Are we at the edge of another pandemic? H5N1

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On 27 June 2024, 9:49 A.M., I summarized the approach to survive a very deadly disease called H5N1 Avian Flu, Highly Pathogenic Avian Influenza. I have covered a lot of information over the past several weeks on the next potential pandemic called H5N1. I have come to realize this pandemic will primarily be transmitted by insects, primarily Mosquitoes. Mosquitoes infect humans with a blood to blood transfer between infected to uninfected birds/animals/humans.

This virus has been evolving over the past few years. It began with birds and spread to animals and humans. The disease is passing across a maze of viruses in recent years including H5N1, H5N2, H5N3, H5N5, and H5N8. But in my opinion the primary threat is H1N1.

H1N1 decimated the human population during the First World War. It went by many names including the Spanish Flu which killed between 50 and 100 million people during the period from 1918-1919. This plague went by many names. The Americans fell ill with "three-day fever" or "purple death." The French caught "purulent bronchitis." The Italians suffered "sand fly fever." German hospitals filled with victims of Blitzkatarrh or "Flanders fever. Sand fly fever is an arthropod-borne viral disease, also known as “Phlebotomus fever”, “mosquito fever”.

From 1918 to 1919, the Spanish flu infected an estimated 500 million people globally. This amounted to about 33% of the world's population at the time. In addition, the Spanish flu killed about 50 million people. Since the world population has grown around 5 times in the last 100 years. The threat might impact 2.5 billion people should it materialize today.


https://www.youtube.com/watch?v=RVpBFy_TRtA

In my humble opinion, these diseases are transmitted by insects. An insect bites an infected bird/animal/human and then transmitted the blood directly to another bird/ animal/human. The following is a good approach to limiting the spread in humans.

1. You can protect yourself from mosquito bites in two ways. If you spend a lot of time outdoors you can create protective clothing (boots, clothing and camping gear) that repel mosquitoes by treating them with Permethrin.

2. You can also protect yourself from mosquito bites by applying mosquito repellent on you skin. This will provide short protection (several hours) to drive away mosquitoes. There are a variety of products available. They include DEET, Picaridin, IR3535, Oil of lemon, Para-menthane-diol eucalyptus, and 2-Undecanone.

3. Another product that can help prevent mosquito bites is Metofluthrin. Metofluthrin is a pyrethroid used as an insect repellent. The vapors of metofluthrin are highly effective and capable of repelling up to 97% of mosquitoes in field tests. Metofluthrin is used in a variety of consumer products, called emanators, for indoor and outdoor use. These products produce a vapor that protects an individual or area. Effectiveness is reduced by air movement. Metofluthrin is neurotoxic, and is not meant to be applied directly to human skin.

4. Accidents can happen. What to do immediately after being bitten by a mosquito? Treat the bite with Tecnu Topical Analgesic Anti-Itch Spray (Diphenhydramine HCl 2% ). There is another product that can diminish the effects of being bitten by an infected insect. It is called ChiggereX. This product contains 10% Benzocaine.

5. If you become infected with H5N1 treat the condition immediately using one of four FDA-approved antivirals for influenza: (1) Oseltamivir phosphate (Tamiflu), (2) Zanamivir (Relenza), (3) Peramivir (Rapivab), (4) Baloxavir (Xofluza). These are prescription drugs and will require a doctors prescription. Time is of the essence here. This condition will begin to destroy the human body and make it impossible to treat within a few days. Time is of the essence.

6. Some people are very vulnerable to mosquito bites. These are people with open wounds. Just covering the wounded area with bandages will not protect you. Mosquitoes can smell your blood and you become a prime target. I suffered a small bleed and was attacked by around 50 mosquitoes in less then two hours outdoors. (Luckily I had protected myself with DEET before I went outside and as a result, NOT ONE MOSQUITO WAS ABLE TO BITE ME.) This may also be a problem for women who are going through their menstrual period.

7. Go on the offensive. Wage a war on mosquitoes. In general, mosquitoes live in a hot humid environment. They most commonly infest Ponds, Marshes, Swamps, and Other wetland habitats. So minimize their breeding grounds. Wage war on mosquitoes.

8. Use our friends. What, you didn't realize we have allies in our war on Mosquitoes? We have many friends. Some are birds like woodpeckers, some are other insects like dragonflies, some are fish like gambusia affinis.

9. Wastewater tracking of H5N1 can identify the specific regions in the U.S. where the outbreak is underway. One of these regions is San Francisco, California. This area could be Ground Zero of the outbreak. But we cannot monitor the threat because the funding for Wastewater tracking has been halted. But time has been wasted and H5N1 is on the move and Central Valley in California is in the epicenter.

In the historic past, migrating birds were the long distance transport agents of Highly Pathogenic Avian Influenza H5N1. Seasonally they would move the infectious disease between the northern and southern hemispheres as the seasons changed from summer to winter. But now as humans have developed means of rapid transport, such as jet aircraft, the speed and distance this virus can spread is rapidly accelerated.

A recent article on Forbes wrote the following:

There’s a saying that those who do not learn from history are doomed to repeat it. Will that be the case with the H5N1 avian influenza virus that’s been spreading among birds for years, jumped to dairy cattle earlier this year and appeared in a pig a month ago? Is hindsight not 2020? Are we seeing the same mistakes made with the H5N1 bird flu that we did during the COVID-19 pandemic? Or is this H5N1 virus situation right now different enough from the severe acute respiratory syndrome coronavirus 2 pandemic that we don’t have to worry about the “p” word this time?

H5N1 Bird Flu Concerns Grow. Are COVID-19 Mistakes Being Repeated?

So let me try and answer this question.

It is a very different virus in the following ways.
1. It is much more deadly. The death rate will be around 100 times more then COVID.
2. It affects an entirely different part of the population. Whereas, COVID primarily affected the aged and those with poor immune systems. This threat will strike the young and those in the peak of their lives.
3. It is much faster. In a similar pandemic H1N1 which struck during the First World War. One person in the family would die in the morning and before the end of the day, the entire family had perished.

It is not COVID but just like the people who lived through the Plague of 1918 witnessed, when the plague began people wore masks and they did not help anyone stay alive. They hid in their homes and died in their homes. It is a very different plague then COVID.

The Forbes article then goes on to say:

Pig Reassortments Were What Led to the 2009 H1N1 Pandemic

It’s important to remember that a series of reassortment events in pigs is what led to the 2009 influenza A(H1N1) pandemic. These pig events resulted in a version of the H1N1 influenza virus that could jump to and spread among humans back in 2009. That pandemic led to an estimated 60.8 million cases, 274,304 hospitalizations and 12,469 deaths in the U.S. and an estimated 284,400 deaths worldwide.

So you start with an H5N1 pandemic and wave a magic wand and it changes overnight into a deadly H1N1 Death Plague.

On 25 Nov 2024, 5:57 pm on this thread, I reported about a case of H5N2.

In April 2024, laboratory results from a hospitalized patient in Mexico City showed the first direct evidence of human infection caused by influenza A virus subtype H5N2 (A/H5N2). The patient died, and the case fatality was reported to the World Health Organization (WHO) on 23 May 2024.

Canada has second flock hit by H5N2 avian flu

Canada has now had two commercial poultry flocks affected by the H5N2 strain of highly pathogenic avian influenza (HPAI). Both H5N2-affected flocks are in Abbotsford, British Columbia, the Canadian municipality that has been hardest hit by HPAI in 2004. The first flock infection of H5N2 there was confirmed on November 8, and the second instance was first reported on November 16.

The first of the two flocks to be affected was part of a commercial egg laying operation, but WOAH has only identified the second flock as a commercial poultry farm.

These last two weeks there's been an egg shortage at the supermarket, when I tried to find out why I discovered there's been an avian flu epidemic among Australian chickens for several months. I had no idea about it.
Definitely that's a concern.

This is a report from Pan American Health Organization.

PAHO: Epidemiological Alert

Human cases of influenza A (H5N1) in the Americas Region

Between 2022 and as of 2 December 2024, 61 human infections caused by avian influenza A(H5N1) have been reported in four countries in the Americas Region: 58 cases in the United States of America, one case in Canada confirmed on 13 November 2024, one case in Chile reported on 29 March 2023, and one case in Ecuador reported on 9 January 2023.

In Canada, on 14 November 2024, the Public Health Agency of Canada (PHAC) reported the confirmation of a human case of influenza A(H5N1), the first domestically acquired human case of influenza A(H5) reported in the country. The case was an adolescent who developed symptoms on 2 November 2024 and was later hospitalized and identified by laboratory testing as a presumptive positive for avian influenza A(H5) by PCR testing. On 13 November, the PHAC National Microbiology Laboratory (NML) in Winnipeg confirmed the identification of influenza A(H5N1). Genomic sequencing from both the British Columbia Centre for Disease Control and NML indicated that the virus is related to the highly pathogenic avian influenza (HPAI) A(H5N1) viruses detected in wild/domestic birds during the current HPAI outbreak in British Columbia (influenza A(H5N1), clade 2.3.4.4b, genotype D1.1).

Analyses conducted showed that the genome has an E627K mutation in the PB2 gene associated with mammalian adaptation and enhanced replication. This mutation has previously been observed in other human and mammalian infections. The HA gene also contained mixed bases, at positions 190 (E190D) and 226 (Q226H) (H3 numbering) in the mature HA protein. Mutations at these positions have been known to affect host specificity. To date, the investigation carried out by the regional health authority has not determined the source of infection of the case. This case has no known exposure to affected poultry farms in the province of British Columbia. The case has received medical treatment including antivirals and remains hospitalized in critical condition. This case was identified through laboratory-based influenza surveillance in British Columbia.

The article then goes on to discuss the cases in the U.S.

State ........Linked to Livestock ... Linked to Poultry ..... Origin Unknown .... Total
California .............. 30 ....................... 0 ............................. 1 ....................... 31
Colorado ................ 1 ....................... 9 ............................. 0 ........................ 10
Michigan ................ 2 ....................... 0 ............................. 0 ..........................2
Oregon .................. 0 ....................... 1 ............................. 0 ..........................1
Texas .................... 1 ....................... 0 ............................. 0 .......................... 1
Washington .......... 0 ....................... 11 ............................ 0 ........................ 11
Total ................... 34 ...................... 21 ............................ 2 ........................ 57

Mysterious illness in Congo has killed dozens of people, health authorities report

Because bird flu virus has been detected in poultry farms in the South Island of New Zealand, as you said in an earlier post, thousands of chickens are being gassed to death today

As ASPartOfMe wrote, the recent deaths in the Congo is in need of a deep dive. According to the internet:

Congo's health minister said Thursday the country's government was on alert over a mystery flu-like disease that has killed dozens of people in recent weeks, nearly half of whom were children. Authorities have so far confirmed 71 deaths, including 27 people who died in hospitals and 44 in the community in the southern Kwango province, health minister Roger Kamba said.

Of the victims who were hospitalized, 10 died due to a lack of blood transfusions and 17 as a result of respiratory problems. Authorities have said symptoms of the illness include fever, headache, cough and anemia.

Source: Mystery flu-like disease in Congo kills dozens, puts authorities "on general alert" as cases investigated

The article ASPartOfMe cited listed the deaths were caused by "fever, headache, nasal congestion, cough, difficulty breathing and anemia."

I remember they referred to the Pandemic of 1918 as the Purple Death. This was an H1N1 pandemic and it was extremely deadly to humans. What happens when you can no longer breath. Your face turns purple.

The article describing the symptoms of people infected with H1N1 at the time:

No matter what they called it, the virus attacked everyone similarly. It started like any other influenza case, with a sore throat, chills and fever. Then came the deadly twist: the virus ravaged its victim's lungs. Sometimes within hours, patients succumbed to complete respiratory failure. Autopsies showed hard, red lungs drenched in fluid. A microscopic look at diseased lung tissue revealed that the alveoli, the lungs' normally air-filled cells, were so full of fluid that victims literally drowned. The slow suffocation began when patients presented with a unique symptom: mahogany spots over their cheekbones. Within hours these patients turned a bluish-black hue indicative of cyanosis, or lack of oxygen. When triaging scores of new patients, nurses often looked at the patients' feet first. Those with black feet were considered beyond help and were carted off to die.

Source: Purple Death: The Great Flu of 1918

Europe is stepping up its surveillance for bird flu, Finland is considering closing its fur farms to prevent the virus from spreading and mutating. The WHO is calling for more international cooperation to find the pathogen that could cause a new pandemic.

Mika Salminen, Director General of the Finnish Institute for Health and Welfare (THL), said that in the spring/summer of 2023, Finland experienced an outbreak of highly pathogenic H5N1 in over 70 fur farms, probably from seagulls. This prompted the country to buy 20,000 doses of the human avian influenza vaccine.

More than 500 veterinarians, laboratory staff, farmers and workers were directly exposed to the virus, and 450 of them took the vaccine.

“Now, there is a citizens’ initiative in the Finnish Riksdag to close down all the Finnish fur farms, which produce 500,000 foxes, mink and raccoon dogs each year,” Mika Salminen told Euractiv.

The THL supports the law, as it believes that fur farming poses too great a threat to human life and health, both nationally and globally, due to the potential risk of creating a pandemic.

“The mink has two cell receptors through which the virus could enter, for example, in the airways, one of which is the same as in humans,” Salminen told Euractiv. This means the H5N1 virus could adapt in a mink and spread more easily to humans.

In the early spring of 2024, three avian influenza outbreaks among domestic birds occurred in Sweden. Wild birds such as gooses, hawks, and swans were also found dead with the virus earlier this year.

Source: Europe increases bird flu monitoring – is it the next Disease X?

Thailand and Cambodia have both had problems with H1N1, and there were restrictions placed by other countries near them.

USDA orders testing of milk for bird flu

Possible bird flu reported in child in Marin County

Marin County, California Public Health is reporting a possible case of H5N1, also known as the bird flu, in a child. It's unclear when exactly the child potentially contracted the disease or where. The Centers for Disease Control and Prevention (CDC) is working on determining how the child was exposed.

This comes just shortly after the Alameda County Public Health Department confirmed a case of bird flu in November in a separate child.

Map of California showing 61.6 miles apart

I came across one article today. I cannot really say that I understand it. But one item caught my attention.

To summarize, avian influenza H5N1 viruses significantly affect poultry production and pose a pandemic threat through sporadic infections in humans and mammals. Since 2021, clade 2.3.4.4b H5 viruses have spread widely, infecting wild birds, poultry, dairy cows, and various mammals, including humans.

Despite the predominance of avian-type receptor specificity in bovine H5 HA, a study demonstrated that a single Gln226Leu mutation can switch receptor binding to human-type receptors.

While weak, this binding mirrors the affinity of some transmissible human influenza viruses, such as the 2009 H1N1 pandemic strain. Additional mutations, like Asn224Lys, enhance binding to human receptors, raising concerns about zoonotic adaptation.

Source: Bovine H5N1 influenza shows potential for human adaptation through key mutations

I think the main threat to humans is H1N1 and the ability of viruses to mutate. They begin as H5N1 and evolve into an extremely deadly H1N1 variant of the virus.

Bird Flu is spreading in Hawaii.

The Hawai‘i Department of Health (DOH) State Laboratories Division has detected H5 avian influenza (bird flu) in a wastewater sample collected on Dec. 2 at the Hilo Wastewater Treatment Plant on Hawaiʻi Island.

This is the first detection of bird flu on a neighbor island and indicates an H5 type of bird flu virus was present. Wastewater testing cannot determine if the detection is specifically the Highly Pathogenic Avian Influenza (HPAI) H5N1 subtype of bird flu virus which was recently found on Oʻahu.

The presence of the H5N1 virus in Hawaiʻi was first confirmed in November 2024 in a backyard flock of birds in Central Oʻahu. That virus strain was a different genotype of the virus that has infected birds and dairy cows on the U.S. mainland.

H5 Avian Flu Detected at Wastewater Sampling Site in Hilo

Another article digs a little deeper into the threat.

Helen Raine, Hawaii conservation coordinator, is concerned the disease could affect some of Hawaii’s native waterbirds found nowhere else in the world.

Many of Hawaii’s endangered and threatened seabirds are already dwindling in population due to other challenges, including habitat loss and climate change. These are culturally important birds, she said, such as the Hawaiian common gallinule, or alae ula, which she describes as a charismatic black bird with a distinctive red shield that can be found near wetlands. The alae ula, a culturally important species, has been lost from all Hawaiian Isles except Kauai and Oahu.

Other native birds she’s concerned about include the Hawaiian stilt, or aeo, with only about 1,500 remaining, and the Hawaiian duck, or koloa maoli, with only an estimated 673 remaining.

All indicators so far point to spillover from migratory birds via the Pacific Flyway — a broad-ranging route that stretches from Alaska down to Patagonia, including the Hawaiian Isles.

Source: Conservation groups voice concern for native birds with H5N1 on Oahu

I came across an article today that provides a good pattern of out-of-box thinking. The article began with:

Domestic cats could provide an unexpected new route for the bird flu virus H5N1 to evolve into a more dangerous form, according to a new study published on Monday.

In the year since the virus began circulating in dairy cattle, it has killed many cats, primarily on farms with affected herds. It has also sickened at least 60 people, most of whom had close contact with infected dairy cows or poultry.

So far, H5N1 does not spread easily among people, although studies have suggested that just one or two key mutations could allow the virus to make that leap.

Could Cats Become a Carrier of Bird Flu?

In reality there are actually three animals to watch and they interact with each other. Two of them are cats and mice. Cats attack mice and mice are carriers of the H5N1 infection. But there is one more animal to watch and these are the most dangerous spreaders of diseases including H5N1. These are rats. They live in large numbers in our cities. They are everywhere and they are not being measured for H5N1 outbreaks. There are more rats in cities both large and small then there are people.

So if cats and mice have H5N1, then there is a high probability that rats also have the infection and they are spreading all over the world in rats and at the edge of humans.



Normally rats are just a nuisance, but when H5N1 explodes, they become a transmission agent. And currently no one is measuring H5N1 in the rat population.