In this latest video from MedCram, Dr. Seheult discusses the H5N1 influenza A virus also known as the bird flu. People are getting excited about this because they’re concerned it may be the cause of a future pandemic. Going back to prior pandemics, in 1918 there was the Spanish Flu that was originally avian in origin and caused 50-100 million to die. In 1957, this was followed with the Asian Flu that was also avian in origin and killed 1 million people. Next, in 1968 another outbreak that was avian in origin killed 1 million people. In 1996 H5N1 was first detected and since 2003, we’ve had multiple H5N1 outbreaks.
Latest update on H5N1
What’s going on now with H5N1 that is different from prior outbreaks? The current virus appears to have made a cow to human transmission as of April 7, 2024. The virus has been already detected in goats and cows but this is the first time with a possible cow to cow transmission and possible cow to human transmission.
For humans there are different types of seasonal influenza viruses with the best being known as influenza A or influenza B. Influenza A has its own subtypes called H1N1 and H3N2.
H5N1 was first detected in 1996 and was related to poultry outbreaks occurring in China and Hong Kong with 18 associated human cases resulting in six deaths in Hong Kong. The virus would then go on to cause more than 860 human infections with a greater than 50% death rate. This virus is highly pathogenic and will kill 90- 100% of chickens within 48 hours.
There are asymptomatic carriers for this virus that can carry the virus and not necessarily die within 24-48 hours and these include ducks, geese, swans and shorebirds. Mammals that have been detected with this virus include foxes, pairs seals and sea lions, polar bears, domestic cats, dogs, minks and now goats and cows.
We know that this virus back in 2008 could potentially infect baby cows and so what is happening now does not appear to be a new mutation.
What about humans and H5N1?
The concerning issues are the human cases of H5N1 and as of April 2024, there have been 888 human cases. Most of these have come directly from birds either commercial or wild with a 50-60% fatality rate. This usually involves contact with infected birds of saliva, mucus, or poop without any protective equipment. There are very wide-ranging symptoms which include conjunctivitis, sneezing, coughing, pneumonia, and death. There are two cases that have occurred in the United States. One occurred in 2022 with a prisoner from Colorado who was infected from poultry and his main symptom was fatigue, and then in 2024 with an individual from Texas that had pinkeye from getting it from an infected cow. What about human to human transmission? There have been about eight total cases documented. However, even with this, it is still difficult to delineate as to whether there was a group of humans working in a similar area that got infected from the animal, or if one of those humans actually passed it on to another human.
What are treatments for H5N1?
What about treatments for H5N1? Since this is an influenza A virus, any treatments for influenza A can also be used which include oseltamivir, zanamivir, peramivir, and baloxavir. The seasonal flu shot does not cover H5N1. Other options include taking NAC, hydrotherapy and interferon. All of these viruses that we have seen typically cause a decline of interferon in the body’s ability to mount an interferon response. Anything that is able to increase interferon levels would theoretically be viewed as beneficial. However, for H5N1 we do need more clinical trials.
Current precautions include avoiding unprotected exposures to sick or dead animals. Also it is recommended to avoid animal carcasses, raw milk, feces, or litter from animals with confirmed or suspected H5N1. A person who has been exposed should be monitored at least 10 days post exposure because this is the length of time for incubation for this virus. Another video to start to prepare for any potential future outbreak of any particular virus is Medcram’s video on Disease X and how to prepare for any pandemic.
LINKS / REFERENCES:
H5N1: What to know about the bird flu cases in cows, goats and people (Live Science) | https://www.livescience.com/health/fl…
Types of Influenza Viruses (CDC) | https://www.cdc.gov/flu/about/viruses…
Emergence and Evolution of H5N1 Bird Flu (CDC) | https://www.cdc.gov/flu/avianflu/comm…
Bird flu kills almost 14,000 pelicans, seabirds in Peru (Phys) | https://phys.org/news/2022-11-bird-fl…
First birds, now mammals: how H5N1 is killing thousands of sea lions in Peru (UNMC) | https:/www.unmc.edu/healthsecurity/t…
Detections of Highly Pathogenic Avian Influenza in Mammals (USDA) | https://www.aphis.usda.gov/livestock-…
Past Examples of Probable Limited, Non-Sustained, Person-to-Person Spread of Avian Influenza A Viruses (CDC) | https://www.cdc.gov/flu/avianflu/h5n1…
Highly Pathogenic Avian Influenza A(H5N1) Virus in Animals: Interim Recommendations for Prevention, Monitoring, and Public Health Investigations (CDC) | https://www.cdc.gov/flu/avianflu/hpai…
Disease X: How to Prepare for the Next Pandemic (MedCram) | • Disease X: How to Prepare for the Nex…