In mid-July, the state of Colorado (US) reported six cases of avian influenza (or H5N1) in samples taken from poultry workers. This brought the national total to 10 cases confirmed by the US Centers for Disease Control and Prevention (CDC) since April 2024.
The U.S. government has increased animal and zoonotic testing and is now finding more cases of H5N1 infection in cows and other mammals. So far, it has reported cases of H5N1 in more than 160 cow herds.
The rising number of cases comes amid growing concern about the spread of the virus, and a recent study published in the journal Nature suggests that the H5N1 found in cows may be more adaptable to humans.
In response to this situation, the US government recently awarded a $176 million project to Moderna to support clinical trials of an mRNA vaccine against the virus. Other countries are also taking note of these developments, such as Finland, which has launched a vaccination campaign aimed at protecting the communities most exposed to the disease.
Increasingly frequent reports of new cases have led some experts to suggest that another pandemic could be on the cusp of happening. While it is not an absolute certainty, we must be prepared for it. However, the world's preparedness to respond to these health threats still appears fragmented and uneven. It should concern us all that we still do not have the right tools for early detection and containment.
What we know so far is that H5N1 is a rapidly spreading and evolving virus that can cause severe illness and death. However, the lack of diagnostic testing and genetic sequencing for humans and animals prevents us from understanding how the virus is mutating and whether there are potential mutations that could increase the likelihood of transmission between humans. The lack of attention to surveillance and investment in diagnostics is irresponsible.
It is essential to avoid repeating the mistakes of the COVID-19 pandemic, especially with regard to the H5N1 virus, whose risks could be even greater due to its high mortality rate. In the past 20 years, fatal outcomes have been recorded in approximately 50 percent of known cases.
It is likely that not enough infections have been reported and diagnosed due to limited testing capacity, so the mortality rate may be lower. Moreover, this rate would not necessarily be reproduced if the virus became established in the human population. Still, there is a risk that an H5N1 pandemic could be significantly different from COVID-19 and more deadly.
The bad news is that there are currently no commercially available diagnostic tests to specifically detect the H5N1 virus. Nucleic acid-based (molecular) tests are the current gold standard for detecting influenza viruses, but they typically require a laboratory infrastructure to support their use. And even when such infrastructure is available, it may not work quickly enough. For example, when a sick Australian girl was tested for bird flu in March, it took several weeks to get a positive result.
As seen during the COVID-19 pandemic, rapid tests that can provide a result in about 10 to 15 minutes are a critical tool for containing the outbreak, even if they are less sensitive than molecular tests. Investing in research and development leading to rapid and affordable H5N1 tests can lay the groundwork for preparedness.
Testing should be available worldwide, including in low- and middle-income countries, and prioritized in populations where there is potential for human exposure to the virus, such as farms or veterinary clinics.
Increasing monitoring of bird and animal populations, effectively training staff, streamlining reporting mechanisms and using cutting-edge technologies such as artificial intelligence to conduct rapid analysis should be priorities for governments. There also needs to be incentives to encourage at-risk populations (currently those working with animals that may be sick) to get tested.
Equally essential is continued and effective collaboration to develop and share treatments and vaccines. Partnerships such as the Access to COVID-19 Tools Accelerator, which includes health leaders from the World Health Organization, the Foundation for Innovative Diagnostics (FIND), the Gavi Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations (CEPI), should be used to encourage governments and pharmaceutical groups to ensure that health countermeasures are produced at scale and made available to all countries.
This is not about charity, but about investing in global public health to ensure we are all protected. No country can stop a pandemic alone.
More than a million lives may have been lost during COVID-19 due to inequity. We must ensure that this does not happen again. There is a need to focus on helping low- and middle-income countries gain access to all the countermeasures needed to deal with the next pandemic.
Action is needed now, while human-to-human transmission has not yet been detected, so that if and when it is detected, a rapid and coordinated global response to H5N1 can be deployed.
The new cases in Colorado do not indicate that the world is about to end, but they are a sign worth paying attention to. While the United States and other Western countries can take action, poorer countries that do not have the resources or access to technology cannot.
This uneven situation not only threatens national health security, but also hampers the global ability to prevent an H5N1 pandemic, should one occur. World leaders must recognize the interconnectedness of health systems and commit to distributing resources fairly.
If H5N1 begins to spread from person to person and we are not prepared for it, we will pay an unimaginably high price in terms of human lives and livelihoods.
The views expressed in this article are those of the author and do not necessarily reflect the editorial stance of Al Jazeera.
