By Daniel R. Lucey MD, MPH, FIDSA
On Feb. 20, 2021 Russia reported the first-ever human infections with H5N8 avian influenza involving seven poultry farm workers in the southern region of Astrakhan Oblast. They were infected after a Dec. 3-11, 2020 outbreak of H5N8 on a poultry farm. Although Russia reported a government lab was developing an H5N8 diagnostic test and vaccine for humans, officials also reported no evidence of person-to-person spread. (Science Speaks, Feb. 20 ) In a Feb. 26 World Health Organization “Disease Outbreak News” describing this first-ever outbreak, the WHO stated: “based on currently available information, the risk of human -to-human transmission remains low.”
On March 12, however, The Moscow Times reported: “The mutating H5N8 strain of avian flu has a high risk of human-to-human transmission, Russian authorities warned”. Anna Popova, who heads Russia’s health watchdog Rospotrebnadzor, made the prediction nearly a month after scientists detected the first case of H5N8 transmission to humans at a southern Russia poultry farm… “This is likely to happen. Colleagues say that the mutation is continuing very actively,” Popova said.
The interview by Anna Popova with TASS, the Russian news agency is here.
Comments in February on this H5N8 outbreak in poultry and humans by WHO, World Organization for Animal Health, Food and Agriculture Organization of the United Nations, and the European Food Safety Authority should be updated now in mid-March based on what has been learned in the past month:
- For example, did acute and convalescent antibody studies of the 24 “close contacts” cited in the WHO Feb. 26 document show evidence of seroconversion and/or a four-fold rise in antibody titer?
- What is the genotypic and phenotypic characterization of the human isolate of H5N8 flu deposited in GISAID reveal?
- Have there been other H5N8 avian flu human cases in Russia, or elsewhere in Europe (e.g., Sweden) or the Middle East (e.g., Kuwait) where multiple recent outbreaks in birds and poultry have occurred in multiple nations?
None of the recent avian influenza viruses known to infect humans (e.g., H5N1, H5N6, H7N9, H9N2) has acquired the ability for sustained person-to-person transmission. International vigilance and cooperation is warranted now for this H5N8 virus.
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.