The world has just about come out of the grip of COVID-19 and a new pandemic lurks in the shadows. An 11-year-old girl has died in Cambodia of bird flu, also known as avian influenza, and multiple others who lived in her area have been sickened — potentially setting the stage for sustained human-to-human transmission.
Reports say that the 11-year-old from Cambodia’s southeastern province of Prey Veng, reportedly became ill on 16 February, suffering from a 102-degree fever, cough, and throat pain. She died shortly after arriving at a hospital in the capital, Phnom Penh, the Associated Press reported, citing the country’s health ministry.
The Khmer Times — a local newspaper — has reported that 12 people living around the deceased girl are suspected of having been infected with the H5N1 bird flu strain and are waiting on laboratory confirmations.
Does this mean that we are now looking at an outbreak of bird flu among humans? Are we prepared for another pandemic?
What is bird flu?
Bird flu is a viral respiratory disease mainly of poultry and certain other bird species, including migratory waterbirds, some imported pet birds, and ostriches. Though rare, it can spread to humans and the first known cases in humans were reported in 1997, when an outbreak of avian influenza A virus subtype H5N1 in poultry in Hong Kong led to severe illness in 18 people, one-third of whom died.
According to Richard Webby, an infectious disease researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee, and director of World Health Organization’s (WHO) Collaborating Centre for Studies on the Ecology of Influenza in Animals and Birds, the virus has been around for quite a long time. Speaking to CNN, he said, “We saw the sort of great-great-granddad of the virus in the late 1990s in Southeast Asia, and we’ve been following its evolution and change ever since.”
Bird flu is a viral respiratory disease mainly of poultry and certain other birds. It is considered one of the largest known threats to domestic birds. Reuters
The virus in birds spreads rapidly owing to which farmers usually have to cull uninfected birds along with infected ones to prevent a wider outbreak. It is considered one of the largest known threats to domestic birds.
How widespread is the recent bird flu outbreak?
Currently, bird flu has wreaked havoc across the world infecting birds as well as other animals too. In the United States alone, it 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 (CDC). It’s because of this outbreak that egg prices have soared in the US, causing many people to give up their daily dose of protein.
Also, bird flu is responsible for the death of 50 million birds across 36 European countries between October 2021 and September 2022.
It has also spread to other mammals across the map of the world. In Alaska, cases have been reported among bears and foxes. The virus has also been found in a bobcat in California, a skunk in Colorado, a raccoon in Washington, possums in Illinois and Iowa, a mountain lion and grizzly bear in Nebraska, seals in Maine and even a bottlenose dolphin in Florida.
A sick pelican sits next to a dead one, on the shores of the river Camana after Peruvian authorities recorded first cases of bird flu in November 2022, in Camana, Peru. File image/Reuters
Besides this, an outbreak of avian flu was also reported on a mink farm in Spain, earlier in January. Officials in Peru said three sea lions found dead in November tested positive for the virus
Also read: Why the spread of Bird flu in animals is worrying
The UK Health Security Agency said that a fox had recently tested positive for H5N1. It joined eight foxes and otters which tested positive in the UK last year.
The infection in mammals also prompted the WHO to react, with Director General Tedros Adhanom Ghebreyesus saying in an 8 February news conference that the situation needed to be “monitored closely” owing to their physiological similarities with humans.
Are humans safe from bird flu?
Bird flu has affected humans who have come in contact with the infected birds. According to experts, bird flu is almost always transmitted by direct contact with sick birds. Only rarely have human cases occurred over the quarter century it’s been known to exist, with no sustained transmission reported among humans.
Globally, nearly 870 human infections and 457 deaths have been reported to the WHO in 20 countries. But the pace has slowed and there have been about 170 infections and 50 deaths in the last seven years.
However, rare in humans the fatality rate is high if it does happen. In a virtual press conference earlier this month, Dr Sylvie Briand, director of the pandemic and epidemic diseases department at the WHO said that when humans are infected, they are more likely to have severe disease. “It’s between a 30-50 per cent case fatality ratio, but again, those viruses are not very transmissible,” Dr Briand said.
Until now, public health officials weren’t particularly worried about the risk of human-to-human transmission. However, the Cambodia incident now does raise apprehensions. As Rajiv Chowdhury, senior epidemiologist and professor of global health at Florida International University, told Fortune, “The Cambodia case does raise the concern that we are transitioning from what has been a bird-to-human status quo to more of a human-to-human transmission scenario.”
Villagers pose with posters about H5N1 virus threats, in Prey Veng province in Cambodia after an eleven-year-old girl died from bird flu, the country’s first fatality from the virus in years. AFP
Dr Eric Feigl-Ding, an epidemiologist and Chief of COVID Task Force at the New England Complex Systems Institute, tweeted: “Hope this wasn’t human to human, but I’m now getting to be worried.”
This worry was also echoed by WHO chief Dr Ghebreyesus, who has advised people not to touch dead or sick wild animals and for countries to strengthen their surveillance of settings where people and animals interact.
There’s a worry that bird flu could mutate and evolve. If it’s not a threat to humans today, it could become one. That’s because influenza viruses are incredibly changeable. Like other viruses, H5N1 — which is currently taking the biggest toll on the bird population — picks up small mutations as it replicates within a host; over time, that can give the virus certain benefits (though mutations are often bad for the virus).
American website Vox also explains that influenza viruses can also undergo much bigger and more consequential shifts through a process called reassortment. Explaining this phenomenon, Vox says it’s when two influenza viruses infect the same cell in the same host, they can trade entire chunks of their genomes with each other, yielding a variety of Franken-flus.
Experts note that if the avian influenza does mutate allowing for human-to-human transmission, it could spell trouble for the world. As Chowdhury said in the Fortune report, “The potential impact could be significant… it could be the start of a “new global influenza pandemic.”
The world needs to get it guard up against bird flu. Today, it is already a nutritional, economical and ecological crisis. We need to ensure that it doesn’t turn into a public health one soon.
With inputs from agencies
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