AVIAN INFLUENZA

Avian influenza, sometimes avian flu, and commonly bird flu, refers to "influenza
caused by viruses adapted to birds !f "reatest concern is #i"#ly pat#o"enic avian
influenza $%&AI'
"(ird flu" is a p#rase similar to "s)ine flu," "do" flu," "#orse flu," or "#uman flu" in
t#at it refers to an illness caused by any of many different strains of influenza viruses
t#at #ave adapted to a specific #ost All *no)n viruses t#at cause influenza in birds
belon" to t#e species influenza A virus All subtypes $but not all strains of all
subtypes' of influenza A virus are adapted to birds, )#ic# is )#y for many purposes
avian flu virus is t#e influenza A virus $note t#at t#e "A" does not stand for "avian"'
Adaptation is non+e,clusive (ein" adapted to)ards a particular species does not
preclude adaptations, or partial adaptations, to)ards infectin" different species In t#is
)ay strains of influenza viruses are adapted to multiple species, t#ou"# may be
preferential to)ards a particular #ost For e,ample, viruses responsible for influenza
pandemics are adapted to bot# #umans and birds -ecent influenza researc# into t#e
"enes of t#e .panis# flu virus s#o)s it to #ave "enes adapted to bot# birds and
#umans/ )it# more of its "enes from birds t#an less deadly later pandemic strains
Influenza pandemic
&andemic flu viruses #ave some avian flu virus "enes and usually some #uman flu
virus "enes (ot# t#e %0N0 and %1N0 pandemic strains contained "enes from avian
influenza viruses 2#e ne) subtypes arose in pi"s coinfected )it# avian and #uman
viruses and )ere soon transferred to #umans .)ine )ere considered t#e ori"inal
"intermediate #ost" for influenza, because t#ey supported reassortment of diver"ent
subtypes %o)ever, ot#er #osts appear capable of similar coinfection $e", many
poultry species', and direct transmission of avian viruses to #umans is possible 2#e
.panis# flu virus strain may #ave been transmitted directly from birds to #umans
In spite of t#eir pandemic connection, avian influenza viruses are noninfectious for
most species 3#en t#ey are infectious t#ey are usually asymptomatic, so t#e carrier
does not #ave any disease from it 2#us )#ile infected )it# an avian flu virus, t#e
animal doesn4t #ave a "flu" 2ypically, )#en illness $called "flu"' from an avian flu
virus does occur, it is t#e result of an avian flu virus strain adapted to one species
spreadin" to anot#er species $usually from one bird species to anot#er bird species'
.o far as is *no)n, t#e most common result of t#is is an illness so minor as to be not
)ort# noticin" $and t#us little studied' (ut )it# t#e domestication of c#ic*ens and
tur*eys, #umans #ave created species subtypes $domesticated poultry' t#at can catc#
an avian flu virus adapted to )aterfo)l and #ave it rapidly mutate into a form t#at
*ills in days over 567 of an entire floc* and spread to ot#er floc*s and *ill 567 of
t#em and can only be stopped by *illin" every domestic bird in t#e area Until %8N9
infected #umans in t#e 9556s, t#is )as t#e only reason avian flu )as considered
important .ince t#en, avian flu viruses #ave been intensively studied/ resultin" in
c#an"es in )#at is believed about flu pandemics, c#an"es in poultry farmin", c#an"es
in flu vaccination researc#, and c#an"es in flu pandemic plannin"
%8N9 #as evolved into a flu virus strain t#at infects more species t#an any previously
*no)n flu virus strain, is deadlier t#an any previously *no)n flu virus strain, and
continues to evolve becomin" bot# more )idespread and more deadly causin" -obert
3ebster, a leadin" e,pert on avian flu, to publis# an article titled "2#e )orld is
teeterin" on t#e ed"e of a pandemic t#at could *ill a lar"e fraction of t#e #uman
population" in American .cientist %e called for ade:uate resources to fi"#t )#at #e
sees as a ma;or )orld t#reat to possibly billions of lives .ince t#e article )as )ritten,
t#e )orld community #as spent billions of dollars fi"#tin" t#is t#reat )it# limited
success
2#e #i"#ly pat#o"enic influenza A virus subtype %8N9 virus is an emer"in" avian
influenza virus t#at #as been causin" "lobal concern as a potential pandemic t#reat It
is often referred to simply as "bird flu" or "avian influenza" even t#ou"# it is only one
subtype of avian influenza causin" virus
%8N9 #as *illed millions of poultry in a "ro)in" number of countries t#rou"#out
Asia, Europe and Africa %ealt# e,perts are concerned t#at t#e co+e,istence of #uman
flu viruses and avian flu viruses $especially %8N9' )ill provide an opportunity for
"enetic material to be e,c#an"ed bet)een species+specific viruses, possibly creatin" a
ne) virulent influenza strain t#at is easily transmissible and let#al to #umans
<91=
.ince t#e first %8N9 outbrea* occurred in 955>, t#ere #as been an increasin" number
of %&AI %8N9 bird+to+#uman transmissions leadin" to clinically severe and fatal
#uman infections %o)ever, because t#ere is a si"nificant species barrier t#at e,ists
bet)een birds and #umans, t#e virus does not easily cross over to #umans, t#ou"#
some cases of infection are bein" researc#ed to discern )#et#er #uman to #uman
transmission is occurrin" ?ore researc# is necessary to understand t#e pat#o"enesis
and epidemiolo"y of t#e %8N9 virus in #umans E,posure routes and ot#er disease
transmission c#aracteristics suc# as "enetic and immunolo"ical factors, t#at may
increase t#e li*eli#ood of infection, are not clearly understood
!n @anuary 9A, 0665, A 0>+year+old )oman from eastern B#ina #as died of bird flu,
B#inese aut#orities said, ma*in" #er t#e second person to die t#is year from t#e
deadly virus 2)o tests on t#e )oman )ere positive for %8N9 avian influenza, said
t#e ministry, )#ic# did not say #o) s#e mi"#t #ave contracted t#e virus

Alt#ou"# millions of birds #ave become infected )it# t#e virus since its discovery,
0CA #umans #ave died from t#e %8N9 in t)elve countries accordin" to 3%! data as
of @anuary 0665, Vie) t#e most current 3%! Data re"ardin" E Bumulative Number
of %uman Bases
2#e avian flu claimed at least 066 #umans in Indonesia, Vietnam, Laos, -omania,
B#ina, 2ur*ey and -ussia Epidemiolo"ists are afraid t#at t#e ne,t time suc# a virus
mutates, it could pass from #uman to #uman If t#is form of transmission occurs,
anot#er pandemic could result 2#us disease+control centers around t#e )orld are
ma*in" avian flu a top priority 2#ese or"anizations encoura"e poultry+related
operations to develop a preemptive plan to prevent t#e spread of %8N9 and its
potentially pandemic strains 2#e recommended plans center on providin" protective
clot#in" for )or*ers and isolatin" floc*s to prevent t#e spread of t#e virus
2#e "lobal spread of #i"#ly pat#o"enic %8N9 in birds is considered a si"nificant
pandemic t#reat
3#ile ot#er %8N9 strains are *no)n, t#ey are si"nificantly different from a current,
#i"#ly pat#o"enic %8N9 strain on a "enetic level, ma*in" t#e "lobal spread of t#is
ne) strain unprecedented 2#e %8N9 strain is a fast+mutatin", #i"#ly pat#o"enic
avian influenza virus $%&AI' found in multiple bird species It is bot# epizootic $an
epidemic in non+#umans' and panzootic $a disease affectin" animals of many species
especially over a )ide area' Unless ot#er)ise indicated, "%8N9" in t#is article refers
to t#e recent #i"#ly pat#o"enic strain of %8N9
".ince 955>, studies of %8N9 indicate t#at t#ese viruses continue to evolve, )it#
c#an"es in anti"enicity and internal "ene constellations/ an e,panded #ost ran"e in
avian species and t#e ability to infect felids/ en#anced pat#o"enicity in e,perimentally
infected mice and ferrets, in )#ic# t#ey cause systemic infections/ and increased
environmental stability
2ens of millions of birds #ave died of %8N9 influenza and #undreds of millions of
birds #ave been slau"#tered and disposed of, to limit t#e spread of %8N9 Bountries
t#at #ave reported one or more ma;or #i"#ly pat#o"enic %8N9 outbrea*s in birds
$causin" at least t#ousands but in some cases millions of dead birds' are $in order of
first outbrea* occurrence'E Forea, Vietnam, @apan, 2#ailand, Bambodia, Laos,
Indonesia, B#ina, ?alaysia, -ussia, Faza*#stan, ?on"olia, 2ur*ey, -omania,
Broatia, U*raine, Byprus, Ira:, Ni"eria, E"ypt, India, France, Ni"er, (osnia,
Azerbai;an, Albania, Bameroon, ?yanmar, Af"#anistan, Israel, &a*istan, @ordan,
(ur*ina Faso, Germany, .udan, Ivory Boast, D;ibouti, %un"ary, United Fin"dom,
Fu)ait, (an"lades#, .audi Arabia, G#ana, Bzec# -epublic, 2o"o, Nepal
%i"#ly pat#o"enic %8N9 #as been found in birds in t#e )ild in numerous ot#er
countriesE Austria, (ul"aria, Denmar*, Greece, Iran, Italy, &oland, .erbia and
?ontene"ro, .lova*ia, .lovenia, .pain, .)eden, .)itzerland .urveillance of %8N9
in #umans, poultry, )ild birds, cats and ot#er animals remains very )ea* in many
parts of Asia and Africa ?uc# remains un*no)n about t#e e,act e,tent of its spread
%8N9 #as lo) pat#o"enic varieties endemic in birds in Nort# America %8N9 #as a
#i"#ly pat#o"enic variety t#at is endemic in dozens of species of birds t#rou"#out
sout# Asia and parts of Africa .o far, it is very difficult for #umans to become
infected )it# %8N9 2#e presence of #i"#ly pat#o"enic $deadly' %8N9 around t#e
)orld in bot# birds in t#e )ild $s)ans, ma"pies, duc*s, "eese, pi"eons, ea"les, etc'
and in c#ic*ens and tur*eys on farms #as been demonstrated in millions of cases )it#
t#e virus isolate actually se:uenced in #undreds of cases yieldin" definitive proof of
t#e evolution of t#is strain of t#is subtype of t#e species Influenzavirus A $bird flu
virus'
As of t#e @uly 08, 066A FA! Avian Influenza Disease Emer"ency .ituation Update,
%8N9 pat#o"enicity is continuin" to "radually rise in endemic areas but t#e avian
influenza disease situation in farmed birds is bein" #eld in c#ec* by vaccination
Eleven outbrea*s of %8N9 )ere reported )orld)ide in @une 066A in five countries
$B#ina, E"ypt, Indonesia, &a*istan and Viet Nam' complared to H8 outbrea*s in @une
066H and 88 in @une 066> 2#e ""lobal %&AI situation can be said to #ave improved
mar*edly in t#e first #alf of 066A <but= cases of %&AI are still underestimated and
underreported in many countries because of limitations in country disease surveillance
systems"