According to the CDC on March 1, 2023, H5N1 Bird Flu has been detected across the United States: 6,284 wild birds detected, 50 States affected and 968 counties affected.
Epidemics can happen anywhere. From the Americas to Africa to Asia, every continent – even Antarctica – has featured an outbreak of infectious disease at some point in history. A more connected world makes it easier for these epidemics to become pandemics, as we have witnessed over the past century. No doubt the Spanish flu and COVID come to mind, but human illnesses are only part of the story.
Avian influenza – “bird flu” colloquially – has been spreading rapidly through the bird population in dozens of countries for the last few years. The terms “bird flu” and “avian influenza” refer to a series of subtypes of the Influenza a virus specifically adapted to birds. H5N1 is one such subtype, and a highly pathogenic strain of H5N1 has been a global problem for about two decades. Since 1996, H5N1 has spread throughout Asia, the Middle East, and Europe in several major outbreaks in the early 2000s. Another serious outbreak started in 2020, and every continent except Australia and Antarctica has reported cases as of February 2023. If you didn’t know about this, you probably still felt the way effects, most acutely on your wallet.
Egg prices skyrocketed during this past holiday season in part because of the impact of bird flu on chickens. In the United States alone, the disease has killed over 50 million chickens and turkeys in the past year, putting a serious strain on egg supply. Prices are finally returning to normal as winter ends and bird flu cases in the States diminish, but the virus is still a major concern. Recent events in Cambodia have the World Health Organization (WHO) paying close attention to the spread of H5N1.
The Cambodian government reported on February 23that an 11-year-old girl living in the Prey Veng province east of Cambodia’s capital city Phnom Penh had died from H5N1 after testing positive a week earlier. Tests of close contacts revealed that her father also had the virus. The crucial question is whether person-to-person transmission of the virus occurred or whether the two were exposed to the same infected bird(s). This is important because transmission of H5N1 between people is extremely rare: the CDC reports only a few scattered, possible cases over the past two decades.
The vast majority of human cases of H5N1 have been the result of animal-to-human transmission, but scientists are concerned that the virus could mutate in such a way as to spread more easily between people. Easy and ongoing human-to-human transmission leads, of course, to human pandemics. If the Cambodian case is an example of human-to-human transmission, the WHO must work quickly with the Cambodian government and neighboring countries to ensure the virus is under control. They must also continue to research and develop therapeutics and vaccines against the virus itself, especially since it has spread so rapidly throughout the world’s bird population.
Sylvie Briand, the WHO’s epidemic and pandemic preparedness and prevention director, said that the global H5N1 situation is worrying. “WHO takes the risk from this virus seriously and urges heightened vigilance from all countries,” she told reporters at a virtual press conference. The WHO is currently updating a bank of vaccine candidate viruses that are suitable for manufacturing, should it be needed, according to a statement released this month. While 20 licensed vaccines targeting H5N1 are available, new strains of the virus may require updated vaccines – a process that could take months.
There are other strategies that must be considered. Culling infected birds works on a small scale, but “the virus is now so widespread in birds that experts are beginning to consider whether broader measures, such as the vaccination of poultry, might be needed,” the New York Times reports. Thankfully, chickens are not known to express anti-vaccination sentiments.
We must also consider the social effects of bird flu. Fear of disease outbreak is frequently transmuted into fear of the other, into racism and xenophobia. Though bird flu is present on nearly every continent, that there are human cases in Asia may bolster anti-Asian prejudice. Such prejudice is not only harmful to people – it is also harmful to our ability to consider facts. A human case of H5N1 was reported in England in 2022, nearly a year before the Cambodian cases, but bigots will likely overlook this. We know that the COVID-19 pandemic stirred racism and violence against Asian Americans, and we know that the way health reporting is conducted can contribute to scapegoating and discrimination. We must also recall that avian influenza is a global problem that requires an international response. If we don’t all work together, we all face devastating consequences.
