus and coryza on 25 December 2022. On 27 December, she was brought to a local health center for medical evaluation and treatment. On 30 December, due to the persistent symptoms including nausea, vomiting and constipation, she was admitted to a general hospital where empirical treatment for meningitis was started with antibiotics and antipyretics. On 3 January 2023, she was transferred to a pediatric hospital in critical condition where she was admitted to the intensive care unit (ICU) with septic shock and was treated with antivirals and mechanical ventilation due to pneumonia.

On 5 January, as part of SARI surveillance activities, a nasopharyngeal sample was collected from the patient. The sample was sent to INSPI and tested positive for influenza A(H5) by reverse transcription-polymerase chain reaction (RT-PCR) on 7 January.

As of 17 January, the patient remains hospitalized, under isolation, and with noninvasive mechanical ventilation.

According to the epidemiological investigation in response to the outbreak, a week before the onset of her symptoms, the family acquired poultry which died without apparent cause on 19 December 2022. In addition, the epidemiological investigations revealed that several incidents of dead backyard poultry (chickens and ducks) have been reported from the same community where the family resided.

Epidemiology of disease
Zoonotic influenza infections in humans may be asymptomatic or may cause disease, from conjunctivitis or mild, flu-like symptoms to severe, acute respiratory disease or even death, depending on factors related to the virus causing infection and the infected host. Rarely, gastrointestinal or neurological symptoms have been reported.

Human cases of infection with avian influenza viruses are usually the result of direct or indirect exposure to infected live or dead poultry or contaminated environments.

Public health response
Public health measures from both human and animal health agencies have been implemented. These include:
• Local authorities carried out epidemiological investigations and follow-up of the case’s contacts in the family, home, and health care facilities.
• Ongoing intersectoral activities with the Ministry of Agriculture and Livestock (MAG), and the Phytosanitary and Animal Health Regulation and Control Agency (Agrocalidad) for active detection, follow-up and control of avian influenza outbreaks in the area.
• Continuous follow-up of persons with respiratory symptoms and suspected influenza cases due to contact with poultry or/and who have been exposed to birds, among the exposed population.
• Seasonal influenza vaccination in risk groups is ongoing according to the guidelines of the National Immunization Program.
• The NIC is in the process of sending the patient’s samples to a WHO Collaborating Center for further characterization.

WHO risk assessment
This is the first reported case of human infection caused by avian influenza A(H5) virus in Ecuador and in Latin America and the Caribbean. This human case was exposed to poultry, which died without apparent cause. Outbreaks of highly pathogenic avian influenza have been detected recently in the provinces of Cotopaxi (influenza A(H5N1)) and Bolívar, Ecuador.

Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore, human cases are expected, although rare.

According to the information received thus far, the virus has not been detected in other individuals beyond this single case. While further characterization of the virus from this case is pending, currently available epidemiological and virological evidence suggests that influenza A(H5) viruses have not acquired the ability for sustained transmission among humans, thus the likelihood of human-to-human spread is low. Based on available information, WHO assesses the risk to the general population posed by this virus to be low. The risk assessment will be reviewed as needed should further epidemiological or virological information become available.

A global risk assessment associated with recent influenza A(H5N1) clade 2.3.4.4b viruseswas published on 21 December 2022. However, the subtype and clade information for this human case is not yet known.

There are no approved vaccines for preventing influenza A(H5) in humans. Candidate vaccines to prevent influenza A(H5) infection in humans have been developed for pandemic preparedness purposes.

Close analysis of the epidemiological situation, further characterization of the most recent viruses (human and poultry) and serological investigations are critical to assess associated risk and to adjust risk management measures in a timely manner.

WHO advice
The reported case does not change the current WHO recommendations on public health measures and surveillance of influenza.

WHO does not advise special traveler screening at points of entry or restrictions regarding the current situation of influenza viruses at the human-animal interface.

Due to the constantly evolving nature of influenza viruses, WHO continues to stress the importance of global surveillance to detect and monitor virological, epidemiological, and clinical changes associated with emerging or circulating influenza viruses that may affect human (or animal) health, and timely virus sharing for risk assessment. The diversity of zoonotic influenza viruses that have caused human infections is alarming and necessitates strengthened surveillance in both animal and human populations, thorough investigation of every zoonotic infection and pandemic preparedness. Vaccination against seasonal influenza infection of selected groups at increased risk of exposure to animal influenza viruses could be considered as a measure to reduce opportunities for the simultaneous infection of humans with animal and human influenza viruses.

In the case of a confirmed or suspected human infection caused by a novel influenza virus with pandemic potential, including a variant virus, the health authorities should be notified and appropriate clinical case management, including testing, triage, clinical assessment for disease severity classification, assessment of risk factors for severe disease and isolation and treatment (e.g., antivirals and supportive care) should be provided. A thorough epidemiologic investigation (even while awaiting the confirmatory laboratory results) of a history of exposure to animals, and travel, and contact tracing should be conducted. The epidemiologic investigation should include early identification of unusual respiratory events that could signal person-to-person transmission of the novel virus. Clinical samples should be tested and sent to a WHO Collaboration Centre for further characterization.

Travelers to countries with known outbreaks of animal influenza should avoid farms, contact with animals in live animal markets, entering areas where animals may be slaughtered, or contact with any surfaces that appear to be contaminated with animal faeces. Travelers should also wash their hands often with soap and water. Travelers should follow good food safety and hygiene practices. Should infected individuals from affected areas travel internationally, their infection may be detected in another country during travel or after arrival. If this were to occur, further community level spread is considered unlikely as this virus has not acquired the ability to transmit easily among humans.

All human infections caused by a novel influenza subtype are notifiable under the International Health Regulations (IHR) and State Parties to the IHR (2005) are required to immediately notify WHO of any laboratory-confirmed case of a recent human infection caused by an influenza A virus with the potential to cause a pandemic. Evidence of illness is not required for this notification.

WHO does not recommend any restrictions on travel and/or trade for Ecuador based on available information on this event.

Further information
• PAHO/WHO. Epidemiological Update Outbreaks of avian influenza and public health implications in the Region of the Americas. 11 January 2022. Available at: https://www.paho.org/en/documents/epidemiological-update-outbreaks-avian-influenza-and-public-health-implications-region-0
• PAHO/WHO. Influenza at the Human-Animal Interface: PAHO Recommendations to Strengthen Intersectoral Work for Surveillance, Early Detection, and Investigation, 9 July 2020. Available at: https://iris.paho.org/handle/10665.2/52563
• PAHO/WHO. Samples from patients suspected of Influenza A/H5 LABORATORY TESTING ALGORITHM. 2 December 2022. Available at: https://www.paho.org/en/documents/samples-patients-suspected-influenza-ah5-laboratory-testing-algorithm
• WHO. Assessment of risk associated with recent influenza A(H5N1) clade 2.3.4.4b viruses. 21 December 2022. Available at: https://www.who.int/publications/m/item/assessment-of-risk-associated-with-recent-influenza-a(h5n1)-clade-2.3.4.4b-viruses
• WHO. Summary of Key Information Practical to Countries Experiencing Outbreaks of A(H5N1) and Other Subtypes of Avian Influenza. First Edition. July 2016. 1 July 2016. Available at: https://www.who.int/publications/i/item/WHO-OHE-PED-GIP-EPI-2016.1
• WHO. Influenza at the human-animal interface summary and assessment. 14 December to 21 January 2022. Emergency Situation Updates. 21 January 2022. Available at: https://www.who.int/publications/m/item/influenza-at-the-human-animal-interface-summary-and-assessment-21-january-2022
• WHO. Case definitions for diseases requiring notification under the IHR (2005). 17 November 2009. Available at https://www.who.int/publications/m/item/case-definitions-for-the-four-diseases-requiring-notification-to-who-in-all-circumstances-under-the-ihr-(2005)
• International Health Regulations (IHR) (2005). WHO. Third Edition. 1 January 2016. Available at: http://www.who.int/ihr/publications/9789241596664/en/
• WHO. Terms of Reference for National Influenza Centers of the Global Influenza Surveillance and Response System. 31 October 2017. Available at: https://cdn.who.int/media/docs/default-source/influenza/national-influenza-centers-files/nic_tor_en.pdf
• WHO. Protocol to investigate non-seasonal influenza and other emerging acute respiratory diseases. WHO/WHE/IHM/GIP/2018.2. Available at: https://apps.who.int/iris/handle/10665/275657
• Government of Ecuador. Ministry of Agriculture and Livestock (MAG) and the Phytosanitary and Animal Health Regulation and Control Agency (Agrocalidad) reinforce measures to contain new cases of avian influenza. 9 January 2023. Available at: https://www.agrocalidad.gob.ec/mag-y-agrocalidad-refuerzan-medidas-para-contener-nuevos-casos-de-influenza-aviar/
• WHO Global Influenza Programme. Available at: https://www.who.int/teams/global-influenza-programme
• Global epidemiological surveillance standards for influenza. Available at : https://apps.who.int/iris/handle/10665/311268
Citable reference: World Health Organization (18 January 2023). Disease Outbreak News; Human infection caused by avian influenza A(H5) - Ecuador. Available at https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON434

Bird flu detected in Chile and human case reported in Equador [Poultry World, 16 Jan 2023]

Chile has detected the H5N1 avian influenza virus strain among dead birds in Valparaiso region, an area that produces poultry. Protective measures have been implemented throughout the country.

As has happened in several Latin American countries, the disease re-emerged in Chile at the end of 2022 via pelicans. Prior to this latest detection, however, all outbreaks occurred in areas without significant poultry production.

Chile was declared avian influenza-free in early 2020. While there are currently no reports of the virus entering backyards or commercial livestock, the country’s Agriculture and Livestock Service (SAG) reports that it is receiving more and more notifications of sick or dead seabirds.

Quick response to bird flu alerts
According to Juan Carlos Dominguez, president of the meat exporters association ChileCarne, the speed of detection and the alert system allows the sector to respond quickly.

“The SAG team carries out permanent monitoring. Since the strain appeared in the United States, we have doubled our efforts, especially in seabirds. For many years, white meat producers and exporters have implemented biosecurity measures in the face of the return of the disease,” he added.

Unspeakable damage and unexplainable consequences | In Poultry World edition 9 of 2022, we look closely at how millions of birds in flocks worldwide have been affected by avian influenza. Getting the virus under control is necessary for multiple reasons, and as the virus spreads, the call for vaccination gets louder. Read this feature article here.

Chile’s poultry market
Chile produced 675,162 tonnes of chicken meat and 71,614 tonnes of turkey in 2021. The country’s chicken meat exports are estimated to have increased by 11% in 2022, to 214,000 mt and with 28% more value. Turkey meat exports could have increased by 25% to 30,000 tonnes.

Human case of avian influenza in Ecuador
Ecuador’s Ministry of Health confirmed the first case of avian influenza human transmission in a 9-year-old girl in Bolivar province. This marks a rare case of human infection and is the first in South America, a month after the country declared an animal health emergency.

According to Reuters, the human disease caused by avian influenza infections ranges from mild to more severe symptoms and could include death.

For the latest updates on avian influenza, click here.

The 9-year-old girl infected with avian flu (A-H5) is “stable with a favourable evolution”, said Francisco Pérez, undersecretary of Surveillance and Health Control of the Ministry of Public Health (MSP) of Ecuador, said on 10 January. He further indicated that the minor had symptoms on 25 December and was treated locally.

According to the United States Centers for Disease Control and Prevention, the spread of the virus that causes the disease, H5N1, among humans is rare.

In the case reported in Ecuador, the country’s Ministry of Health stated that humans and animals in that province are being closely monitored. “It is assumed that the infection occurred through contact with birds. So far, no other cases have been reported in humans,” the note added.

A health emergency
Ecuador declared a health emergency at the end of November and issued an epidemiological alert in December. They registered cases in Cotopaxi and Bolívar, where thousands of birds were culled to contain the disease.

Avian flu has decimated poultry flocks since last year in Europe, Asia and North America, including in the US, which reported the first human case last April.

After migrating from North and Central America, the avian flu virus entered the continent through Colombia and soon reached Venezuela, Peru, Ecuador and Chile. To date, there have been no reported cases in Argentina, Brazil, Paraguay or Uruguay.

Around the world, hundreds of millions of commercial birds were culled to stop the spread of the disease, and millions more wild birds have died.

Ecuador confirms first human bird flu infection in 9-year-old girl [Reuters.com, 11 Jan 2023]

QUITO, Jan 10 (Reuters) - Ecuador reported its first case of human transmission of bird flu in a 9-year-old girl, the Health Ministry said on Tuesday, marking a rare case of human infection a month after the country declared an animal health emergency.

Human illness from bird flu infections have ranged from no symptoms to mild illness to severe disease resulting in death, according to the U.S. Centers for Disease Control and Prevention, which advised that spread between humans is very rare.

Bird flu wiped out tens of millions of birds last year across the United States, which reported a first human case last April. Many of the birds were slaughtered to stop the disease from spreading.

Ecuador's Health Ministry said humans and animals in the area where the child was infected in the central province of Bolivar were being closely monitored for transmission.

It did not report on the girl's condition.

"It is presumed that the infection occurred through direct contact with birds that carried the virus," the ministry added. "So far no other cases have been reported in humans."

Ecuador declared an animal health emergency in late November and an epidemiological alert in December after an outbreak had been detected in the provinces of Cotopaxi and Bolivar, where thousands of birds were slaughtered to contain the disease.

The government assured that the consumption of eggs and chicken meat does not represent a risk to human health. It recommended strengthening "biosecurity" measures and seeking medical help in case of symptoms related to influenza.

USDA reports more H5N1 avian flu in mammals, including bears [CIDRAP, 10 Jan 2023]

By Lisa Schnirring

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) recently reported 12 more highly pathogenic H5N1 avian flu detections in mammals, including skunks, bears, a raccoon, and a red fox.

Most of the animals that tested positive were from West Coast states, including Oregon, Washington, and Alaska. Oregon reported the virus in six skunks and a raccoon. Washington reported the virus in a racoon, and Alaska confirmed H5N1 in a Kodiak bear on Kodiak Island.
Edward Alexander / Flickr cc

Elsewhere, Nebraska reported the H5N1 strain in a grizzly bear from Scotts Bluff County. A Jan 5 report from the Scottsbluff Star Herald said a bear was among four animals at the Riverside Discovery Center that died from avian flu. The others were a cougar and two tigers. The report said the animals ate local geese that had been donated to the zoo.

Also, Montana reported the virus in a grizzly bear from Teton County and a red fox from Madison County. The reports lift the number of H5N1 detections in US mammals since April 2022 to 110.

Also, APHIS has reported a few more outbreaks in poultry in the first days of 2023, in Kansas, Missouri, and Oregon. The outbreaks in Missouri and Oregon involve backyard birds, while the Kansas outbreak affected a commercial game bird farm in Anderson County that houses 8,900 birds.

Since the H5N1 Eurasian virus was first detected in US poultry in February 2022, the virus has led to the loss of a record 57.8 million poultry across 47 states.

Bird flu is the new 'Silent Spring' [Birdguides, 9 Jan 2023]

As authorities across the world assess the impact of the global outbreak of bird flu, the crisis has been singled out as the most rapid loss of wild birds in the UK for decades.

James Pearce-Higgins, Director of Science at the British Trust for Ornithology (BTO), said: "The last time we experienced such large-scale and rapid losses of wild birds in the UK would be the impacts of DDT on birds of prey in the 1950s and 1960s associated with the Sile

His reference to Rachel Carson's groundbreaking 1962 book compares the impact of avian influenza to that of pesticides including DDT during the 1950s and '60s. The use of these chemicals killed birds and other animals, and resulted in eggs with shells so delicate they were broken by incubating adults.

Bird flu wreaked destruction across the whole length of the UK in 2022, with seabirds including Northern Gannets and Great Skuas suffering some of the worst impacts. Pearce-Higgins warned that cases among wintering wildfowl already detected this winter do not bode well for 2023, which could see the virus return to seabird colonies.

According to the World Organisation for Animal Health, more than 50,000 wild birds have died of the H5N1 subtype since October 2021. However, it is widely believed that this is only a tiny fraction of the true death toll, with very few infected birds reaching laboratories for testing.

Likewise, the detection of 3,500 cases in wild birds in Europe between 2021 and 2022 will be an underestimate, though the 63 species recorded with the virus provides an indication of the indiscriminate impact of the virus.

Michelle Wille from the University of Sydney said: "Reported numbers are likely a vast underestimate. For example, of the approximate 8,000 Sandwich Terns that died in the Netherlands, only a handful are included in the official numbers – in this case a more than 200x difference between reported numbers and observed. The lack of appreciation for the scale of wild bird mortality is concerning as there may be species- or population-level ramifications."

UN mapping data shows North America follows Europe in terms of number of reports of bird flu. It has also ripped through bird populations in Africa, Asia and South America, the latter raising concerns that it will reach vulnerable species in the Galapagos.

Japan to Cull Record Number of Chickens due to Bird Flu [Nippon.com, 9 Jan 2023]

Tokyo, Jan. 9 (Jiji Press)--The number of chicken to be culled in Japan due to bird flu will hit a record high of about 9.98 million this season, according to a tally as of Monday.

The previous season high was some 9.87 million chickens culled in the period from November 2020 through March 2021.

The prefectural government of Ibaraki, northeast of Tokyo, said Monday it has confirmed an outbreak of highly pathogenic avian influenza at a poultry farm in the town of Shirosato.

About 930,000 chickens raised for eggs at the farm will all be culled, prefectural officials said.
The Ibaraki case represents this season's 56th bird flu outbreak across Japan, a record high for the country.

'Worst strain ever recorded' of avian flu killing countless birds in Colorado [KRDO, 5 Jan 2022]

By Scott Harrison

COLORADO SPRINGS, Colo. (KRDO) -- Colorado Parks and Wildlife has confirmed that a new strain of avian flu is killing large numbers of birds across the state and the U.S.

The strain was first discovered in fall and winter of 2021 and is described by a CPW official as "the worst strain ever recorded."

The strain is the same that has spread to some chickens and other domestic birds, forcing some poultry providers to euthanize many of its fowl and leading to higher prices for and shortages of eggs.

Social media has been active recently with reports of people seeing large numbers of dead birds and expressing concern about the situation.

CPW said that the worst outbreak of the strain -- highly pathogenic avian influenza, or HPAI -- is occurring since November, primarily around reservoirs in northeastern and southeastern Colorado, affecting largely snow geese and other migratory birds.

Around 600 geese have died between John Martin Reservoir, in Bent County, and Lamar, in Prowers County, CPW said.

The local chapter of the Audubon Society said that some birds have died around Prospect Lake, in Colorado Springs, and at Big Johnson Reservoir, in El Paso County; CPW has confirmed that eight Canada geese were found dead at the lake this week and are being tested for the virus.

At this point, only relatively small numbers of dead birds have been reported in the Pikes Peak region, but CPW said that the outbreak will likely continue through spring when bird migrations resume.

Seasonal bird migrations are believed to be responsible for spreading the virus; CPW said that avian flu has been deadliest to snow geese, vultures and raptors (birds of prey).

"We're studying it and trying to learn all we can about it," said CPW spokesman Travis Duncan. "It's too soon to know what the long-term impact will be on bird populations. But we recommend that you don't touch a dead bird because it can be transmitted to humans. Just contact our local office and report if you see three or more dead birds within a two-week period. We'll come out and investigate, We're not overwhelmed with testing dead birds -- as some people think -- because we're testing based on species and where a bird came from."

Symptoms of avian flu in humans can range from mild to deadly; and you may be unaware that you have it.

Linda Hodges belongs to the local 900-member Aiken Audubon Society, and said that the virus is yet another blow to the fragile bird population.

“Mainly because of habitat loss and habitat fragmentation and climate change are the big factors," she explained. "And of course, cats and building collisions, as well.”

Hodges said that some residents are taking down bird feeders and draining bird baths to help limit the spread of the virus.

"We have no guidance on that," said CPW spokesman Bill Vogrin. "We don't like bird feeders anyway, because they attract bears and can make deer sick."

Bird flu causing egg shortage, spiking up prices in Arizona grocery stores [Arizona's Family, 5 Jan 2022]

By Casey Torres

PHOENIX (3TV/CBS 5) - A viral outbreak is disrupting breakfast for millions of Americans, prompting a nationwide egg shortage. Now, Arizona families are seeing egg prices skyrocket.

Amanda Gray got her grocery shopping done, but she’s exhausted with one thing. “Prices are outrageous for eggs. They’re just outrageous, and I’m sure from farm to table, everyone is struggling. But definitely, prices are going up,” said Gray.

According to the Consumer Price Index, the price of eggs shot up by 49% in the past year. Julie Murphree, with the Arizona Farm Bureau Federation, said egg producers nationwide are getting hit hard by the bird flu and impacting egg-laying hens. She said Arizona is hanging on.

“As of right now, Arizona is OK in terms of our laying hens here in the farms that have birds that lay eggs,” said Murphree. “It’s still one of our most economical natural proteins. So at almost 50% increase, it’s still very economical in the world of proteins.”

The Arizona Food Marketing Alliance represents most major grocery stores in the state. Its president, Mark Miller, said supply and demand is driving up prices at stores. “The price is set by the national level because there’s so many different producers that move throughout the states. Where one might have a problem, then the other one tries to fill it up and causes a shortage in our state,” said Miller.

He said from his visits, inventory and selection are still good in many stores. However, it’s not the case for others. One Valley store employee said eggs are going fast, but Gray hopes the high prices will go away faster. “Some relief would be nice. We are fortunate enough to be able to put food on our table but other families are not in the same situation,” said she said. “We all just need some relief.”

Bird flu in Washington cracks Alaska's egg supply chain [Alaska Public Media News, 5 Jan 2022]

By Isabelle Ross

On a recent, snowy afternoon in Dillingham, Michael Yingst scanned the dairy section at the AC grocery store.

“I came here to look for eggs,” he said. “Tomorrow is my birthday and I was hoping to make some banana cream pie. But it looks like we’re going to be out of luck for a while.”

Like Yingst, people across Alaska are running into egg shortages. Many are posting photos on social media of empty shelves and trying to crowdsource where they can buy eggs. Even large grocery chains like Fred Meyer are limiting how many cartons of eggs people can buy.

Meanwhile, prices are spiking. Rural areas are getting hit especially hard, because many only have one or two grocery stores, which leaves them with fewer options. And the shortages aren’t expected to let up any time soon.

“It’s not good news in any way,” said Kyle Hill, the president of the Alaska Commercial Co. “It’s really farm-dependent.”

The Alaska Commercial Co., or AC, has 35 stores in the state and calls itself the “largest retailer in rural Alaska.” It gets most of its eggs from Washington state, and one of those providers, Oakdell Farms, was recently hit hard by the bird flu.

“They’ve had to unfortunately deal with over a million birds that have had avian flu in that farm,” Hill said. “So there’s huge supply issues, in the sense that we’re struggling to get any eggs at all.”

When they can get eggs, it’s just a trickle. Hill said AC is telling its suppliers that rural communities don’t have a lot of options when it comes to groceries. If AC doesn’t have eggs, that means an entire community might not have eggs, which then becomes a food security issue. But Hill said it’s tough, because AC is competing with large, national chains.

“They are trying to leverage their national scale and their national distribution to get eggs from elsewhere,” he said. “But, you know, when it comes down to it, there’s only so many eggs out there.”

Hill said pressuring suppliers only goes so far. It’s a supply and demand issue, and all retailers are pushing their suppliers.

“It is a fight, because every retailer is making their case to the same suppliers,” he said. “And then this isn’t even just a Pacific Northwest issue. Down in Texas over the holidays a friend said that they saw eggs at $9 a dozen, because they have a farm down there that’s having avian flu issues. So it’s really farm-dependent.”

Prices aren’t going to be any cheaper in rural Alaska. And when supplies run low, costs go up.

At the front of the Dillingham AC store this week, Sarah Nanalook waited for fellow shoppers.

She had traveled with them about 30 miles over the tundra on snowmachines from their hometown of Manokotak to Dillingham to go shopping.

“We only have one small trading store which is owned by Manokotak Native Limited. There’s no other store,” she said.

She said she has watched the price of eggs skyrocket.

“For Christmas I had to buy two dozen for, I mean, almost $20,” she said.

A smaller group of Alaskans, like Alicia Swan, are leaning on their backyard flocks of chickens.

Alicia Swan perused the dairy aisle, but not for eggs. That’s because she and her family own chickens.

“Out of 17 birds we’re averaging six to nine eggs a day,” she said. “That’s pretty good.”

But it’s not easy to keep chickens in rural Alaska, particularly in the winter, when chickens tend to produce fewer eggs.

“It can be complicated getting feed here,” she said. “Especially during the winter, you have to continually give them water because it freezes, keep them warm. We give them extra light to keep them laying eggs. They kind of have a vacation during the winter.”

And what about Michael Yingst and his birthday banana cream pie? He’s trying to come up with a new plan.

“Researching egg substitutes and see if there’s anything else I can use as a replacement for eggs,” he said. “But they’re kind of irreplaceable when it comes to a lot of things. So hopefully we’ll figure that out.”

Dillingham’s other grocery store, Bigfoot, is also out of eggs, but hopes to get a delivery early next week. Meanwhile, AC expects a shipment to stores throughout the state by the end of next week, but anticipates the egg shortage will last for at least a couple months.

Egg prices skyrocket, largely attributed to avian flu outbreaks across the country [WRIC ABC 8News, 4 Jan 2022]

By Sierra Krug

HENRICO COUNTY, Va. (WRIC) — If it feels like the price of your morning omelet has gradually increased since last year, you’re not imagining things. The prices of eggs in Central Virginia — as well as the rest of the country — have been on the incline.

This phenomenon parallels inflated rates we’ve seen for other common groceries, in which heightened gas prices and supply chain issues have contributed to big price tags. However, these increasingly alarming egg prices stem from health-related concerns too.

Mary Rapoport, with the Virginia Egg Council, told 8News around 44 million laying hens have died from avian flu in 2022. While Virginia hasn’t been hit too hard by that form of flu, the agricultural economy relies on egg imports from other states — some of which have endured large-scale outbreaks.

Dog left in crate outside Colonial Heights shelter, shelters see increase in abandoned animals
“We are actually a deficit state when it comes to egg production,” Rapoport said. “We have to import the eggs. As soon as they get avian flu under control, the prices will start coming down.”

8News searched grocery stores across the community to compare prices. One woman at Walmart audibly gasped at the $8.22 price tag for Walmart-branded, “Great Value,” 18-count large white eggs. Walmart charged $4.88 for “Eggland’s Best” large white eggs. Those same “Eggland’s Best” eggs cost $5.49 at Kroger.

Of course, prices varied significantly depending on factors like egg count, size, brand and whether or not the batch was organic. Kroger and Walmart also tout differing deals each week and have different membership programs, which could further alter prices. Rapoport noted her experience visiting different stores each week.

“It seems every time I’m at the market they’re a different price,” Rapoport said.

Egg shelves go bare as bird flu woes hit grocers in Sonoma County, across California [The Santa Rosa Press Democrat, 4 Jan 2022]

By SARA EDWARDS

The bird flu has been affecting turkeys and egg-laying hens since February of last year. The supply issues have hit large national producers, distributors and grocery chains hardest.| 21
Sonoma County residents are scrambling to find eggs, noting empty shelves and low inventory at grocery store chains across the region.

Supply issues at the nation’s giant egg producers and distributors are largely to blame, with a prolonged bout of avian flu the main culprit.

Local consumers have taken to Reddit threads and Nextdoor to share their egg shopping woes. Many reported local Costco, Safeway, Trader Joe’s and FoodMaxx stores are out of eggs.

The shortage is largely attributed to the outbreak of highly pathogenic avian influenza, or more popularly known as the bird flu, which has infected millions of turkeys and egg-laying hens.

According to the Animal and Plant Health Inspection Service at the U.S. Department of Agriculture, highly pathogenic avian influenza is an extremely infectious virus strain that is often fatal to chickens and can spread rapidly between flocks.

It’s been an ongoing concern for poultry farmers since the outbreak started in February of last year.

The last major outbreak of the bird flu in the U.S. was in 2015, according to reporting from CNN Business, but it was quickly contained by June of that year.

Thanksgiving meal staples to cost 13.5% more this year
Data from the United States Department of Agriculture provided by the American Egg Board, an egg marketing group of farmers, showed 43 million egg-laying hens are gone because of the bird flu, CNN reported.

Jordan Mahrt, whose family owns Petaluma Egg Farm and Skippy’s Egg Store, said the egg shortage is largely driven by the bird flu and it’s been affecting production across the globe.

What’s happened in the past is the bird flu has gone away around December.

“But it’s still very prevalent and that’s never happened before,” Mahrt said. “So no one really knows when it might end.”

Sue Ostrom, assistant agricultural commissioner for Sonoma County, said no commercial flocks in the county have been impacted by the bird flu.

To protect its laying flocks, Petaluma Egg Farm has locked down facilities, only allowing workers to interact with the chickens after changing shoes and clothes to prevent outside contaminants reaching the chickens.

“We’re very scared,” Mahrt said. “The burden is easily carried and we don’t really know where it is, when it is so we’re doing everything we can.”

He said larger grocery chains including Safeway and Raley’s have been hit hardest because they rely on national supply chains to distribute to their stores, whereas independent grocery stores get their eggs from local distributors.

“They deal with huge supplier contracts,” he said. “Independent grocery stores definitely have a better supply of eggs than the big chain stores such as Safeway and especially Costco.”

Representatives of Safeway have not responded to inquiries about the egg shortage. Attempts to reach representatives of Raley’s have been unsuccessful.

Nate Rose, senior director at the California Grocers Association, said the grocery industry is taking measures to mitigate impacts for consumers on pricing and availability of eggs with the bird flu cutting into supply.

He said in California, there have been 26 detected cases of bird flu in domestic flocks, such as egg-laying chickens, hens and turkeys, in over 13 counties and 207 cases in wild birds in 42 counties, including Sonoma, Napa and Mendocino.

“It’s a statewide situation and it’s still being detected, so we’re not out of the woods on this issue,” he said.

The range of scale and demand can make some stores more vulnerable to supply issues in such cases than others, Rose said.

Larger grocery stores have to patch together supply from a greater number of vendors to meet their higher sales volume.

“It’s easier for an independent grocer with fewer vendors,” Rose said. “They’ve had an easier time navigating it so far.”

Local grocers say their ties with local producers and distributors have allowed them to keep their egg shelves stocked.

Casey Rodacker, the owner of Pacific Market in Sebastopol, said the market isn’t experiencing an egg shortage.

Dustin Canter is the natural grocery buyer for Oliver’s Market and said the stores’ egg supply is 60% to 80% full and have been working with local distributor partners to maintain that supply for customers.

“I think we’re OK,” Canter said. “Right now it’s the tightest and shortest (supply) and what we’ve been seeing is a bunch of price increases to prevent this (shortage).”

Despite the tight supply, Canter doesn’t anticipate putting a limit on how many egg cartons customers can purchase and hopes that limiting customers doesn’t come up.

Bill Mattos, the president of the California Poultry Federation, said the bird flu has wiped out around 60 million chickens and turkeys, creating a shortage on the market.

“The main reason it’s affecting prices in California and everywhere else is because there are a lot less chickens,” he said. “What happens when you have to get rid of a layer chicken, it can take a year or two for them to get to laying eggs again.”

Mattos said California poultry farmers have implemented “high quality biosecurity standards” to protect egg layers from catching the bird flu, such as not letting anyone on or off the ranch and requiring workers to wear a hazmat-style suit when near the chickens.

Mattos said these measures have been successful at keeping the flu away from chickens, but he doesn’t expect an ease in the shortage soon.

“I don’t think it’s going to get better before the spring, probably because when you get to Easter, demand goes up,” he said. “I don’t see the shortage being filled until well into the year.”

New Coronavirus News from 8 Jan 2023

BY JOSEPH CHOI

The XBB.1.5 omicron subvariant is raising concerns of a potential surge in COVID-19 cases as it sweeps across the Northeast.

Officials have warned in recent weeks that the strain is highly transmissible, can more easily evade the immunity offered by vaccines or prior infections than past variants — and is likely to drive cases up around the country.

The subvariant has already rapidly spread in the Northeast, where it is currently estimated to be causing about 72 percent of infections.

Data from the Centers for Disease Control and Prevention indicated last week that XBB.1.5 was the most prevalent subvariant in the U.S. as a whole, accounting for 40.5 percent of cases in the country. However, this information is subject to change as more data is collected from states, and XBB.1.5’s share of U.S. cases has fallen to an estimated 27.6 percent as of Friday.

But while another omicron subvariant, BQ.1.1, is still dominant in the country beyond the Northeast, XBB.1.5 has also reached all other regions of the U.S., and officials predict it will continue to spread. Due to its recent ascent, data on XBB.1.5 is limited, but health officials have disclosed some key insights into the strain, as well as what questions remain unanswered.
Here is what know about XBB.1.5:

‘Most transmissible’ omicron subvariant so far
XBB.1.5 is “the most transmissible subvariant that has been detected yet” of the already highly contagious omicron strain, Maria Van Kerkhove, technical lead of the World Health Organization’s (WHO) COVID-19 response, said in a recent briefing.

Van Kerkhove attributed the subvariant’s high transmissibility to the mutations it carries allowing it to “adhere to the cell and replicate easily.”

Ashish Jha, the White House’s COVID-19 response coordinator, concurred with Van Kerkhove’s assessment, saying on Twitter that XBB.1.5 was most likely more able to evade immunity than previous omicron subvariants.

People who have not recently been infected with COVID-19 or vaccinated against it probably have “very little protection against infection” caused by XBB.1.5, Jha further advised.

Cases are expected to rise
The northeastern regions of the country have already seen a recent rise in cases, according to data from the Department of Health and Human Services. Hospitalizations in these areas have also risen between 10 and 15 percent, though it remains to be seen if XBB.1.5 causes more severe illness than previous subvariants and is behind this jump.


Food and Drug Administration Commissioner Robert Califf said when speaking about XBB.1.5 this week that he expected a further increase in cases.

“The XBB variant and its related variants (XBB.1 & XBB.1.5) are sweeping through the Northeast and will likely move to other regions quickly,” he tweeted.

But Califf noted that the cases caused by XBB.1.5 and other new variants don’t appear to be more serious than those caused by past strains of the virus.

“At this point, we’re experiencing an increase in cases with no evidence of increased severity of illness related to these variants,” he said.

Van Kerkhove echoed Califf’s forecast, saying, “We do expect further waves of infection around the world.”

“But,” she added, “that doesn’t have to translate to further waves of death, because our countermeasures continue to work.”

First detected in the US before spreading globally
While XBB, the subvariant from which XBB.1.5 descends, was initially detected in India, the latter mutation is believed to have first been identified in the U.S. in October.

It has since been detected in 29 other countries, according to the WHO. Roughly a dozen countries in the European Union alone have detected XBB.1.5, though levels of the subvariant remain low there, according to the European Centre for Disease Prevention and Control.

It’s a recombinant virus. What does that mean?
XBB.1.5 is considered a recombinant virus, meaning it carries genetic data from two previous viral mutations.

The subvariant is descended from XBB, which in turn has genetic data from two viral strains that descended from the BA.2 “stealth” subvariant. That strain, characterized by its mutations that made it difficult to track with PCR tests, was the most prevalent in the U.S. in early 2022 before being overtaken by two other omicron subvariants, BA.4 and BA.5.

Treatments and vaccines likely still effective
Countermeasures are currently still expected to be effective at treating COVID-19 infections caused by XBB.1.5 and reducing the severity of illness, as Van Kerkhove said.

Jha said the updated bivalent COVID-19 booster is still the “best protection” against infection and severe illness.

Califf noted that while that booster has been observed to be less effective in neutralizing against the XBB strain when compared to the ancestral strain, the neutralization it offered was still strong enough to provide “some degree of protection.”

Columbia University researchers found in an early preprint study that subvariants descended from the BQ and XBB lines are better than previous strains at evading neutralizing antibodies.

Neutralizing antibodies, which can be gained through prior infections or vaccination, stop infections by binding to viruses and blocking them from attaching to cells.

Mutations and changes to the SARS-CoV-2 virus can make it harder for neutralizing antibodies to recognize and detect the virus when it enters a person’s system, enabling the virus to evade an immune response that could have otherwise stopped it from causing infection.

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But the researchers noted that vaccines have still been shown to be effective against such strains.

“It is important to emphasize that although infections may now be more likely, COVID-19 vaccines have been shown to remain effective at preventing hospitalization and severe disease even against Omicron as well as possibly reducing the risk of post-acute sequelae of COVID-19 (PASC or long COVID),” they said.

Oral antivirals like Paxlovid and molnupiravir are also still expected to be effective against XBB.1.5, as they don’t function by boosting antibodies — which the strain appears better able to evade — but by hindering the virus’s ability to replicate itself.

New Coronavirus News from 9 Jan 2023

What China’s Covid Crisis Means for the Rest of the World [WIRED, 9 Jan 2023]

By DAVID COX

The country’s surge in cases is a human tragedy but isn’t showing signs of changing the Covid picture in the West—where the virus is already running free.

AFTER NEARLY THREE years of strict restrictions to keep cases to a minimum, the Chinese government announced last month that it was ending its zero Covid policy—unleashing the biggest coronavirus outbreak the world has ever seen.

Across a population that’s both undervaccinated and underexposed to the virus, up to 250 million people may have been infected in the first 20 days of December alone, according to a leaked estimate from Chinese health officials. In the eastern province of Zhejiang, home to more than 64 million people, the provincial government has reported around 1 million new cases a day.

Infections are likely to escalate further this month following the Lunar New Year on January 22. The event is the world’s largest annual migration, as Chinese people travel across the country to gather with friends and family. “There’s going to be about a billion infections in China this winter,” predicts Ben Cowling, an epidemiology professor at the University of Hong Kong.

“Starting within the next two weeks, any village in China which has so far managed to avoid Covid is not going to avoid it for much longer.”

Domestically, this viral surge is nothing short of a crisis. Grim reports tell of hospitals being overwhelmed and huge queues to crematoriums, with modelers predicting that nearly 2 million Chinese people could die this winter because of the country not being ready to fully open up.

At the start of November, 60 percentof over-80s in China were either not vaccinated at all or not boosted with a third dose. “They made this decision to rapidly transition out of the pandemic without a high enough vaccine coverage, without hospitals being prepared, without antivirals stockpiled, and so on,” says Cowling.

But outside of China, this surge of new cases may be less of a concern than first appears.

Epidemiologists point out that there’s already significant ongoing transmission of the coronavirus in most countries, and so incoming Chinese travelers are unlikely to trigger a noticeable spike in local Covid cases. “There are a lot of cases in China, but they represent just a fraction of cases in terms of the global picture,” says Francois Balloux, director of the University College London Genetics Institute. “It’s a major problem for China, but I’m not convinced it’s a major problem for the rest of the world.”

Nevertheless, Australia, France, India, Israel, Italy, Morocco, Spain, the UK, and the US have all announced mandatory Covid tests for inbound Chinese travelers. Morocco has imposed a complete travel ban. However, the European Union has said these measures are “unjustified,” given the higher levels of immunity in places such as Europe, and that the variants infecting people in China are the same as those circulating in the West.

Since Omicron was identified in November 2021, possessing a collection of completely new mutations that made it substantially more transmissible than any variant seen before, virologists haven’t detected anything radically different. From BA.5, which circulated widely in the UK during summer 2022, to XBB.1.5, which is currently spreading rapidly in the US, every notable variant that has appeared within the past 14 months has been a subvariant of Omicron.

The fear is that the sudden spread of Covid through a new population with relatively little prior exposure to the virus will lead to the emergence of a new “supervariant”—one that has the potential to change the face of the pandemic like the Alpha, Delta, and Omicron forms of the virus did before. But whether there’s a significant risk of this happening isn’t clear.

In 2020, Ravi Gupta, a professor of clinical microbiology at the University of Cambridge, published a paper in the journal Naturedemonstrating that chronic SARS-CoV-2 infections—where the virus lingers and multiplies inside the body of someone whose immune system is compromised—provide the virus with a greater opportunity to evolve. “A billion new infections means more opportunity for more chronic infections,” says Gupta. “You’re upping the numbers game in favor of the virus to make new, potentially problematic variants.”

But Cowling argues that because the level of immunity is much lower in China than the rest of the world, it will be relatively easy for the virus to spread through the population without needing to evolve. He says that if a new supervariant were to emerge, it might be more likely to come from North America or Europe, where more people have built up immunity through both vaccination and prior infection.

“My gut instinct is that the risk of a major new variant is probably not higher in China,” Gupta says. “In the UK, for example, if Covid is going to continue circulating, it’s got to find a new direction and way around the immunity from previous waves of Omicron and all its subvariants, whereas in China it’s quite happily spreading anyway.”

Even if a new supervariant does appear, scientists are unsure whether it would be more or less virulent than what’s already out there. Last year, Gupta and his colleagues showed that Omicron is less lethal than its predecessors because it does not infect lung cells as efficiently.

“Instead it infects nasal cells,” he says. “Omicron chose a pathway that exists in the upper airways, so it’s less severe and transmits very, very well.”

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But Gupta cautions that this doesn’t necessarily mean that the whole trajectory of the virus has shifted to being less severe, and says it is still biologically plausible for an immune-evasive version to emerge that is more virulent. “There’s no evolutionary reason why the virus couldn’t go back to being quite pathogenic,” he says.

Whatever happens, it’s possible that it will take some time before the full consequences of China’s Covid surge becomes apparent. While some global consortiums such as GISAID in Germany are still dedicated to tracking coronavirus mutations, in general, countries around the world have scaled down their efforts to sequence viral samples, making it harder to track new variants and how they are being introduced to different countries. “People have realized how much it costs, and it’s not just in the UK and the US—it’s happened globally,” says Gupta. “So for that reason, we are maybe at our most vulnerable at the moment, in a relative sense, just because we don’t know what’s out there.”

For much of Europe and North America, Balloux describes Covid as currently being comparable to many other common respiratory infections, although that picture could change if a dangerous new supervariant were to emerge. The alarming spikes of cases,
hospitalizations, and deaths of 2020 and 2021 have been replaced by a steady, more insidious death toll.

Between January and November 2022, 41,620 people in England perished from Covid. Most are believed to have been elderly people who were already frail and suffering from multiple underlying health conditions, or people whose immune systems were suppressed—either because of illness or medicines they were taking—though no precise data exists. In comparison, a particularly severe flu season tends to result in around 30,000 fatalities.

“There are very few young healthy people who die from Covid now in the UK or the US,” says Balloux. “What Covid does at the moment is essentially add to the stress of other issues—people who already have underlying problems, and the fact that in the UK, the hospital system can’t cope. It’s amplifying these underlying risks.” China’s Covid surge, at least for now, will do little to change this already-existing threat that the virus poses.

90% of people in China province infected with Covid, says local health official [The Guardian, 9 Jan 2023]

Almost 90% of people in China’s third most populous province have now been infected with Covid-19, a top local official has said, as the country battles an unprecedented surge in cases.

Kan Quancheng, director of the health commission for central Henan province, told a press conference that “as of January 6, 2023, the province’s Covid infection rate is 89%”.

With a population of 99.4 million, the figures suggest about 88.5 million people in Henan may now have been infected.

Visits to fever clinics peaked on 19 December, Kan said, “after which it showed a continuous downward trend”.

The opening of China’s borders on Sunday was one of the last steps in the dismantling of the country’s zero-Covid regime, which began last month after historic protests and has led to a huge wave of infections.

Covid cases are expected to soar further as the country celebrates lunar new year later this month, with millions set to travel from big cities to visit vulnerable older relatives in the countryside.

In the first wave of pre-holiday travel, official data showed 34.7 million people travelled domestically on Saturday – up by more than a third compared with last year, according to state media.

While Beijing’s move to drop quarantine requirements is expected to boost outbound travel, many nations are demanding negative tests from visitors from China, seeking to contain an outbreak that is overwhelming many of China’s hospitals and crematoriums.

Officially, China reported just 5,272 Covid-related deaths as of 8 January, one of the lowest rates of death from the infection in the world.

But the World Health Organization has said China is under-reporting the scale of the outbreak and international health experts estimate more than 1 million people in the country could die from the disease this year.

China’s top health officials and state media have repeatedly said Covid infections are peaking across the country and they are playing down the threat now posed by the disease.

“Life is moving forward again!”, the official newspaper of the Communist party, the People’s Daily, wrote in an editorial on Sunday praising the government’s virus policies, which it said had moved from “preventing infection” to “preventing severe disease”.

“Today, the virus is weak, we are stronger.”

China’s state Xinhua news agency said the country had entered a “new phase” in its Covid response.

Asian shares lifted to a five-month high on Monday as investors bet that China’s reopening would help revive the $17tn economy and bolster the outlook for global growth.

“It’s a huge relief just to be able to go back to normal … just come back to China, get off the plane, get myself a taxi and just go home,” Michael Harrold, 61, a copy editor in Beijing, told Reuters at Beijing Capital International Airport on Sunday after he arrived on a flight from Warsaw.

Harrold said he had been anticipating having to quarantine and do several rounds of testing on his return when he left for Europe for a Christmas break in early December.

State broadcaster CCTV reported on Sunday that direct flights from South Korea to China were close to sold out.

However, a spike in demand will be hampered by the limited number of flights to and from China, which are currently at a small fraction of pre-Covid levels.

Korean Air said earlier this month that it was halting a plan to increase flights to China due to Seoul’s cautious stance towards Chinese travellers. South Korea, like many other countries, now requires travellers from China, Macau and Hong Kong to provide negative Covid test results before departure.

Flight Master data showed that on Sunday, China had a total of 245 international flights, combining inbound and outbound, compared with 2,546 flights on the same day in 2019, representing a fall of 91%.

China’s domestic tourism revenue in 2023 is expected to recover to 70-75% of pre-Covid levels, but the number of inbound and outbound trips is forecast to hit just 30-40% of pre-Covid levels this year, China News reported on Sunday.

China Covid: More than 88 million people in Henan infected, official says [BBC, 9 Jan 2023]

By Nicholas Yong

Nearly 90% of people in Henan, China's third most populous province, have now been infected with Covid, local health officials say.

Provincial official Kan Quancheng revealed the figure - amounting to about 88.5 million people - at a press conference.

China is battling an unprecedented surge in cases after abandoning zero-Covid policies in December.

The move followed rare protests against lockdowns, quarantines and mass tests.

Mr Kan did not specify a timeline for when all the infections happened - but as China's previous zero-Covid policy kept cases to a minimum, it's likely the vast majority of Henan's infections occurred in the past few weeks.

He said visits to fever clinics in Henan province peaked on 19 December "after which it showed a continuous downward trend".

The Henan provincial figures are in stark contrast to Covid figures from the central government

According to official data, just 120,000 people in the country of 1.4 billion have been infected and 30 died since the shift in Covid policy.

Meanwhile on Sunday, authorities reported three Covid deaths in mainland China, one more than the day before.

However, with the definition of Covid deaths narrowed and mass testing no longer compulsory, government data is no longer reflective of the true scale of the outbreak.

Other local and provincial officials have also been providing very different data to that from the central government. On Christmas Eve, a senior health official in the port city of Qingdao reported that half a million people were being infected each day. Those case figures were swiftly removed from news reports.

Meanwhile Chinese health officials said they would not include Pfizer's antiviral Covid medicine Paxlovid in its basic medical insurance schemes as a result of the high price quoted by the US firm.

The drug, temporarily covered by China's broad healthcare insurance scheme until 31 March, has seen a sharp increase in demand since China's Covid cases surged last month.

Pfizer would continue to collaborate with the Chinese government and all relevant stakeholders to "secure and adequate supply" of the medicine in China, the company said in a statement.
On Sunday, Beijing also lifted mandatory quarantine for all international arrivals and opened its border with Hong Kong.

In the first wave of pre-holiday travel, official data showed that 34.7 million people travelled domestically on Saturday. This represented an increase of more than a third compared to last year, according to state media.

Infections are expected to soar as the country celebrates Lunar New Year later this month, with millions expected to travel from big cities to visit older relatives in the countryside.
Overall, more than two billion individual journeys are expected to take place, officials have said.

By Olivia Bowden

Though the Public Health Agency of Canada said last week it’s “too early” to tell if the Omicron subvariant XBB.1.5 is spreading in Canada beyond scattered cases cropping up— there’s still cause for concern and the public should be prepared by engaging in health measures, infectious disease experts say.

And the new variant is an indication that not only is COVID-19 continuing to evolve, it’s highlighting the need for vaccine equity globally to prevent more variants from emerging.

XBB.1.5 is a subvariant of the Omicron variant of COVID-19, nicknamed “Kraken”, and scientists began to warn about a new lineage from Omicron in the fall.

But now, XBB is the dominant variant in the U.S. and officials with the World Health Organization said at a press conference on Jan. 4 that this version of the COVID-19 virus is the most transmissible detected so far.

“The reason for this are the mutations that are within this subvariant of Omicron allowing this virus to adhere to the cell and replicate easily,” said Maria Van Kerkhove, the COVID-19 technical lead for the WHO, at the press conference.

She said XBB has been found in 29 countries so far, but it’s likely in more. Genomic sequencing initiatives have declined world-wide so it’s now harder to track how widespread a variant is, she explained.

And though there’s no evidence so far that the variant causes more severe illnesses, it’s clear XBB is easily transmissible and possibly more immune-evasive, said Dr. Lisa Barrett, an assistant professor in the Department of Microbiology and Immunology and in the Faculty of Medicine at Dalhousie University.

Barrett said in an interview with CTV’s New Channel Sunday that the vaccines available will continue to work against this new form of the virus.

But, there’s still much we don’t know about COVID-19, and it’s a virus that is mutating more quickly than usual respiratory viruses at the moment. That means the population needs to have continued awareness of COVID-19 and protections, she said.

“COVID is a bit of a master class for the general population, unfortunately, in how viruses evolve,” she said, adding COVID-19 has been given the chance to mutate due to a high abundance of cases.

“This is one of the reasons why we need to continue to do work on COVID…there’s lots we can do about it, good respiratory hygiene culture needs to happen right now,” she said. And countries need to continue to invest in sequencing to better understand variants like XBB.

Barrett encourages people to keep up with their booster shots, wash their hands frequently, stay home when sick and consider wearing a mask in crowded indoor spaces.

On Jan. 4, the Public Health Agency of Canada announced that 21 cases of the XBB variant had been identified across the country.

“XBB.1.5 is currently considered to be only detected sporadically,” PHAC told CTVNews.ca in an email Wednesday. “As data rolls in, growth rates can be more accurately estimated.”

PHAC had not identified XBB as a variant of concern.

According to PHAC data from the week of Dec. 18, close to 94 per cent of sequenced COVID-19 cases were the variant BA.5., another subvariant of Omicron known for its transmissibility.

The creation of variants like Omicron and its subvariants has been fuelled by vaccine inequity, as undervaccinated regions, particularly in the Global South, continue to lack access to vaccines while the West offers multiple boosters and disposed of unused vaccines, according to infectious disease researchers.

In a report published in October, infectious disease experts say the pandemic will be prolonged as new variants emerge from regions of the world that continue to lack access to vaccines to properly inoculate populations.

For now, Canadians are encouraged to get their bivalent booster shot as soon as possible as it’s widely available and will likely prevent serious illness from the XBB subvariant and COVID-19 overall, said Dr. Dale Kalina, an infectious disease doctor with Joseph Brant Hospital and Foundation in Burlington, Ont. in an interview with CTV News Atlantic.

Only about 20 per cent of Canadians age five and older have received a booster shot of a COVID-19 vaccine since Aug. 1, according to the federal government.

New Coronavirus News from 7 Jan 2023

Health Experts Warily Eye XBB.1.5, the Latest Omicron Subvariant [The New York Times, 7 Jan 2023]

By Carl Zimmer

A young version of the coronavirus makes up one-quarter of Covid cases across the United States and over 70 percent of new cases in the Northeast.

Three years into the pandemic, the coronavirus continues to impress virologists with its swift evolution.

A young version, known as XBB.1.5, has quickly been spreading in the United States over the past few weeks. As of Friday, the Centers for Disease Control estimated that it made up 72 percent of new cases in the Northeast and 27.6 percent of cases across the country.

The new subvariant, first sampled in the fall in New York State, has a potent array of mutations that appear to help it evade immune defenses and improve its ability to invade cells.

“It is the most transmissible variant that has been detected yet,” Maria Van Kerkhove, the Covid-19 technical lead at the World Health Organization, said at a news conference on Wednesday.

XBB.1.5 remains rare in much of the world. But Tom Wenseleers, an evolutionary biologist at KU Leuven in Belgium, expects it to spread quickly and globally. “We’ll have another infection wave, most likely,” he said.

Advisers at W.H.O. are assessing the risk that XBB.1.5 poses. Jacob Lemieux, an infectious disease doctor at Massachusetts General Hospital, said that the surge in cases would not match the first Omicron spike that Americans experienced a year ago. “Is it a Category Five hurricane?” he said. “No.”

Still, he warned that XBB.1.5 could worsen what is already shaping up to be a rough Covid winter, as people gather indoors and don’t receive boosters that can ward off severe disease.

Dr. Ashish K. Jha, the White House Covid-19 response coordinator, said that the Biden administration was monitoring the emergence of XBB.1.5 and urging people to take advantage of existing countermeasures. Preliminary studies suggest that bivalent vaccines should provide decent protection against XBB and its descendants. Paxlovid will also remain effective at fighting infections.

“We feel pretty comfortable that our countermeasures are going to continue to work,” Dr. Jha said. “But we’ve got to make sure people are using them.”

One thing Dr. Lemieux and other experts are confident about is that XBB.1.5 is not the last chapter in the coronavirus’s evolution. In fact, they expect that a descendant of XBB.1.5 may soon gain mutations that make it even better at spreading.

That descendant may already exist, infecting people without raising notice yet. But sequencing efforts have declined so much worldwide that the discovery of the next generation of XBB.1.5 may be delayed. “As sequencing becomes less and less available at a global level, it’s difficult for us to track each of the subvariants of Omicron,” Dr. Van Kerkhove said.

Scientists have reconstructed the evolution of XBB.1.5 (which some have nicknamed Kraken) by poring over new sequences of coronaviruses in online databases. The first major step came last year when two earlier forms of Omicron infected the same person. As the viruses replicated, their genetic material was shuffled together. A new hybrid form emerged, with genetic material from both viral parents. Virus-watchers named it XBB.

This mixing, called recombination, happens fairly often among coronaviruses. Over the course of the pandemic, scientists have found a number of recombinant forms of SARS-CoV-2, the cause of Covid-19.

Most recombinant SARS-CoV-2 viruses have dwindled away in a matter of weeks or months, unable to outcompete other lineages. XBB, on the other hand, got a winning ticket in the genetic lottery. From one parent, it gained a set of mutations that helped it evade antibodies from previous infections and vaccinations. From the other parent, it gained a separate set of mutations that made it even more evasive.

“XBB literally picked up the most possible mutations that it could possibly pick up from those two parents,” said Thomas Peacock, a virologist at Imperial College London. The new combination made XBB one of the most evasive Omicron subvariants in existence last summer.
Recent experiments suggest that XBB paid a steep price for its power to evade immunity. The mutations allow it to escape antibodies by altering the shape of the protein, called spike, that covers its surface. But some of those mutations also make it harder for XBB spike proteins to grab tightly to cells — the first step required for an infection.

That loose grip may have lessened XBB’s advantage against other forms of the virus. In late 2022, it jostled alongside a number of other Omicron subvariants. In Singapore, XBB caused a surge in October, for example, while remaining rare in many other parts of the world.

As XBB multiplied, it continued to mutate into new forms. The earliest samples of XBB.1.5 were isolated in October in New York. The new subvariant gained one crucial mutation, known as F486P.

Yunlong Cao of Peking University and his colleagues tested out XBB.1.5 in dishes of cells, comparing how it fared against earlier forms of XBB. The researchers found that the F486P mutation allowed XBB.1.5 to grab tightly to cells again. But the new subvariant could still evade antibodies as well as earlier forms of XBB.

Dr. Cao and his colleagues posted their results online on Thursday. The data has not yet been published in a scientific journal.

XBB.1.5 most likely evolved somewhere in the northeastern United States, where early samples were first identified and where it remains most common. Once scientists could recognize it, they could track its growth.

In Connecticut, for example, Nathan Grubaugh at Yale University and his colleagues found that by mid-December, other Omicron subvariants were falling. Only XBB.1.5 cases were growing. Dr. Grubaugh estimates that it is about 20 percent more transmissible than BQ.1, which had been the dominant form.

“It doesn’t have those signs of a really big wave like we saw before,” he said. “It’s not going to come close to what it was last year.”

How severe XBB.1.5 infections are compared with other forms of the coronavirus is not yet clear. “It’s serious,” Dr. Grubaugh said. “I just don’t necessarily know if it’s really more serious than some of the other Omicron lineages in terms of the overall impact.”

XBB.1.5 has already spread to other countries, and is growing rapidly in Germany, Denmark and elsewhere in Europe. But its impact is likely to differ from place to place. In India, for instance, it will encounter many people who were infected with its parental strains last year, so it may face stronger immunity, Dr. Peacock said.

In China, which experienced a large surge of cases in late 2022, its prospects are even harder to predict. For most of the pandemic, China almost never shared virus sequences with international databases. Cooperation has increased in the past few weeks, but the databases may still not reflect the state of play in the country.

Much of XBB.1.5’s advantage in the United States comes from its ability to evade existing immunity, including that which is against other Omicron subvariants. In China, where there is less immunity, it may not have that edge. Dr. Peacock speculated that after other variants spread through China, it may then be XBB.1.5’s turn to rise.

Dr. Wenseleers said that the spread of XBB.1.5 outside China made him skeptical that restrictions on Chinese travelers would keep cases down. “It’s kind of pointless,” he said. “It would be better to make sure the elderly are well-vaccinated.”

As XBB.1.5 spreads, it continues to mutate, and experts believe that it can become even better at evading antibodies.

Scientists are already scanning new sequences being uploaded to an international database called GISAID in the hopes of spotting an upgraded version of XBB.1.5. But their job is getting harder because governments are pulling back on sequencing efforts. “Worldwide, sequencing has taken a real hit,” Dr. Peacock said.

The United States, which once lagged behind other nations, has managed to maintain a fairly strong sequencing effort. Without it, Dr. Peacock said, XBB.1.5 might have stayed below the radar for much longer. If XBB.1.5’s next generation is evolving somewhere with little sequencing, it may go undetected for some time to come.

Dr. Lemieux said that paring back on sequencing was a mistake, given how many infections and deaths the virus is still causing. “This is a part of public health,” he said.

And Dr. Peacock said that XBB.1.5 demonstrated that the evolution of the coronavirus would not slow down anytime soon. “Give it another two years, and maybe we can reassess where we think this is,” he said.