It’s like a slow burn that threatens to explode into flames at any moment. The bad news about bird flu keeps trickling out gradually while we continue to shrug off the accumulating risks.
The latest troubling news is that a B.C. teen was infected with H5N1 from an unknown source early last month.
This young person (no age, gender or other identifying information has been released) was diagnosed with conjunctivitis (pink eye) on Nov. 2., and a week later, was suffering from a fever and acute respiratory distress. At last report, they were still in critical condition and required a ventilator.
The case is unsettling for a couple of reasons. No one is quite sure how the teen contracted the flu virus that is usually only present in birds, and more recently cattle. The source is likely a wild bird, but even if the teen handled a dead bird, transmission should be highly unlikely – unless the virus is adapting to infect humans.
A genetic analysis has revealed it’s doing just that: the virus that infected the B.C. youth has two mutations that could enhance the ability of the virus to infect human cells, and a third mutation that makes it able to replicate in the human body. The latter helps explain why the teen is so sick while almost all cases of H5N1 in humans to date have produced mild symptoms.
Speaking of which, a young child in the San Francisco area was also diagnosed with H5N1 recently and, again, the source is unknown. That case raises the frightening possibility that the child was infected by another human.
A third isolated incident that has raised the fears of researchers is that of a pig in Oregon infected with H5N1. Swine are considered ideal mixing bowls for various strains of influenza, so once a new virus gets into that population it can spell big trouble.
Let’s not forget that The Great Influenza of 1918 likely began with infected swine on a Kansas farm, and a farm worker who contracted the previously unknown H1N1 flu virus, before it ripped its way across the world. When all was said and done, the misnamed Spanish flu killed an estimated 50 million people worldwide, including 50,000 in Canada.
Today, we don’t have an outbreak in swine (yet), but in cattle. Roughly a year ago, the H5N1 flu virus that has been decimating wild birds and poultry found a new host – dairy cattle in the U.S.
To date, 675 herds have been infected in 15 U.S. states, and little effort is being made to contain its spread. (There have been no cases detected in Canadian cattle.)
In the past year, there have been 52 documented cases of humans contracting avian influenza in the U.S., over half of whom worked with dairy cattle. (All told, there have been almost 900 H5N1 cases of human infection recorded globally since 1997.)
The U.S. currently has two recalls out for raw milk tainted by the bird flu virus, yet only two states of the 30 that allow the sale of unpasteurized milk are actually testing it. This at a time when RFK Jr. is touting the benefits of raw milk, making it another potential vector for transmission.
With attention focused on cattle, we seem to have forgotten the continuing threat H5N1 poses to poultry stocks. In December, 2021, the virus jumped from wild birds to North American poultry – with the first case detected on a farm near St. John’s.
Since early 2022, the U.S. has slaughtered more than 111 million birds in infected flocks, and Canada another 12.9 million. That includes 7 million birds slaughtered since 2021 in B.C.’s Fraser Valley, where there are currently 54 H5N1 outbreaks.
And the Fraser Valley is where the infected teen also lives. Coincidentally no doubt.
It’s also “normal” flu season. This raises the possibility of H5N1 co-mingling with circulating viruses. If this happens, things can go south quickly.
It’s foolish to try and project the trajectory of a virus, especially one like H5N1, which has been kicking around, sporadically wreaking havoc, since 1997. But it’s even more foolish to pretend there is no threat.
Of course, no one likes to utter the p-word, but the slow burn of bad news all seems to be pointing in that direction.
As Robert Redfield, former director of the U.S. Centers for Disease Control and Prevention has said: “It’s not a question of if, it’s more a question of when we will have a bird flu pandemic.”
Editor’s note: (Dec. 3, 2024): A previous version of this article incorrectly stated that the B.C. teen infected with H5N1 requires a respirator. They require a ventilator to aid with breathing. This version has been updated. (Dec. 5, 2024): A previous version of this article incorrectly stated that 7 million birds were slaughtered in B.C.'s Fraser Valley in the last month. In fact, 7 million birds were slaughtered since 2021. This version has been updated.