By Daniel R. Lucey MD, MPH, FIDSA
Today Russian announced that last December seven workers on a poultry farm in southern Russia were infected with H5N8 bird (avian) flu. Although H5N8 avian influenza (“bird flu”) has been found in several avian species in multiple nations on several continents for more than three decades, it has never been reported to infect humans. Thus, there is no human immunity to this virus. Such news is very concerning.
The Moscow Times reported today:
“Russia said Saturday its scientists had detected the first case of transmission of the H5N8 strain of avian flu to humans and had alerted the World Health Organization.
In televised remarks, the head of Russia’s health watchdog Rospotrebnadzor, Anna Popova, said scientists at the Vektor laboratory had isolated the strain’s genetic material from seven workers at a poultry farm in southern Russia, where an outbreak was recorded among the birds in December. The workers did not suffer any serious health consequences, she added.”
The following questions are a small sample that address key issues:
- What mutations did the Vektor laboratory identify in this virus that infected humans, compared with prior H5N8 flu viruses that did not infect humans?
- Has the full genetic sequence of this virus, or the virus itself, been shared with WHO?
- Was the virus found in the nose or throat of patients, and what was their viral load?
- How many other persons who worked on this farm and other facilities in this (unspecified) region in southern Russia were tested for this infection by PCR, next generation sequencing, or other methods?
- Have “look back” (retrospective) serosurveys using human H5N8 antibody tests begun in the region of the outbreak, and in comparison regions without human infections?
- What are the results of resistance testing for all known anti-influenza drugs?
- Was convalescent plasma, or peripheral blood mononuclear cells (PBMCs), requested from the patients to develop polyclonal convalescent sera or monoclonal antibody treatments (from virus-specific B-cells), or to assess T-cell responses from the PBMCs?
Daniel Lucey, M.D. MPH, FIDSA, FACP, is a Clinical Professor of Medicine at Dartmouth Geisel School of Medicine, Infectious Disease adjunct Professor at Georgetown Medical Center, senior scholar at Georgetown Law, Anthropology Research Associate at the Smithsonian Museum of Natural History and a member of the Infectious Diseases Society of America Global Health Committee. He served as a volunteer to outbreaks overseas including hands-on Ebola patient care in Sierra Leone and Liberia (Doctors without Borders) 2014, MERS 2013, SARS 2003, as well as HIV, H5N1, Zika, yellow Fever, and pneumonic plague 2017 (with WHO/USAID/CDC). Since Jan. 6, 2020 he has contributed over 75 posts to Science Speaks on COVID-19 and traveled to China in February 2020. He initially proposed, then fundraised and helped design the content for 2018-2022 Smithsonian Exhibition on Epidemics due to zoonotic viruses. From 1982-1988 he trained at University of California San Francisco and Harvard and was an attending physician at the NIH (NIAID) in the 1990s while in the US Public Health Service.