Worst ever avian flu outbreak

Avian flu is swooping in to put us at risk of another pandemic...
18 January 2022

Interview with 

Christine Middlemiss, Government Veterinary Services


A free-range chicken on a farm


With cases of Avian flu appearing in the UK, Chris Smith interviews head of the Government Veterinary Services & advisor on Avian Flu, Christine Middlemiss, about how concerned we should be about this new virus amidst our current covid pandemic...

Chris - The cause is the H5N1 strain of influenza virus which doesn't, at the moment, spread well among humans. But, the situation is alarming because the virus could adapt to us and then begin to spread, potentially triggering a parallel pandemic alongside COVID - perish the thought. But there's another aspect to this: why are these viral outbreaks happening at all, and why now? Are we doing enough to stop them? Do we need to up our surveillance game? Christine Middlemiss is the UK's chief veterinary officer:

Christine - In the UK and across Europe, we are seeing the greatest number of bird flu outbreaks in kept birds that we've ever seen before. In the UK, we have 79 confirmed infected premises. Italy are having a lot of outbreaks - they're at nearly 300 - Hungary, the Netherlands, France and Ireland as well. That's because there's an overwhelming level of infection in migrating wild birds that have come back to us for the winter, and they're bringing infection and that's getting into our own kept birds.

Chris - And what sort of flu are we talking about?

Christine - Bird flu - mostly specific to birds. There have, globally, been a few reported cases - mostly in Asia - of infected people. We did, sadly, have one person infected in the UK, but he's been quite well in himself. He had very close living circumstances with his own birds. So, a very low risk to people, but it's very nasty in birds and particularly some types of birds: chickens and turkeys, particularly - it's fatal for them. That's why we want to control it.

Chris - Apart from the obvious economic and possibly food supply impact, is there a human risk down the track? In the sense that, obviously, if you've got a type of flu, and it can jump the species barrier, could it either turn itself into a form that's better at spreading among people? Could it mix up with human seasonal flu and produce a sort of hybrid which is the worst of both?

Christine - What we're seeing so far is that the genetics of this virus are very clearly linked to birds but it's important that we all keep checking. As we know, viruses can change and that's why routine hygiene precautions for people, all those things we've become really familiar with in the last two years; wash your hands every time after you've handled your birds, don't handle dead or sick birds - those things are really important so that the virus doesn't get an opportunity to think about changing.

Chris - Why is this year so bad?

Christine - Because of the overwhelming level of infection in the migratory, wild birds. The birds on the flight pathway that come to us go back to the north of Russia in the summer and that's where a number of different flight pathways all meet up. So, birds that are covering different parts of the world are exchanging their viruses and things there. Then, when they come back to us in the winter, they might be bringing different or slightly changed strains. Why we're seeing it this year when we had an outbreak last year (because usually we expect to have two or three quiet years) we're not sure. It's something we're looking really closely at because we want to think about what might happen next winter and the winter after that.

Chris - Does it teach us anything about what we need to do by way of surveillance for these sorts of infectious diseases in the future? Because one of the things people keep saying is that it's unfortunate that we weren't better prepared for what happened with COVID. Do we need better surveillance to include things like animal viruses; like bird flu?

Christine - We actually have good surveillance. I have a team that looks every day, around the world, for any changes in animal disease and animal health status. Then we translate that into what it might mean in the UK for diseases, ones we call zoonotic, that can spread from animals to people. We share that with our public health colleagues. We're really joined up in that space, but what I think we can do more of is working internationally to share information on new and emerging things, the known unknowns and unknown unknowns, so that, when, internationally, somebody somewhere spots something different, there's a pathway and route and mechanism where they can share that information so that policy makers around the world can be better informed and prepared more quickly.

Chris - All that sounds absolutely terrific, but we missed COVID didn't we? Which, I know, the jury is out on over exactly where it came from, and still people are debating about whether this is a laboratory experiment that got away or whether it really does have a genuine wildlife origin, but the end point has been the same: dramatic spread and loss of human life. A lot of these sorts of diseases do have their direct origins in animals, don't they? So, monitoring like the type you are describing is absolutely critical to keeping the lid on infections in the future. I'm just wondering how many more we might have to miss, because we missed this one?

Christine - I wouldn't necessarily say we missed this one because trying to do surveillance of all the different world's animal populations in a systematic way that would be valid enough to give you an indication - I think we have to be realistic - is, particularly when it's wildlife that might be concerned, pretty impossible. It would be really, really difficult. So, we have to understand where their interactions with other animals or people happen and monitor those spots. That's what I was conveying about sharing information internationally in a more coordinated way: people are monitoring those connection spots, but we could do it more systematically and in more of a coordinated way, working the concept of what we call one health - which is human, animal and environment health - all coming together. We're quite good now at the animal and human bit, but we need to build on having more of the environment in it so that we understand if we change something in the environment, or it changes of its own accord, we're thinking what might be the impact for animals and what might be the impact for humans.



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