Zoonotic Bird Flu News since 24 Feb till 10 Mar 2023

Bird Flu" from dead crows in Fukuoka City: Positive in simple test, confirming whether it is highly pathogenic [TV Nishinippon, 10 Mar 2023]

Fukuoka Prefecture announced that a dead crow suspected of being infected with highly pathogenic avian influenza was recovered in Fukuoka City.

According to the prefecture, on the morning of March 9, the carcass of a raven was found in Fukuoka City, and as a result of a simple test, it was confirmed positive for avian influenza.

A genetic test is currently being conducted at the National Institute for Environmental Studies to confirm whether or not it is highly pathogenic avian influenza, and the results are expected to be known within a few days.

The Ministry of the Environment has designated the area within a 10-kilometer radius of where the carcass was recovered as a priority wild bird monitoring area, and the prefecture is continuing to strengthen its monitoring of wild birds and calling for the attention of poultry farms and others in the prefecture.

A total of 10 cases of highly pathogenic avian influenza have already been confirmed in the prefecture this season, the highest number ever recorded.

(translated by M.Y.)

Avoiding the Culling of All Birds Due to Bird Flu by Split Control of Poultry Houses...A Poultry Farmer in Aomori Takes the Lead [Yomiuri Shimbun, 4 Mar 2023]

The highly pathogenic avian influenza raging in Japan has prompted an egg-laying poultry farmer in Aomori Prefecture to introduce a "split management" system for sanitary control on farms, whereby each group of poultry houses is managed separately. Normally, if any part of a farm is infected, all the birds in the farm will be subject to culling, but by treating the chicken coop groups as "separate farms," the number of birds subject to culling can be reduced. The Ministry of Agriculture, Forestry and Fisheries plans to promote the introduction of this system to large-scale farms nationwide through prefectural governments.

This season's outbreak of highly pathogenic avian influenza has occurred at 55 egg-laying farms nationwide since last October. As of the 3rd of this month, a record 13.79 million hens, or 10% of all egg-laying hens, had been culled. Of these, five farms had more than 1 million chickens, accounting for 5.97 million. The shortage of eggs is spreading and prices continue to soar.

Under the split management, large farms with over 1 million eggs are divided into multiple groups of poultry houses, each with separate personnel, vehicles, equipment, egg sorting and packaging facilities, and other facilities. By eliminating back and forth traffic, the spread of the virus can be prevented, and in the event of an outbreak, the killing of infected chickens can be limited to the same group of poultry houses as the infected chickens. This is also called "block management" or "separate farm management (translated by M. Y.).

Cambodia Child Dies of Bird Flu "No Mutation to Spread to Humans" [nhk.or.jp, ３ Mar 2023]

In response to the death of an 11-year-old child infected with bird flu in Cambodia last month, the U.S. Centers for Disease Control and Prevention (CDC) has released its latest analysis of the virus found in the country, which found no genetic mutations that could spread the disease from human to human or weaken the effectiveness of drugs against the virus.

In Cambodia, an 11-year-old girl and her father were infected with H5N1 avian influenza, and the girl died last month.

The CDC had been analyzing the virus found in the dead girl, and announced on April 2 that no genetic mutation had been identified in the virus that could spread the virus from human to human or weaken the effectiveness of drugs against the virus.

Since the two infected individuals had the opportunity to come in contact with infected birds in an environment where birds are raised, the CDC now believes that the case is not human-to-human, but bird-to-human transmission.

According to the World Health Organization (WHO), the H5N1 avian influenza virus has been reported to infect birds in many parts of the world, and cases of infection in mammals have also been found one after another, prompting health authorities in various countries to increase their vigilance. (translated by M.Y.)

A Record Number of 240,000 Cattle Killed in Fukuoka; Japan Self-Defense Forces Requested to Dispatch Dispatchers - Avian Influenza "Confirmed" at Large Poultry Farm [rkb.jp, 2 Mar 2023]

Chickens found dead at a large-scale poultry farm in Fukuoka City have been "confirmed" positive for avian influenza by genetic testing. Fukuoka Prefecture announced the news on the morning of March 2. This is the fourth case this season at a farm in Fukuoka Prefecture. A record number of more than 240,000 chickens will be killed. Disinfection points will be set up at various locations. Due to the large scale of the disaster, Fukuoka Prefecture has requested the Self-Defense Forces to be dispatched to the disaster site.

"Positive" Even with Highly Accurate Genetic Tests
A large poultry farm in Fukuoka City was newly confirmed "positive" in a genetic test for avian influenza. The prefecture will not disclose the specific location or name of the facility.

According to the prefectural government, about 90 chickens died on February 28 and about 100 on March 1 at the poultry farm, and since a simple test on the morning of the 1st tested "positive," a more accurate genetic test was conducted.

The Self-Defense Forces were requested to be dispatched to the disaster site.

All chickens, numbering over 240,000, are to be destroyed. The prefecture has requested the Self-Defense Forces to be dispatched to the disaster site. The period of time will be from the 2nd to the end of the operation. In addition, based on national guidelines, quarantine measures will be taken, including the establishment of restricted movement zones and disinfection points at various locations. This is the fourth case of avian influenza this season at a farm in Fukuoka Prefecture.

Not contagious to humans.
The government has stated that there is no possibility that the avian influenza virus can be transmitted to humans by eating chicken or chicken eggs.

How the fourth case was "confirmed" by genetic testing
March 1, 8:10 a.m. The farm notifies Fukuoka Prefecture
March 1, 11:15 a.m. 12 out of 13 birds test positive in relation tests.
March 2, 9:00 a.m. Genetic testing (PCR test) confirms the H5 subtype gene, and the animals are determined to be highly pathogenic avian influenza pseudo-affected.

This is the first to third highly pathogenic avian influenza cases in Fukuoka Prefecture.
December 19, 2022: Confirmed at a poultry farm in Itoshima City
December 26, 2022: confirmed at a poultry farm in Itoshima City
January 3, 2023: Confirmed at a poultry farm in Koga City

(translated by M. Yamage)

Falcon Found in Komatsu City, Identified as Highly Pathogenic Avian Influenza [NHK, 2 Mar 2023]

In February, a wild falcon was found dead in Komatsu City, infected with avian influenza.

The prefectural government will continue to conduct a focused survey of the surrounding area until late March.

On February 27, a dead wild falcon was found in Komatsu City and was found to be infected with the avian influenza virus.

Detailed examination of the specimen has been conducted at a laboratory in Ibaraki Prefecture, and as a result, the avian influenza virus that infected the falcon was identified as the highly pathogenic "H5 subtype," which is highly infectious.

The Ministry of the Environment has designated a 10-kilometer radius around the area where the dead birds were found as a priority area, and the prefectural government is continuing to investigate whether there are any dead or weakened birds in reservoirs, riverbeds, etc. within this area.

The prefectural government has also called on poultry farms to disinfect their premises and prohibit unauthorized entry.

In the prefecture, the same H5 subtype was detected in two wild birds found in Kanazawa in January of this year, making this the third highly pathogenic virus confirmed in the prefecture this year. (translated by M. Yamage)

Bird flu kills 1.52 million egg-laying hens, more than 10% of all hens raised in Japan [Asahi Shimbun, 2 Mar 2023]

On March 2, the Ministry of Agriculture, Forestry, and Fisheries (MAFF) announced that Fukuoka Prefecture will begin culling 243,000 egg-laying hens following the confirmation of a suspected highly pathogenic outbreak of avian influenza at a poultry farm in Fukuoka City. This brings the total number of egg-laying hens targeted for culling nationwide to 13.85 million, more than 10% of the 137.29 million hens kept nationwide (as of last February).

The bird flu has spread at a record pace this season (last fall through this spring), with 77 cases reported in 25 prefectures as of the morning of February 2. A total of 15.02 million birds, including meat chickens and ducks, have been targeted for culling.

The spread of the disease has also affected the supply of eggs, with some supermarkets experiencing a shortage. According to a survey of price trends conducted by the Ministry of Agriculture, Forestry and Fisheries at 470 stores nationwide, the price of eggs in February was 262 yen per pack (mixed size, 10 pieces). The price has remained high, at 108% of the previous month's level and 125% of the normal level. At a press conference on February 28, Minister of Agriculture, Forestry and Fisheries Tetsuro Nomura explained, "This is not a story of an immediate solution, so it will take six months or nearly a year (for normalization).

Bird Flu Detected in Jay Carcass in Moka City (Tochigi TV) [Yahoo News, 1 Mar 2023]

Regarding the bird flu virus detected in the carcass of a wild jay found in Mooka City on February 21, Tochigi Prefecture announced on March 28 that a national genetic test showed that the virus was highly virulent and highly pathogenic. 　This is the sixth case this season in the prefecture. According to the prefectural government, no abnormality has been confirmed at poultry farms in the area. (translated by M. Yamage)

Wholesale Egg Prices Hit New Highs in February Due to Spread of Avian Influenza [N H K, 28 Feb 2023]

This month's wholesale price of eggs reached its highest level since 1993, when statistics were first published, due to soaring feed prices and the spread of bird flu.

The average price per kilogram of medium-size eggs in the Tokyo area of JA Zen-Noh Eggs　（ ja.z-tamago.Co.,Ltd）, the standard for wholesale egg prices, was 327 yen this month, up 152 yen, or 86%, compared to the same month last year.

The price in December last year was 284 yen, the highest price since 1993, when statistics were first published, and this month's price was 43 yen higher.

According to the Ministry of Agriculture, Forestry and Fisheries, egg prices usually peak in December, when demand for Christmas cakes and Osechi dishes is high, and then tend to fall.
This season, however, the high prices are due to soaring prices for corn and other feedstuffs as a result of Russia's invasion of Ukraine and the continued spread of avian influenza since the beginning of the year, which has led to a decrease in the number of shipments.

Because of the decline in egg shipments, poultry farmers are prioritizing the supply of eggs for households, and convenience stores and restaurants have been unable to offer some of their products using eggs.

Regarding the outlook for the future, the Ministry of Agriculture, Forestry and Fisheries states, "Since the number of bird flu outbreaks in Japan usually tends to decrease after March, we will continue to monitor the situation closely.

We asked Seiji Nobuoka, a former professor at Tokyo University of Agriculture and executive advisor to the "Japan Poultry Farmers Association," about the outlook for egg prices.

In Japan, approximately 14.78 million chickens have been destroyed so far this season due to the avian influenza.

Of these, approximately 10% of the chickens raised in Japan for egg production have been destroyed.

Mr. Nobuoka commented, "It is not easy to immediately put new birds into poultry farms after killing the chickens. It takes more than a year to bring a poultry farm up to full operation. The price of corn, the raw material for feed, remains high, so there is concern that the impact will be prolonged," he said.

Nobuoka then points out that egg prices are higher in rural areas than in the Tokyo metropolitan area.

According to JA Zen-Noh Eggs, the average wholesale price per kilogram of M-size eggs this month was 341 yen in the Nagoya area, 332 yen in Osaka, and 337 yen in Fukuoka, all higher than the 327 yen in Tokyo.

Mr. Nobuoka commented on this, "Outside of the Tokyo metropolitan area, major production areas such as Kyushu, Chugoku, and Shikoku were severely affected by bird flu, so egg prices are higher in western Japan. Also, Nagoya ships not only locally but also to Osaka and Tokyo, so demand has increased and prices have risen," he said.

(translated by M. Yamage)

How concerning is bird flu? [The Financial Express, 27 Feb 2023]

A recent report published in the British multidisciplinary science journal, Nature, says that a variant of bird flu virus, H5N1, that can spread from mammal to mammal also poses risk to both humans and wild animals. At an American mink farm in Spain, the outbreak of H5N1 occurred in October 2022. Scientists through genetic sequencing found that the bird flu virus that infected the minks was a new variant of the H5N1. The genetic material included a strain from gulls and it also bore the mark of a genetic change that increases some bird flu virus's ability to reproduce in mammals. In fact, this change in the genetic makeup of the avian flu makes it unpredictable. The virus found in the American mink farm in Spain should be under closer scrutiny so that it may not infect people, scientists warned. What is worrying is that the H5N1 seems to be gaining its capacity for jumping from birds to mammals. So far as the American experience goes, about a dozen species including racoon fox, seal and grizzly bear have been found to be infected by the avian flu virus.

According to the US Centers for Disease Control and Prevention (CDC), the ancestors of the H5N1 bird flu that were infecting wild birds and poultry since 2021, first emerged in southern China in 1996. That was followed by widespread infection in the poultry population in Hong Kong in 1997. However, the outbreak could finally be controlled. Later the bird flu (H5N1) reappeared in 2003 and broke out among birds throughout Asia. Then it spread to Africa, Europe and the Middle East infecting poultry birds. But there were also some sporadic reports of human infection by the avian flu virus. In 2014 and 2015, it again appeared in the wild birds and poultry in the USA and Canada leading to massive outbreak of the avian flu among the poultry population of those two countries.

However, as the records of the World Health Organization (WHO) goes, since 2003 reports of human infections with avian flu H5N1 have been few and far between. Meanwhile, through comparing the properties of H5N1 viruses responsible for earlier outbreaks of avian flu with those of 2021and 2022, the US national public health agency, CDC, also found some differences (in properties of H5N1 of 2021-22). And the CDC views the observed changes in the H5N1 virus to be benign in nature since some elements of the past bird flu that were responsible for infections among humans are absent in latest version of bird flu (H5N1).Even so, the recent devastating impact of the avian flu on poultry population with some 15 million birds dead and 193 million culled, its fast spread across the continents, the changes found in the genetic make up of H5N1 that enabled it to jump from birds to mammals. The occasional reports, though rare, of human infections by the virus give reasons to be concerned. As recently as in January, a WHO report said that a young girl was infected by the avian flu in Ecuador. This is first such report from South America. Al Jazeera reports that last year there were only five cases of human infection by the bird flu. In the past, according WHO, the mortality rate of the humans infected by bird flu was 53 per cent. Actually, between 2003 and 2009, 468 people, mostly poultry workers, were reported to have been infected by the bird flu.

And 282 of those infected died of the disease. In the last two decade, 457 cases of people dying after the bird flu infection could be confirmed. Though epidemiologists are seeing no cause for alarm, still the general public with their recent experience with covid-19 pandemic want to be reassured. The recent history of the H5N1 variant's ability to kill birds and mammals like the American minks on an unprecedented scale is obviously concerning.

Against this backdrop, it would be worthwhile to see under what conditions the bird flu virus infected people leading to their deaths. The illness caused by the avian flu among people was both mild and severe. In milder cases, from eye infection to upper respiratory infections occurred. In the severer cases, it turned into pneumonia causing the deaths. Those who got infected by the bird flu were in close contact with the infected birds for long without taking any precautionary measures such as wearing of gloves, masks or other protective gears to safeguard their lungs and eyes from the virus. The victims touched or even breathed in from air polluted with droplets of the sick birds' saliva, mucous, faeces, etc. Such long exposure of the unprotected human subjects to the bird flu can cause mild to severe respiratory conditions and may ultimately prove deadly for some. Scientists have discovered five subtypes of the bird flu viruses that can spread to people causing respiratory illness. Those include H5, H6, H7, H9 and H10. And the subtypes causing most of the infections are H5N1, as we already know and the H7N9 variants. However, reports of the bird flu-infected people spreading the disease among other people by contagion are indeed rare. Until now, the avian flu is still an animal health issue, says the US national public health agency, CDC.

But that does not mean that precautionary measures are not necessary. The behavioural interventions including social distancing and other health protocols, even resorting to lockdowns in extreme cases as were practised during the covid-19 pandemic is the proven deterrents against any new pandemic. If the bird flu virus by any accident of natural origin turns into a deadly virus infecting humans on a massive scale, then behavioural interventions should be the first weapon to fight it. That is, until, of course, an effective vaccine is developed against the new pandemic.

Viruses in Cambodian bird flu cases identified as endemic clade [Reuters.com, 27 Feb 2023]

Feb 26 (Reuters) - The viruses that infected two people in Cambodia with H5N1 avian influenza have been identified as an endemic clade of bird flu circulating in the country, the U.S. Centers for Disease Control and Prevention (CDC) said.

The cases reported last week had raised concerns they were caused by a new strain of H5N1, clade 2.3.4.4b, which emerged in 2020 and has caused record numbers of deaths among wild birds and domestic poultry in recent months.

But work so far suggests this is not the case.

Preliminary genetic sequencing carried out in Cambodia led its health ministry to identify the viruses as H5 clade 2.3.2.1c, which has circulated in Cambodia among birds and poultry for many years and has sporadically caused infections in people, the CDC said in a statement on Saturday.

"Yes, this is an older clade of avian influenza that had been circulating around the region for a number of years and while it has caused human infections in the past, it has not been seen to cause human-to-human transmission. However, that doesn't mean that the threat is any less," said Erik Karlsson, director of the National Influenza Center of Cambodia and acting head of virology at the Institut Pasteur du Cambodge, which sequenced the virus.

He added that the response needed to be coordinated and swift to prevent any further spread and to limit exposure to any common source.

An investigation into the source and to detect any additional cases is ongoing, the CDC said, adding that so far there had been no indication of person-to-person spread.

Cambodia tested at least 12 people for the H5N1 strain last week, after an 11-year-old girl died from the virus in the first known transmission to humans in the country in nearly a decade.

The victim's father, who was part of a group the girl had been in contact with in a province east of the capital Phnom Penh, tested positive for the virus but did not exhibit any symptoms, Cambodia's Health Minister Mam Bunheng had said in a statement on Friday.

Only the girl's case has been sequenced and the father's case is still being worked on, Karlsson said.

The World Health Organization said it is working with Cambodian authorities following the cases, describing the situation as worrying due to the recent rise in cases in birds and mammals.

Lateral flow tests being prepared for UK outbreaks of avian flu [The Guardian, 26 Feb 2023]

By　Robin McKie

People are being warned to be careful when in contact with wild birds. Photograph: Maureen McLean/REX/Shutterstock

British health officials are preparing plans to deploy lateral flow tests if signs emerge that avian flu has begun to spread from one person to another.

The programme would provide rapid information about the dangers posed by the disease.

The UK Health Security Agency (UKHSA) is also working on blood tests to detect antibodies against the virus and officials will analyse the disease’s genetic mutations to reveal data about the increased risk to human health from avian flu.

The moves follow last week’s news that an 11-year-old girl in Cambodia has died from H5N1, the flu strain that is being spread around the globe by migrating birds and is infecting poultry farms.

Investigators are now trying to establish if infected birds were the cause of the Cambodian case, rather than human-to-human transmission.

At present, evidence suggests the H5N1 virus does not pass easily to people although scientists have urged care and caution.

“Viruses constantly evolve, and we remain vigilant for any evidence of changing risk to the population,” said Dr Meera Chand, incident director for avian influenza at the UKHSA .

This point was backed by Professor Ian Brown of the Animal and Plant Health Agency (APHA). “There have been over 850 cases in humans across the globe since 1996 with a high case- fatality rate.

“Almost all cases to date have not resulted in human-to-human transmission but vigilance is required.”

Scientists also warned last week that although direct risks of infection were low, people should avoid contact with sick or dead wild birds in public areas such as parks or waterways and should wash their hands after feeding wild birds.

Last week, the UKHSA confirmed it had found avian flu cases in poultry at 145 premises and in 656 wild birds in England, a rise of 15 new premises and 209 detections in wild birds since December 2022.

In addition, 14 out of 134 wild mammals collected since October 2021 were found to have avian flu: four in foxes in England and one in Wales. In Scotland, there were four cases in otters, four in seals and one in a fox.

“This virus keeps cropping up in various mammals and this could increase the possibility of further human infections,” said Prof Jonathan Ball, of Nottingham University. “The risk to humans is still very low, but it’s important that we continue to monitor circulation of flu in both bird and mammal populations.”

The human Spanish flu pandemic of 1918 ? which killed an estimated 50 million people ? is believed to have been triggered by a successful transmission of an avian flu virus to humans.

“The initial strain then adapted and became endemic in the human population, giving rise to the seasonal flu viruses,” said Professor Massimo Palmarini, director of the Centre for Virus Research, Glasgow University.

“This is why it is important to detect human cases of avian influenza as quickly as possible and make sure that we give as little opportunity as possible to the virus to be transmitted further and mutate.”

Cambodia reports H5N1 avian influenza clade is 2.3.2.1c - Outbreak News Today [Outbreak News Today, 25 Feb 2023]

In a follow-up on the H5N1 avian influenza cases reported in Cambodia this week, the Cambodian CDC announced on their Facebook page today that the clade identified is 2.3.2.1c.

Here’s what they wrote (computer translated):
Bird flu virus H5N1, which is the cause of death of girls living in Rolang village, Khlach commune, Central Sitha district, is a virus that has been studied among local birds, wild birds in Cambodia during the last few years.


Bird flu H5N1 (clade 2.3.2.1c): Different from H5N1 bird flu in other countries around the world.

Monitoring of the disease is ongoing, while the population in contact with the patient remains monitored.

As of today, there has not been any clear evidence of transmitting H5N1 bird flu from person to person.

Request all citizens to avoid direct harm with sick or dead birds. Let’s protect and prevent together for our health.

From the World Health Organization:
A(H5) viruses from birds and non-human mammals characterized from September 2022 to February 2023 belonged to the following clades:
Clade 2.3.2.1a viruses were detected in poultry in Bangladesh. There were up to 10 amino acid substitutions in the HA of recent viruses compared to the HA of A/duck/Bangladesh/17D1012/2018, from which a candidate vaccine viruses (CVV) has been developed. Some of the recent viruses did not react well to a post-infection ferret antiserum raised against the A/duck/Bangladesh/17D1012/2018 CVV but instead reacted well with a post-infection ferret antiserum raised against the A/duck/Bangladesh/19097/2013 CVV.

Clade 2.3.2.1c viruses were detected in birds in Viet Nam and Lao People’s Democratic Republic. Viruses from Viet Nam reacted well with a post-infection ferret antiserum raised against the A/duck/Vietnam/NCVD1584/2012 CVV, despite recent strains having up to 9 amino acid substitutions in the HA.

Clade 2.3.2.1e viruses were detected in Timor-Leste. The HAs of these viruses were most closely related to viruses previously detected in Indonesia. There are no CVVs representative of this HA clade and the viruses from Timor-Leste reacted poorly with post-infection ferret antisera raised against clade 2.3.2.1a and 2.3.2.1c CVVs. No human infections have been associated with viruses of this clade and the extent of their circulation is uncertain.

Clade 2.3.4.4b viruses were detected in birds in many countries in Africa, Asia, Europe, North America and, for the first time, in Central and South America. An increasing number of infections in wild and captive mammals has been reported, with mink-to-mink transmission suspected on a farm in Spain. Viruses from this clade have been associated with several different NA subtypes with N1 now predominating. The high levels of infection in birds with these viruses and increased geographic distribution have been accompanied by genetic diversification. Some A(H5N1) viruses from Europe, the United States of America (USA) and Viet Nam show reduced reactivity with post-infection ferret antisera raised against the A/Astrakhan/3212/2020 CVV. All viruses from Europe reacted well with post-infection ferret antiserum raised against A/chicken/Ghana/AVL763_21VIR7050-39/2021; a representative CVV is being developed. Many viruses from the USA that had reduced reactivity with antisera raised against the A/Astrakhan/3212/2020 CVV showed better reactivity with post-infection ferret antisera raised against A/American wigeon/South Carolina/22-000345-001/2021.

The US Centers for Disease Control and Prevention writes: HPAI A(H5N1) virus infections have been reported in more than 880 people with approximately 50% case fatality proportion since 1997, including 20 cases and 7 deaths in Hong Kong during 1997-2003, and more than 860 cases reported in 21 countries since November 2003. Mild upper respiratory tract symptoms, lower respiratory tract disease, severe pneumonia with respiratory failure, encephalitis, and multi-organ failure have been reported. One case of asymptomatic infection was reported in Vietnam in 2011, and another asymptomatic case was reported in the United Kingdom that occurred in late 2021. The spectrum of illness caused by human infection with current H5N1 bird flu viruses is unknown. Since 2016, a small number of sporadic infections have been reported each year globally. Illness in humans from all bird flu virus infections has ranged in severity from no symptoms or mild illness to severe disease that resulted in death.

Bird flu: UK health officials make contingency plans [BBC, 24 Feb 2023]

By Michelle Roberts

UK health experts are sharing details of their Covid-style plans against bird flu, including modelling for the unlikely scenario that it could mutate and cause a pandemic in people.

The UK Health Security Agency (UKHSA) says there is no evidence H5N1 virus is an imminent threat or can spread between people, despite some getting sick after contact with infected birds.

But there is no room for complacency.

One expert told the BBC "we must prepare for the worst" just in case.

The World Health Organization (WHO) is urging heightened vigilance from all countries, following the death of an 11-year-old girl in Cambodia from H5N1.

The girl's father has also tested positive, according to Cambodia's health minister.

Investigators are working to establish if infected birds were the cause, rather than a case of human-to-human transmission.

Humans rarely get bird flu, but when they do it is usually from coming into direct contact with infected birds.

Since late 2021, the world has been experiencing one of the worst global avian influenza outbreaks on record, with tens of millions of poultry culled and mass wild bird die-offs.

And there have been a few infections in some mammals, including foxes and otters in the UK.
Dr Meera Chand, from the UKHSA, said all of the latest evidence suggested H5N1 could not currently spread easily to people.

"However, viruses constantly evolve, and we remain vigilant for any evidence of changing risk to the population, as well as working with partners to address gaps in the scientific evidence."
In preparation for a worst-case scenario of human-to-human spread, the UKHSA is modelling:
? How many might become infected and get very sick
? Whether lateral flow tests and blood tests would be helpful
? What genetic mutations might signal an increased risk to human health

When the Covid pandemic hit, there were no suitable vaccines available to fight that virus. But for bird flu, there are already several good candidates that might help.

WHO-affiliated labs already hold two flu virus strains that are closely related to the circulating H5N1 virus, that manufacturers can use to develop new shots if needed, experts said at a meeting on Friday.

Prof Peter Openshaw, from Imperial College London, is a member of Nervtag - the group that advises the British government on new and emerging threats from respiratory viruses.

He told the BBC that the fact that we are still in a Covid pandemic in no way lessened the possibility of another pandemic coming from elsewhere.

"We absolutely need to watch this one," he said.

"The good news at the moment is that there's no evidence of human-to-human spread.
"We need to prepare for the worst but obviously hope for the best, to use the old phrase."

"Not another pandemic" might well be the exasperated response of many to talk of the risks from bird flu.

Covid fatigue is understandable but the H5N1 virus is a real concern to many scientists who monitor global disease threats.

Thankfully, the virus does not spread easily from birds to humans, requiring close contact.

That would need to change if the threat of a human pandemic was to be realised, which would require the virus to mutate.

Since 2003 the WHO has recorded 868 cases in humans, of which 457 were fatal, so the mortality rate is more than 50%.

Scientists want to see better surveillance, more investment in vaccines and antivirals - so that should the worst ever happen, the world will be better prepared than it was when Covid emerged.

Bird Flu pandemic plan drawn up by scientists as they prepare for 'biggest threat' [GB News, 24 Feb 2023]

By Carl Bennett

It comes following the death of an 11-year-old girl in Cambodia
The brains behind Britain’s Covid lockdown measures have met to prepare for the latest global pandemic threat amid growing fears the Bird Flu outbreak could transfer to humans.

The group of experts meets twice a year to decide which strain of seasonal flu to include in the vaccine for the upcoming winter season, with the H5N1 avian flu being considered following a record number of bird deaths worldwide in recent months.

Officials from the UK Health Security Agency (UKHSA) are said to be developing “scenarios of early human transmission” in order to “facilitate preparedness.”

Since the latest outbreak of Bird Flu only one Briton has caught the disease, and the World Health Organization (WHO) say the threat to humans is low.

But experts are concerned amid recent reports of mass deaths in infected mammals, from seals to bears, as well as potential mammal-to-mammal transmission on a Spanish mink farm last year.

It also follows Cambodia reporting the death of an 11-year-old girl after she was infected by the H5N1 strain of Bird Flu, the Southeast Asian country’s first known human infection with the strain since 2014.

Health workers have since disinfected the property in Prey Veng province, east of the capital Phnom Penh, where the girl lived.

Speaking ahead of the meeting, Sylvie Briand, WHO director of global infectious hazard preparedness, said “"we are more prepared (than for Covid), but even if we are more prepared, we are not yet prepared enough," adding “We need to really continue the efforts for a flu pandemic."

Those working on the models in the UK include Professor Neil Ferguson, whose Covid projections led to the UK Government to force the first lockdown.

Experts are already discussing potential vaccines.

WHO-affiliated labs have two flu virus strains which are closely related to the H5N1 virus, which could be used by manufacturers to create a human vaccine if needed.

One of them was added following the previous WHO flu meeting in September 2022, with labs globally testing how closely both subtypes match the strain spreading among animals to determine whether any more updates are necessary.

A number of companies that produce season flu vaccines could also make pandemic flu vaccines.

Having the strains ready and prepared could save two months in vaccine development, according to Briand. The problem, however, would be producing enough vaccine quickly, experts warn.

Whilst extremely rare, human-to-human transmission of H5N1 can happen.

In 1997, 18 cases were discovered in Hong Kong, but these were maintained and ultimately did not lead to a global viral spread.

The World Health Organization warns that of the 868 human H5N1 cases reported to it over the last two decades, 456 were fatal.

Bird flu spreading from mammals to humans 'increasingly worrying,' experts warn [Daily Star, 24 Feb 2023]

BY Adam Cailler

Bird flu experts fear we are sleepwalking into disaster with more than half of folk dying after catching the disease.

Of the 860 known human cases of avian flu since 2003, 53% have died, a British Medical Journalstudy found.

Dr Quinton Fivelman, of London Medical Lab, fears we are becoming “used to outbreaks on poultry farms” while the rising virus spread from bird to mammals was incredibly worrying.

Dr Fivelman said: “The fact that it is now spreading to mammals shows we cannot let our guard down against this virus. The higher number of cases mean a greater chance of mutation. It’s concerning there is no vaccine as yet.”

The first human cases were recorded in Hong Kong and China in 1997.

It comes as we reported a a girl had died from bird flu, confirming the worst fears of scientists who predicted it could jump from mammals to humans just last month.

The sad death of the 11-year-old was reported in Cambodia earlier today (Thursday, February 23).

The girl first became ill just six days before her death, and suffered from a fever, cough and sore throat.

Her death was confirmed by the country's Communicable Disease Control Department, who said that the girl from the Prey Veng province “tested positive for H5N1”.

As a result, the World Health Organization has said: "The recent spillover to mammals needs to be monitored closely."

The news comes just a weeks after we reported that it was found that a deadly strain of the avian bird flu had mutated and can now impact mammals.

Scientists had found that the avian flu had been transmitted from wild birds to a group of mink on a farm in the Spanish city of La Coruna.

The study, published on top infectious disease surveillance website Euro Surveillance, stated that the outbreak happened in Spain in October 2022.

Explainer: H5N1 Bird Flu in Mammals Sparks Fears of Virus Spreading Among Humans [Bloomberg, 24 Feb 2023]

By Michelle Fay Cortez

An avian influenza ? bird flu ? outbreak with the H5N1 strain that began in 2020 has hit record levels, affecting millions of animals. As the virus mutates genetically and spreads geographically, the normal ebb and flow of infection has given way to a persistently elevated level in wild birds. They are spreading the highly contagious pathogen to domesticated poultry and a rising number of mammals, including badgers, bears, ferrets, pigs and raccoons ? as well as a handful of people. Though the virus has been around for decades, there are no signs of it having made the jump to human-to-human transmission. Still, the possibility exists that it could further evolve to cause catastrophic outbreaks in people ? just as the world is moving beyond the worst of the Covid-19 pandemic.

Avian influenza in the US alone has affected nearly 60 million birds ? including wildlife, commercial poultry and backyard flocks ? since January 2022, according to the Centers for Disease Control and Prevention. That’s on top of the 50 million birds destroyed in 36 European countries between October 2021 and September 2022. And it’s not just birds. In the UK, there have been 10 reports of infections in non-avian wildlife since the start of 2022, including in red foxes, Eurasian otters and harbor seals.

Bird flu death: What will happen next and is there a vaccine? [New Scientist, 24 Feb 2023]

By Clare Wilson

An 11-year-old girl in Cambodia has died in hospital after catching bird flu. Her father has tested positive for the virus responsible, but it is unclear whether he caught the infection from her or the family's poultry collection

A girl has died from bird flu in Cambodia after possibly catching it from her family’s small flock of chickens and ducks. At least one of her close contacts has also tested positive, but authorities are still waiting on the results of testing her wider circle.

How many people have died from bird flu in the latest cluster of cases?
An 11-year-old girl from Cambodia has died from a subtype of the bird flu virus called H5N1 in the rural Prey Veng province, a region close to the capital Phnom Penh. She developed flu-like symptoms on 16 February and after her condition deteriorated, she was sent to hospital, where she died. Out of 12 of her close contacts who have been tested, only her father has so far been found to be positive for the virus.

How did she catch it?
It could have been from her family’s small collection of ducks and chickens, as all the animals at her home ? 22 chickens and three ducks ? had recently died, according to BNO News, but the cause of their deaths is unknown. There have also been a number of fatalities among wild birds in the area.

Is bird flu now spreading between people?
Even if more of the girl’s 12 contacts test positive, this doesn’t mean the virus has evolved to spread easily between people. Her father and any other cases could have caught the virus directly from infected birds, says Wendy Barclay at Imperial College London. “If she’s had contact with backyard poultry, there’s a chance that friends she played with have also had contact [with the birds],” she says.

Should we expect more cases?
Since 2021, bird flu has been surging in wild bird populations and spreading to domestic poultry flocks and occasionally other animals, such as foxes and seals, which eat birds. That raises the likelihood of the virus crossing over to people, says James Wood at the University of Cambridge. “We expect there to be some cases of [human] disease with such a widespread infection,” Wood said in a statement to the Science Media Centre in the UK.

How deadly is bird flu in people?
Over the past 20 years, there have been about 900 known cases of human infection with various strains of H5N1, of which about half were fatal. But the death rate may appear higher than it really is because there are likely to be many cases where people didn’t develop symptoms or weren’t tested for the virus, says Barclay. There is now thought to be about 30 different genetic variants of H5N1 viruses circulating in birds, which probably differ in their ability to make people sick.

Has vaccine production begun?
Mass production of a bird flu vaccine cannot begin because we don’t yet know which variant, if any, could make the jump to start freely spreading between people. The effectiveness of flu vaccines hinges on making them from viruses that are as close a match as possible to the one that people eventually catch.

Manufacturers are about to start making the usual seasonal vaccines ahead of the northern hemisphere’s winter. If they were to switch to making H5N1 vaccines prematurely, that would risk not enough seasonal flu vaccines being available later this year. “Seasonal vaccine is very important in saving lives,” Sylvie Briand at the World Health Organization (WHO) said at a press conference this week. “You need to balance the risks and benefits when you talk about switching vaccines.”

But manufacturers routinely carry out preparatory work using “candidate vaccine viruses” and the WHO has asked them to do this using a selection of the H5N1 viruses, the organisation announced this week.

Are there any treatments?
There are several antiviral treatments for seasonal flu, such as oseltamivir (Tamiflu), which has been used as a treatment as well as a preventative medicine among the close contacts of people known to have bird flu.

In a few cases, the H5N1 virus evolved resistance to oseltamivir, although this seemed to be linked with the virus also becoming less virulent and less transmissible. At the press conference, the WHO said it has been in talks with manufacturers of antivirals about how quickly they could scale up production.

What happens if bird flu does start spreading between people?
Briand has said that if human-to-human transmission were discovered, health authorities would try to prevent further crossover events from animals to people, as well as aiming to stop the virus’s spread between people. This would be “by treating cases, isolating cases so that they don’t further transmit the virus and also identifying contacts”, she said. “We can use antivirals to treat contacts for post-exposure prophylaxis and reduce the likelihood of further human transmission.”

The WHO would also try to prepare neighbouring areas for further spread using intense surveillance of viruses, informing communities about how to reduce their risk of infection and helping healthcare workers avoid infection with protective equipment.

How concerned should we be about bird flu? [The Hub at Johns Hopkins, 24 Feb 2023]

By Katie Pearce

Johns Hopkins epidemiologist and environmental microbiologist Meghan Frost Davis discusses the current state of the H5N1 outbreak and its global reverberations

Now two years in, the global avian flu outbreak has devastated wild and domestic bird populations, leapt into various species of mammals, and cost governments and farmers billions as consumers feel the pain in their grocery bills. Despite containment efforts, the record-breaking outbreak?caused by a highly contagious new variant of H5N1?shows no signs of slowing as migration season looms.

While the virus so far has not posed significant threats to humans, many unknowns remain as it continues to evolve, according to Johns Hopkins epidemiologist and environmental microbiologist Meghan Frost Davis. "What we know about flu strains is that they're constantly changing. Our influenzas have the potential to become epidemics or pandemics," she says. "So that's what we keep at the back of our minds."

"RIGHT NOW, THERE'S NO REASON TO BELIEVE THAT THESE AVIAN INFLUENZA STRAINS WILL RISE TO THE NEED TO BE INCLUDED IN OUR DECISION-MAKING OVER HUMAN VACCINES. WE'LL SEE IF THAT CHANGES."

In particular, the jump from birds to mammals?including foxes, bears, mink, whales, and seals?is "significant and something to pay attention to," says Davis, an associate professor in environmental health and engineering at Johns Hopkins University's Bloomberg School of Public Health. "What people may not remember from high school biology is that there are larger differences between birds and mammals than there are among mammals, so finding the virus in mammals indicates an expanded host range."

Davis recently spoke with the Hub about the current state of the outbreak and its global reverberations.

What can you tell us about the extent of this outbreak?
What we're seeing is an epizootic?the term we use for an epidemic, but with animals?happening in wild birds in many parts of the world, which has caused a record-breaking outbreak of avian flu in domestic poultry, including chickens and turkey raised for meat and eggs, as well as backyard poultry kept for the household or as pets. So the outbreak is of great concern for animal health, starting with the poultry especially. But now we've also seen it detected in a number of other animals, including mammals. And it's shown up in a very small number of people globally.

What makes this avian flu outbreak stand out from other similar ones of the past?
What we more typically see with outbreaks in animals is that they'll surface and then go away, usually within the space of a season. What's unusual about this one is that it's been going on for some time, starting sometime in 2021, with various sub-strains developing. It's been persistent and widespread, and now has affected an estimated 58 million birds in the United States and more globally.

What usually happens to prevent these outbreaks from spreading further is going to commercial flocks to depopulate them. So remove the animals, then wait out the viability of the virus in the local environment. They'll do a good cleaning to make sure everything's good, then repopulate the flock.

These control measures aren't enough to contain the current outbreak. That's pretty significant because we're not just talking about the loss of animal lives, which is tragic, but we're talking about widespread impacts to our food systems and our ecosystem, not to mention the commercial and psychosocial impacts on people raising the animals. This can all be quite devastating.

Why is it significant that the avian influenza has shown up in mammals?
From a public health perspective, we're perennially concerned about any infectious agent that has potential to move from one species to another species, and in particular from an animal species into a human. And if thatbecomes the kind of virus that can transmit human-to-human, that's where we see outbreaks, epidemics, or even pandemics. Of course the SARS-CoV-2 virus that caused the COVID-19 pandemic is one example of this, and we're still struggling with it.

"THERE HAVE BEEN RARE CASES WHERE AVIAN FLU HAS BEEN FOUND IN PET ANIMALS SUCH AS CATS AND DOGS. THE BASIC ADVICE IS TO PREVENT CONTACT WITH WILD BIRDS … I WORRY MORE ABOUT PET BIRDS, INCLUDING THOSE THAT ARE INDOORS BUT MIGHT HAVE INDIRECT CONTACT WITH WILD BIRDS THROUGH A SCREENED WINDOW OR DOOR."

What level of concern is there that this could spread more widely among humans?
Thankfully with the current outbreak we've seen fewer than 10 human cases documented, one of those in the United States. And we've been doing targeted surveillance of people who have been in contact with positive birds, which was the case for the individual in the U.S., who experienced mild symptoms for a few days. Surveillance is key to catching these groups with potential exposure, who could help us identify and track new strains.

With the current strains circulating, we haven't seen high risk to humans?so that's reassuring, right? However, what we know about flu strains is that they're constantly changing. This is why our seasonal influenzas have the potential for epidemics or pandemic strains. Those are the worst-case scenarios we imagine.

Even though the number of cases in humans from this outbreak is small, the recent death of a girl in Cambodia shows how severe the disease can be.

You mentioned depopulation as a control method. What are other methods to limit the spread of bird flu?
With the wild bird population, clearly it's not really possible to control it. But as far as what individuals can do, you'll hear advisories for people to disinfect bird feeders, or to not use bird feeders or bird baths at all because you don't want congregations of birds. For people who deal closely with birds, wear N95 masks, and if you suspect an animal might be sick?maybe they're not eating or drinking well, maybe you see discharge around the eyes, or unkempt feathers?it's time to call your veterinarian or potentially also contact appropriate state agencies.

With domestic poultry, some of these flocks are hundreds of thousands of birds, so once the virus gets into the flock, it can spread quickly. In these facilities, prevention focuses on biosecurity and biocontainment. Basically, you stop any new elements from coming into a large farm, for example. You disinfect, you limit visitors, you try to enclose the facilities. Even with backyard flocks these principles can be used?you isolate chickens in coops.

Different states may have different agencies or groups handling this kind of thing; for example in Maryland we have an extension service through the University of Maryland as well as the state Department of Agriculture monitoring this situation and taking action. It's something that's on the radar and a high priority for the poultry industry as well as for animal health professionals.

What about vaccines? What role could they play here?
With human vaccinations, we have expert groups come together to decide which strains to include in our seasonal flu vaccines. Right now, there's no reason to believe that these avian influenza strains will rise to the need to be included in our decision-making over human vaccines. We'll see if that changes.

With animal vaccination, there are two different considerations: How effective is it in preventing disease, and is it economically feasible? We tried this with COVID-19 vaccines for animals and found that the cost-benefit ratio wasn't really where it should be. With the bird flu, I'm not certain these questions have been fully addressed to the point where an effective vaccine could be brought to market. To my knowledge, there is no widespread deployment right now of vaccines for poultry.

Should we be concerned about impacts to our pets, i.e. cats that interact with birds?
There have been rare cases where avian flu has been found in pet animals such as cats and dogs. The basic advice is to prevent contact with wild birds. Since outdoor cats can sometimes hunt wild birds, this could lead to exposure, so you'd want to keep them indoors to decrease risks. I worry more about pet birds, including those that are indoors but might have indirect contact with wild birds through a screened window or door.

What misunderstandings do you think may exist about the bird flu?
The biggest thing I've been hearing is how upset and horrified people are about the price of eggs going up?which, yes, is an economic issue related to this avian influenza outbreak. But I think many general consumers aren't fully comprehending or appreciating just how complex our food systems are and how something like this can impact supplies coming into the market and their price points. To me this really illustrates how vulnerable our food system is and the value of investing in animal health?research and resources that look at the entirety of the food system and try to build as resilient a structure as possible.

The challenges we face with animal health diseases aren't limited to avian flu. For example, almost a decade ago, porcine epidemic diarrhea (PED, a coronavirus) caused a major outbreak that impacted pork production. Right now we're seeing African Swine Fever causing disease in pigs around the world, though it hasn't yet been identified in the U.S. There are major efforts underway to try to prevent introduction of this virus and to protect animal health and the food supply.

How closely is human health connected to animal health and well-being?
I think the bird flu gives us a window into how animal diseases broadly impact human health and all the different pathways for that to occur. After COVID-19 we're all sensitized to the possibility of a virus in animals spilling over into humans. That's not something we want to happen, but it's something that we now understand occurs more frequently than we once thought.

But when we think about these animal diseases, we shouldn't limit our concerns just to the possibility of human infection. There can be major global impacts regardless?affecting our food systems, our livelihoods, and causing major disruptions to our ecosystems. Healthy ecosystems can support cleaner air and cleaner water and also can help mitigate impacts from flooding or extreme weather events. If we can't understand and respect the way all of this works together, we'll lose many of these benefits and human populations will certainly feel impacts in one way or another.