The group of scientists, regulators and vaccine manufacturers meets twice a year to decide which strain of seasonal flu to include in the vaccine for the upcoming winter season, in this case for the Northern Hemisphere.

But it is also a chance to discuss the risk of animal viruses spilling over to humans and causing a pandemic. At this week’s meeting, H5N1 clade 2.3.4.4b was a key topic, the World Health Organization (WHO) and global flu experts told Reuters. They will brief reporters on both the seasonal flu vaccine composition and spillover risks later on Friday.

“We are more prepared (than for COVID), but even if we are more prepared, we are not yet prepared enough,” Sylvie Briand, WHO director of global infectious hazard preparedness, said ahead of the meeting. “We need to really continue the efforts for a flu pandemic.”

Experts have been tracking H5N1 clade 2.3.4.4b since it emerged in 2020, but recent reports of mass deaths in infected mammals from seals to bears, as well as potential mammal-to-mammal transmission on a Spanish mink farm last year, have raised concern.

However, there have been very few human cases, and the WHO currently assesses the threat to humans as low.

“This is a natural experiment playing out in front of us, and I don’t think we are complacent,” said Nicola Lewis, director of the WHO Collaborating Centre on Influenza at the Crick Institute in London. Speaking before the meeting, she said it would include assessments of the situation worldwide.

Experts also discussed potential vaccine development.

WHO-affiliated labs already hold two flu virus strains that are closely related to the circulating H5N1 virus, which could be used by vaccine manufacturers to create a human vaccine if needed. One of them was added after the previous WHO flu meeting in September 2022, and labs around the world are currently testing how closely both subtypes match the strain spreading among animals to determine whether any more updates are necessary.

A number of companies that produce seasonal flu vaccines can also make pandemic flu vaccines. For example, GSK and CSL Seqirus are already working with the United States Biomedical Advanced Research and Development Authority (BARDA) to test shots based on one of the closely-related strains.

Having these strains ready could save around two months in the development of a vaccine, said the WHO’s Briand. But getting enough vaccine developed quickly would still remain a challenge in a pandemic situation, the experts said.

— Jennifer Rigby is Reuters’ global health correspondent in London, England.

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Manitoba Public Health on Monday said the H3N2 influenza variant (H3N2v) seen in this case is related to flu viruses that circulate in pigs, noting that while such viruses don’t normally infect people, “sporadic” infections with variants have been known to occur.

The H3N2 case was spotted early this month when a person sought testing after developing an “influenza-like illness,” the province said Monday. The person reported mild symptoms, was tested and then recovered.

Tests in this case were negative for the COVID-19 coronavirus, but later turned up influenza A(H3N2)v through “routine influenza surveillance processes.”

“Based on available evidence, the current assessment is that there is no increased risk to people, with no evidence of sustained human-to-human transmission at this time,” Manitoba Public Health said Monday in a release.

The finding follows the confirmation of one case each of influenza A(H1N2)v and influenza A(H1N1)v in Manitoba in late April — both of which are “rarely seen in humans,” the province said.

The case of H1N2v was just the second identified in Canada, the first appearing last year in Alberta. The two April infections were unrelated, the province said at the time.

The recent detections of these kinds of flu cases could be for “a number of reasons,” the province said. Increased “respiratory surveillance” for COVID-19 and influenza has been occurring during the pandemic.

However, the province said, “it is also possible that there is a true increase in the number of these cases, possibly occurring from exposure to infected pigs or through subsequent, limited human-to-human transmission.”

The H3N2 case “appears to be isolated” and investigations are now ongoing to learn how transmission may have occurred.

In the meantime, the province said, “the current assessment is that there is no increased risk to Manitobans, Canadians or the food supply chain at this time.”

The viruses in these cases “are not a food-related illness (and) are not transmissible to people through pork meat or other products that come from pigs and there is no risk associated with eating pork.”

That said, anyone who works with pigs or poultry, has influenza-like symptoms, and is seeking testing or treatment is asked to identify themselves as an agricultural worker to medical officials — including at COVID-19 testing sites.

Otherwise, people who have contact with pigs should take measures to reduce the spread of influenza viruses between pigs and people, the province said. Among the recommended measures:

• Avoid contact with pigs if you have flu symptoms.
• Do not take food, drink or other items into pig areas and do not put anything in your mouth in pig areas.
• Avoid close contact with pigs that look or act ill or are known or suspected to be sick, and call a veterinarian if such illness is suspected.
• Limit contact with pigs that appear sick. If contact is required, wear personal protective equipment such as protective clothing, gloves and masks that cover the mouth and nose.
• Wash hands often with soap and running water before and after exposure to pigs. If soap and water are not available, use an alcohol-based hand rub.
• Anyone at high risk of complications from influenza should avoid pigs and pig barns.
• If you develop flu symptoms, call a health-care provider and tell them about your exposure to pigs. Influenza antiviral drugs used to treat seasonal flu can also be used against variant influenza virus infections.

— Glacier FarmMedia Network

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The virus was spotted in mid-October after a patient sought medical care with “influenza-like symptoms,” provincial chief medical officer Dr. Deena Hinshaw and chief provincial veterinarian Dr. Keith Lehman said in a statement Wednesday.

The patient, they said, “experienced mild symptoms, was tested and then quickly recovered,” and there’s “no evidence at this time” that the virus spread further in people beyond the one person.

However, they said, the province’s health and agriculture departments have now launched an investigation “to determine the source of the virus and to verify that no spread occurred.”

In hogs, H1N2 influenza is a provincially notifiable disease, meaning veterinarians must report suspected or confirmed cases to the province within 24 hours.

The virus shows up in hogs as an infectious respiratory disease, symptoms of which can include fever, coughing/barking, sneezing, breathing difficulty, red or inflamed eyes and loss of appetite — though officials noted some infected hogs may not show any signs of illness at all.

People can become infected if they inhale “respiratory droplets” spread when an infected pig coughs or sneezes, according to Health Canada. A person can also be infected by touching an object with the virus on it, then touching his or her own mouth or nose.

H1N2 is not a food-related illness, officials emphasized; it’s not transmissible to people through products made from pigs, and there is “no risk associated with eating pork.”

“We are taking this seriously, but Albertans should know that sporadic cases of variant influenza have been reported over the past decade in North America,” Hinshaw and Lehman said.

The influenza A (H1N2) variant in people is rare, they said, with only 27 cases reported anywhere in the world since 2005, and “no cases in Canada prior to this one.”

Of those 26 other cases, two were in Brazil and 24 were in the U.S., Health Canada said, also noting there’s “no evidence of sustained person-to-person spread.”

Among the more recent U.S. cases, three people are believed to have contracted an H1N2 variant with the pandemic M gene from the 2009 H1N1 virus while exhibiting or spending time around pigs at the Minnesota State Fair in 2012.

Of the three, two had underlying health conditions for high risk of serious flu complications, according to the U.S. Centers for Disease Control. All three later recovered.

In people, infections with H1N2v usually lead to “mild” respiratory illness, with symptoms similar to those seen with seasonal influenza, the province said. Most people recover from the flu within a week or 10 days, but some are at risk for more severe complications, such as pneumonia.

Farmers, farm workers, farm family members and others in contact with pigs should protect themselves from animal-related influenzas by frequent handwashing, the province said.

Anyone working with hogs should also avoid close contact with pigs that look or act ill, and “take protective measures if they must come in contact with pigs that are known or suspected to be sick,” including personal protective equipment such as protective clothing, gloves and masks that cover the mouth and nose.

People who develop flu-like symptoms in those cases should avoid further contact with livestock, particularly sick animals, and should also contact their doctor.

Livestock producers are also advised to follow basic biosecurity measures, including controlling movements of people, animals and equipment on the farm, observing animals daily for signs of disease, and calling a veterinarian if animals appear sick.

People working in food production or in “agricultural settings” should also get a seasonal flu shot each year, Health Canada said, as it can help reduce the spread of flu viruses between people and animals.

The Alberta H1N2v case has also been reported to the World Health Organization, as per international health regulations, Health Canada said Wednesday. –– Glacier FarmMedia Network

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A team of Chinese researchers looked at influenza viruses found in pigs from 2011 to 2018 and found a “G4” strain of H1N1 that has “all the essential hallmarks of a candidate pandemic virus”, according to the paper, published by the U.S. journal Proceedings of the National Academy of Sciences (PNAS).

Pig farm workers also showed elevated levels of the virus in their blood, the authors said, adding that “close monitoring in human populations, especially the workers in the swine industry, should be urgently implemented.”

The study highlights the risks of viruses crossing the species barrier into humans, especially in densely populated regions in China, where millions live in close proximity to farms, breeding facilities, slaughterhouses and wet markets.

The coronavirus that caused the worldwide COVID-19 pandemic is believed to have originated in horseshoe bats in southwest China, and could have spread to humans via a seafood market in Wuhan, where the virus was first identified.

The PNAS study said pigs are considered important “mixing vessels” for the generation of pandemic influenza viruses and called for “systematic surveillance” of the problem.

China took action against an outbreak of avian H1N1 in 2009, restricting incoming flights from affected countries and putting tens of thousands of people into quarantine.

The new virus identified in the study is a recombination of the 2009 H1N1 variant and a once prevalent strain found in pigs.

But while it is capable of infecting humans, there is no imminent risk of a new pandemic, said Carl Bergstrom, a biologist at the University of Washington.

“There’s no evidence that G4 is circulating in humans, despite five years of extensive exposure,” he said on Twitter after the paper’s publication. “That’s the key context to keep in mind.”

— Reporting for Reuters by David Stanway.

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The first of the transgenic chicks will be hatched later this year at the Roslin Institute at the University of Edinburgh in Scotland, said Wendy Barclay, a professor of virology at Imperial College London who is co-leading the project.

The birds’ DNA has been altered using a new gene editing technology known as CRISPR. In this case the “edits” are to remove parts of a protein on which the flu virus normally depends, making the chickens totally flu-resistant.

The idea is to generate poultry that cannot get flu and would form a “buffer between wild birds and humans,” Barclay said.

Global health and infectious disease specialists cite the threat of a human flu pandemic as one of their biggest concerns.

The death toll in the last flu pandemic in 2009-10 — caused by the H1N1 strain and considered to be relatively mild — was around half a million people worldwide. The historic 1918 Spanish flu killed around 50 million people.

The greatest fear now is that a deadly strain could jump from wild birds via poultry into humans, and then mutate into a pandemic airborne form that can pass easily between people.

“If we could prevent influenza virus crossing from wild birds into chickens, we would stop the next pandemic at source,” said Barclay.

In research published in 2016 in the journal Nature, Barclay’s team found that a gene present in chickens called ANP32 encodes a protein that all flu viruses depend on to infect a host. Laboratory tests of cells engineered to lack the gene showed they cannot be infected with flu.

Teaming up scientists at the Roslin, Barclay said the plan is to use CRISPR to edit the chicks’ DNA so that only one part of the key protein is changed, leaving the rest of the bird exactly the same, genetically, as it was before.

“We have identified the smallest change that will stop the virus in its tracks,” she said.

Roslin Institute scientists gained fame in 1996 as creators of “Dolly the sheep,” the world’s first cloned animal. They have also created gene-edited pigs to make them resistant to a virus.

Barclay said one of the biggest hurdles to this approach would be poultry producers’ concerns about public acceptance. “People eat food from farmed animals that have been altered by decades of traditional breeding,” she said. “But they might be nervous about eating gene-edited food.”

— Kate Kelland is a Reuters health and science correspondent based in London.

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The Canadian Food Inspection Agency on Thursday announced restrictions on imports of uncooked poultry products, live birds and/or eggs from those two states until further notice.

The U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS) on March 5 and 16 confirmed cases of highly pathogenic H7N9 avian influenza in separate commercial chicken breeder flocks in southern Tennessee’s Lincoln County.

Alabama, meanwhile, has recently reported three suspected outbreaks of avian flu in flocks along its northern border with Tennessee, but as of Thursday was still waiting on USDA confirmation.

Alabama state agriculture officials said Thursday a sample from one of the state’s outbreaks had tested positive for low-pathogenic H7N9, while results from the other two outbreaks were still pending.

Alabama and U.S. federal officials emphasized the H7N9 flu virus in the Tennessee cases is not the same lineage as the Chinese high-path H7N9 strain reported to be infecting people as well as poultry in Asia.

Before coming to Canada, cross-border travellers who buy poultry and eggs while visiting the U.S. will want to make sure they have proof that those products originated from, and were bought in, states not under CFIA’s restrictions, the agency said Thursday.

For travellers, the list of restricted items includes live birds, hatching eggs, eggs, yolks, egg whites, uncooked or partially-cooked poultry meat, raw poultry-based pet foods, feathers, poultry manure/litter and laboratory materials containing poultry products or byproducts.

If the goods originate in either of the affected states, “you may not bring these items into Canada,” CFIA said.

Live pet birds will be allowed if they arrive with the appropriate certification from USDA.

Commercial-level poultry and egg imports are restricted only from “specific quarantine zones” within affected states until further notice, CFIA said.

Canada has been free of notifiable avian flu as per World Organization for Animal Health (OIE) standards since late November 2016, following an outbreak of low-path H5N2 last summer on a commercial duck farm near St. Catharines, Ont. — AGCanada.com Network

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Multiple outbreaks have been reported in poultry farms and wild flocks across Europe, Africa and Asia in the past three months. While most involve strains that are currently low risk for human health, the sheer number of different types, and their presence in so many parts of the world at the same time, increases the risk of viruses mixing and mutating — and possibly jumping to people.

“This is a fundamental change in the natural history of influenza viruses,” Michael Osterholm, an infectious disease specialist at University of Minnesota, said of the proliferation of bird flu in terms of geography and strains — a situation he described as “unprecedented.”

Global health officials are worried another strain could make a jump into humans, like H5N1 did in the late 1990s. It has since caused hundreds of human infections and deaths, but has not acquired the ability to transmit easily from person to person.

The greatest fear is that a deadly strain of avian flu could then mutate into a pandemic form that can be passed easily between people — something that has not yet been seen.

While avian flu has been a prominent public health issue since the 1990s, ongoing outbreaks have never been so widely spread around the world — something infectious disease experts put down to greater resilience of strains currently circulating, rather than improved detection or reporting.

While there would normally be around two or three bird flu strains recorded in birds at any one time, now there are at least half a dozen, including H5N1, H5N2, H5N8 and H7N8.

The Organization for Animal Health (OIE) says the concurrent outbreaks in birds in recent months are “a global public health concern” and the World Health Organization’s director-general warned this week the world “cannot afford to miss the early signals” of a possible human flu pandemic.

The precise reasons for the unusually large number and sustained nature of bird outbreaks in recent months, and the proliferation of strains, is unclear — although such developments compound the global spreading process.

Bird flu is usually spread through flocks through direct contact with an infected bird. But Osterholm said wild birds could be “shedding” more of the virus in droppings and other secretions, increasing infection risks. He added that there now appears to be “aerosol transmission from one infected barn to others, in some cases many miles away.”

Ian MacKay, a virologist at Australia’s University of Queensland, said the current proliferation of strains means that “by definition, there is an increased risk” to humans.

“You’ve got more exposures, to more farmers, more often, and in greater numbers, in more parts of the world — so there has to be an increased risk of spillover human cases,” he told Reuters.

Britain to Bangladesh

Nearly 40 countries have reported new outbreaks of highly pathogenic avian influenza in poultry or wild birds since November, according to the WHO.

In China, H7N9 strains of bird flu have been infecting both birds and people, with the of human cases rising in recent weeks due to the peak of the flu season there. According to the WHO, more than 900 people have been infected with H7N9 bird flu since it emerged in early 2013.

In birds, latest data from the OIE should that outbreaks of highly pathogenic avian flu have been detected in Britain, Italy, Kuwait and Bangladesh in the last few days alone.

Russia’s agriculture watchdog issued a statement describing the situation as “extremely tense” as it reported H5N8 flu outbreaks in another four regions. Hungarian farmers have had to cull three million birds, mostly geese and ducks.

These come on top of epidemics across Europe and Asia which have been ongoing since late last year, leading to mass culling of poultry in many countries.

Strains currently documented as circulating in birds include H5N8 in many parts of Europe as well as in Kuwait, Egypt and elsewhere, and H5N1 in Bangladesh and India.

In Africa — which experts say is especially vulnerable to missing flu outbreak warning signs due to limited local government capacities and weak animal and human health services — H5N1 outbreaks have been reported in birds in Burkina Faso, Cameroon, Ghana, Niger, Nigeria and Togo. H5N8 has been detected in Tunisia and Egypt, and H7N1 in Algeria.

The U.S. has, so far this year, largely escaped bird flu, but is on high alert after outbreaks of H5N2, a highly pathogenic bird flu, hit farms in 15 states in 2015 and led to the culling of more than 43 million poultry.

David Nabarro, a former senior WHO official who has also served as U.N. system senior coordinator for avian and human influenza, says the situation is worrying. “For me the threat from avian influenza is the most serious (to public health), because you never know when,” he told Reuters in Geneva.

Highly pathogenic H5N1

H5N1 is under close surveillance by health authorities around the world. It has long been seen as one to watch, feared by infectious disease experts because of its pandemic potential if it were to mutate an acquire human-to-human transmission capability.

A highly pathogenic virus, it jumped into humans in Hong Kong in 1997 and then re-emerged in 2003-04, spreading from Asia to Europe and Africa. It has caused hundreds of infections and deaths in people and prompted the culling of hundreds of millions of poultry.

Osterholm noted that some currently circulating H5 strains — including distant relatives of H5N1 — are showing significant capabilities for sustaining their spread between wild flocks and poultry, from region to region and farm to farm.

“What we’re learning about H5 is, that whether it’s H5N6, H5N8, H5N2 or H5N5, this is a very dangerous bird virus.”

Against that background, global health authorities and infectious disease experts want awareness, surveillance and vigilance stepped up.

Wherever wild birds are found to be infected, they say, and wherever there are farms or smallholdings with affected poultry or aquatic bird flocks, regular, repeated and consistent testing of everyone and anyone who comes into contact is vital.

“Influenza is a very tough beast because it changes all the time, so the ones we’re tracking may not include one that suddenly emerges and takes hold,” said MacKay.

“Right now, it’s hard to say whether we’re doing enough (to keep on top of the threat). I guess that while it isn’t taking off, we seem to be doing enough.”

— Kate Kelland is a Reuters health and science correspondent based in London. Additional reporting for Reuters by Ed Stoddard in Johannesburg, Stephanie Nebehay in Geneva, Polina Devitt in Moscow and Sybille de La Hamaide in Paris.

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But an Alberta medical doctor still wants to know more. Q fever, known as coxiella, is an infection that can affect livestock handlers and their animals.

“In Alberta, we only have about six human cases a year that are recognized — it’s not very common,” said Stan Houston, professor of medical and public health at the University of Alberta and an infectious disease specialist.

“Basically, these are the people who get sick enough to get intensive medical investigation. Many doctors aren’t very familiar with this and would not make the diagnosis unless there was a correct, specific test.”

Q fever is an infection caused by a bacterium that forms hardy spores, which can be airborne and remain in an environment for a long time.

“It’s blown through the air very efficiently. That’s most often how people are infected with this organism,” said Houston.

The risk is greater for livestock handlers who work in poorly ventilated barns and deal with bodily fluids like placenta. The disease is more likely to affect sheep and goats than cattle.

“A poorly ventilated lambing barn would be the perfect place to get Q fever,” said Houston.

There is no systematic monitoring of the infection because there is no risk to consumers of agricultural products, said Houston.

This year, Houston treated one patient who was hospitalized for two weeks with Q fever. The patient, from Peace River, likely caught the infection after helping his parents improve their lambing barn. The patient is better now, after the use of antibiotics and a long recovery period. His case is a rarity.

“Most people who get Q fever have no symptoms or have symptoms that are non-specific, so they get better on their own,” said Houston. “Most people don’t get seriously ill. Most doctors would not do the test, so it is probably under-reported and it’s not known how much transmission is happening.”

And the lack of knowledge concerns Houston.

“We’re not pushing this as the next ebola; it’s not going to take over and decimate Alberta farming families. But the biggest issue is that we really haven’t a clue as to how much transmission is out there and that’s hardly the ideal situation. We should know more about what is going on, and then we can make an informed decision, if there’s anything that should be done about it, or not.”

Many people who catch the infection and who show no symptoms will not see any ill effects, although the infection could cause miscarriages in pregnant women.

Mild cases may look like the flu or pneumonia.

“It’s reasonably likely that this is happening at some level in the province all the time and is not recognized,” said Houston.

But in rare cases, Q fever can infect the heart valves and be fatal.

Even though little is known about the infection, livestock handlers can reduce the case of infection by wearing gloves, practising good hygiene in the barn, and washing their hands. Proper ventilation in barns can also mitigate the risk.

Since Q fever is a zoonotic disease, it can infect animals and cause abortions.

“If a producer is seeing more abortions in their flock than usual, then you can get that checked out by the vet,” said Houston.

The vet can arrange a test on the fetus or placenta.

Q fever was discovered in the 1930s in Australia, after a group of abattoir workers fell ill with the infection.

“But nobody knows how long it has been here. There’s been no systematic look at the disease in Alberta,” said Houston.

To learn more about the disease, Houston recently sampled blood from 45 volunteers in the Peace River region in Alberta and B.C. Thirty of the volunteers were producers, while 15 of them worked in a local abattoir. The samples are now being tested in the national reference laboratory in Winnipeg. If the samples show that the volunteers have been exposed to Q fever, Houston will share the information with Alberta Health and discuss what to do.

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Avian influenza has killed nearly 50 million chickens and turkeys in the U.S. and hit a handful of Ontario and B.C. operations earlier this year.

“We saw what a big hit that took out of the poultry industry and the ag industry overall,” said Susan Schafers, chair of the Egg Farmers of Alberta.

But while producers “do the best they can” to protect their barns, there’s no guaranteed defence against a disease that can originate with wild birds and spread quickly from farm to farm.

“You can have the best type of operation, and if it’s an airborne issue, there’s very little you can do as a farmer,” said Schafers.

“Having that continued support from government for major disease issues is something we would be looking for.”

The federal government supports national biosecurity programs to protect farmers against disease outbreaks like avian influenza, including reporting systems, lab facilities, and veterinarians. But financial support is important as well, she said.

“At this stage, avian influenza losses are often covered under government support programs, and it’s important that that continues on.”

Any disease outbreak erodes consumers’ confidence, she said.

“There are certainly concerns with any disease and any biosecurity issues, in that consumers just don’t feel as confident purchasing the product,” said Schafers.

Her industry will also be expecting the next government to stand by supply management, she said.

“If we move away from supply management, we’re going to move away from small family farms and local business into very large, vertically integrated farms.”

There seems to be “very good” support for supply management at the federal level, “but there’s a lot of concern from farmers from all across the country about this,” she said.

“They need to be keeping the farmers and their communities in mind when they go to these trade negotiations,” said Schafers. “We’re asking them not to trade off supply management for access for other commodities.”

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The Department for Environment, Food and Rural Affairs (Defra) said that the risk to humans was minimal, and that a cull of all 6,000 ducks on the farm in east Yorkshire should be completed later on Tuesday.

“The advice from the Chief Medical Officer and Public Health England remains that the risk to public health is very low,” said a Defra spokeswoman.

“The Food Standards Agency have said there is no food safety risk for consumers.”

Officials said Monday a 10-km restriction zone had been put in place around the duck farm.

In Sweden, the board of agriculture said poultry should be kept indoors as a preventative measure as it was possible that the current bird flu had been spread by wild birds. The viral disease infects wild water fowl such as ducks, geese and swans which can spread it to domestic poultry.

Britain has not seen a dangerous strain of avian flu since 2008, when a case of the deadly H5N1 strain was last reported in birds.

The H5N8 strain has never been detected in humans, but it led to the destruction of millions of farm birds in Asia, mainly South Korea, after an outbreak earlier this year.

Other bird populations in Europe were likely to be infected with bird flu and a few people might also be susceptible, although the virus is highly unlikely to spread in the human population, the World Health Organization said on Tuesday.

German discount chain Aldi South warned that it expected egg shortages due to a three-day ban on shipments of all poultry products from the Netherlands, the world’s largest egg exporter.

Dutch authorities said on Sunday that they had identified the H5N8 strain at a poultry farm in the central Netherlands, more than a week after the first reported case in Europe at a German turkey farm.

— Costas Pitas is a Reuters correspondent based in London, England. Additional reporting for Reuters by Anna Ringstrom in Stockholm.

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