I received a number of inquiries from concerned friends and colleagues about an op-ed in the New York Times this week, “An Even Deadlier Pandemic Could Soon Be Here” by Zeynep Tufekci.
I’ve been writing about the risk of pandemic bird flu for several years and couldn’t agree more with the sense of urgency and call to action in her article.
More than 50,000 mink at a facility in northwestern Spain were killed and their carcasses destroyed in late 2022, when it was discovered that a deadly avian influenza H5N1 virus (aka “bird flu”) was behind the outbreak. While none of the farm workers became infected, the episode reignited fears that H5N1 could trigger a human pandemic.
According to data from the Centers for Disease Control and Prevention, since early 2022, more than 49 million birds in 46 states have either died because of bird flu virus infection or have been culled due to exposure to infected birds. Since 2003, the World Health Organization (WHO) has received reports from 19 countries of more than 860 human infections with H5N1 bird flu viruses, with about 53 percent of those resulting in death.
While bird flu does not yet easily jump to humans, we need to remember that highly pathogenic H5N1, at its core, is an influenza virus which figured out how to become a transmittable human viral vector a millennium ago.
To put this into perspective, SARS CoV-2 virus killed approximately 1 percent of its human targets around the world, and you know the profound global impact on morbidity and mortality that has had, along with the devastating economic toll.
A viral bird flu pandemic with a 53 percent mortality rate would be a catastrophic event, so it’s time to start worrying and taking action.
But how, you may wonder, could a virus that infects primarily birds become a global extinction event in humans? As we’ve seen with SARS CoV-2, viruses in humans constantly undergo rapid genetic reassortment and mutation. The genetic information in these viruses could reassort and combine to create a new influenza A virus mutation with genes from the avian bird flu virus and other genes from the influenza A virus. Such viral mutations could create viruses against which humans have little or no immunity that are more likely to result in sustained human-to-human transmission. Therefore, careful evaluation of influenza A viruses recovered from humans who are infected with avian influenza A viruses is very important to identify if such worrisome reassortment occurs.
Now that bird flu is widespread and endemic among poultry in the U.S., there are a few specific action steps we should immediately implement:
1.) Establish a cabinet level office of pandemic preparedness to facilitate rapid intergovernmental, academic and industrial resources and mobilization.
2.) Increase WHO surveillance, particularly in Asia.
3.) Support government/industry/academic research and development now so we have a vaccine ready and therapeutic drug interventions available so we can move even faster if needed.
On a local level, bird owners, wild game hunters and people who have backyard or hobbyist flocks should wash their hands with soap and water after touching birds and report any dead birds to their local wildlife agency. The U.S. federal government maintains a stockpile of vaccines, including vaccines against A(H5N1) and A(H7N9) bird flu viruses. These vaccines could be used if similar viruses were to begin spreading easily from person to person, although the ability to scale up to the numbers needed in the event of a pandemic could be daunting with the older production technology. mRNA vaccines for influenza, including bird flu, are in development, which could improve strain match and vaccine production over current approaches.
We still have time to get ahead of this potential catastrophe, so let’s not bury our heads in the sand.
David Segarnick, PhD, is chief medical officer at MedEvoke, an iNIZIO company, and an adjunct assistant professor of pharmacology, physiology and neuroscience at Rutgers/NJ Medical School. He lives in Upper Black Eddy.
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