New Delhi: The central government announced Monday that it has the seasonal and avian influenza situation under control. However, it is intensifying nationwide surveillance for influenza-like illnesses (ILI) and expediting the development of a testing plan for mammals for the highly pathogenic avian influenza (HPAI) virus, ThePrint has learnt.
Last week, Jharkhand reported an outbreak of bird flu spread by the H5N1 or HPAI virus, becoming the fourth Indian state to do so this year, following Maharashtra, Andhra Pradesh, and Kerala. This strain of bird flu has been affecting wildlife globally for several years.
In Ranchi, authorities culled over 2,000 birds, including chickens and ducks, last week. Additionally, eight individuals, two of whom are doctors who were exposed to the infected birds, have been placed under quarantine.
In the US, a massive outbreak of the disease has been reported among birds this year, which subsequently spread to cattle and was passed on to a human — marking what is believed to be the first mammal-to-human transmission case.
The H5N1 A virus, specifically clade 2.3.4.4b, was identified in cattle across at least eight US states, and traces have been found in raw milk, though not in pasteurised milk.
The development was discussed at a meeting between Union health ministry officials and authorities from Maharashtra Sunday, and a statement by the ministry, citing experts, advised caution in using milk and meat products.
“..with (the) use of proper hygienic practices, such as boiling of milk, proper cooking of meat at adequate temperature would help in preventing the virus transmission from the product (if the virus is present) to the human beings”, it said.
So far, India has not tested cattle, such as cows, for the presence of H5N1, but a senior official in the Department of Animal Husbandry and Dairying (DAHD) under the Ministry of Fisheries, Animal Husbandry and Dairying said that it was working to formulate a policy for the surveillance programme.
ThePrint reached DAHD secretary Alka Upadhyay over email and the telephone but was unable to get a comment. This report will be updated as and when she responds.
Meanwhile, virologists and scientists ThePrint spoke to underlined that the country needed to act swiftly to monitor mammals for the virus.
“The concern right now should be increased detection of influenza A (H5) virus in various mammals. It allows the virus to adapt and be more easily transmitted to other mammals. It also increases the chances of transmission to humans,” said virologist Dr Shahid Jameel, a fellow at Green Templeton College, University of Oxford and visiting professor at Ashoka University.
Jameel said that India has a reasonably good respiratory disease surveillance network, but stressed that all human cases should be reported, and there should also be increased surveillance of poultry markets while ensuring that data is publicly available.
On its part, the government has maintained that it is “keeping a close watch on the seasonal influenza situation in various states through the Integrated Disease Surveillance Programme (IDSP) network on a real-time basis”.
“A near real-time surveillance of cases of ILI and Severe Acute Respiratory Infections (SARI) presenting in OPDs (out-patient departments) and IPDs (in-patient departments) of health facilities is undertaken by IDSP, National Centre for Disease Control (NCDC) through the ICMR (Indian Council of Medical Research) network of laboratories across the country,” read the statement by the health ministry.
Also Read: Bird flu outbreak in the US: What is H5N1 avian influenza & should India be concerned
‘Unprecedented spread’
Since 1996, avian influenza A5 viruses, commonly known as bird flu, have been circulating among wild and domestic birds, first identified in China. Occasionally, these viruses infect humans who are in close contact with birds, with a fatality rate exceeding 50 percent in such cases, according to the World Health Organization (WHO).
Jameel explained that, so far, the transmission of bird flu viruses to humans is very inefficient due to the nature of these viruses and the types of cells that line the human upper and lower respiratory tracts.
However, the past two years have seen an increase in the frequency and spread of the virus among both birds and mammals.
The WHO reported that in 2022, 67 countries across five continents experienced outbreaks of H5N1 high pathogenicity avian influenza, resulting in the loss of over 131 million domestic poultry through death or culling.
In 2023, 14 additional countries, primarily in the Americas, reported outbreaks. Mass fatalities in wild birds have been attributed to influenza A(H5N1) clade 2.3.4.4b viruses.
There has also been a rise in reports of deadly outbreaks among mammals caused by influenza A(H5) viruses, with 10 countries across three continents reporting such outbreaks since 2022.
“There are likely to be more countries where outbreaks have not yet been detected or reported,” Jameel highlighted.
The virus has impacted both terrestrial and marine mammals, including mink farms in Spain, seals in the US, and sea lions in Peru and Chile, affecting at least 26 species.
H5N1 viruses have also been detected in domestic pets like cats and dogs in several countries, with recent detections in cats announced by Polish authorities.
Since 2022, there have been 24 human cases of A(H5N1) in countries, including China, Spain, the US, Chile, and Vietnam. Additionally, three cases of avian influenza (H9) affecting humans have been reported in China this year.
Given the rapid spread of the virus from birds to other animals and humans, some scientists are seeing it as a potential mega threat— capable of causing a pandemic worse than COVID-19.
“All such outbreaks are serious in terms of potential and require alertness,” said Dr Anurag Agarwal, a biologist associated with the Ashoka University.
Is India doing enough?
According to a senior genomic scientist, given the seriousness of the outbreak, authorities and institutions should have been far more proactive than they appear now.
“There seems to be a severe lack of coordination as birds fall in the category of animals and until the virus spills over to humans, the health department will not act,” he said.
He added that, so far, none of the institutions — the National Institute of Virology, the Indian Council of Agriculture Research, or the National Institute of High-Security Animal Diseases (NIHSAD) — have even declared the virus strain that has caused the outbreak in different states.
In contrast, the scientist said, people in the US are grilling the United States Agriculture Department for delay in making genomes available. Understanding the virus lineage would enable us to swiftly develop diagnostics as well as vaccines, he added.
Meanwhile, Dr Aniket Sanyal, director of ICAR-NISHAD, said that the institute is conducting genomic sequencing of the viruses affecting birds in India, identifying subtypes H9N2, H5N1, and H5N8.
“The genetic sequencing of the viruses from recent outbreaks in India is currently underway,” he said, adding that the institute was undertaking research to develop vaccines against highly pathogenic avian influenza in birds and animals.
Jameel, meanwhile, cautioned that, based on the available information, immunity among people against the influenza A(H5) clade 2.3.4.4b virus is expected to be minimal in those who have taken the vaccine (against influenza) or have natural infection-based immunity.
“Therefore, caution is recommended around poultry,” he warned.
On a positive note, Jameel said that the virus sequences from human cases, where available, did not show markers for resistance to the antiviral medications Oseltamivir and Baloxavir, which are commonly used to treat influenza.
In light of the ongoing elections in the country, which lead to larger gatherings, Jameel urged the public to exercise caution and called for heightened alertness from health officials.
Meanwhile, biologist Agarwal also said that, while there may not be an immediate major threat to public health, preparatory measures are needed should the situation worsen.
“I don’t think anyone is fully prepared, but we are hopefully better prepared than before,” he said.
(Edited by Richa Mishra)
Also Read: How coronavirus, bird flu and rumours to stay off non-veg hit poultry industry hard in India