Avian influenza update shows continued threat and medication deficiencies

A recent report from the Centers for Disease Control and Prevention notes that the avian influenza A (H5N1) epizootic (animal outbreak) in Asia and parts of Europe, the Near East, and Africa is not expected to diminish significantly in the short term. It is likely that H5N1 infection among birds has become endemic in certain areas and that human infections resulting from direct contact with infected poultry and/or wild birds will continue to occur.

So far, the spread of H5N1 virus from person-to-person has been rare, limited and unsustained. No evidence for genetic reassortment between human and avian influenza A virus genes has been found; however, this epizootic continues to pose an important public health threat.

There is little pre-existing natural immunity to H5N1 infection in the human population. If these H5N1 viruses gain the ability for efficient and sustained transmission among humans, an influenza pandemic could result, with potentially high rates of illness and death.

In addition, genetic sequencing of influenza A (H5N1) viruses from human cases in Vietnam and Thailand shows resistance to the antiviral medications amantadine and rimantadine, two of the medications commonly used for treatment of influenza. This would leave two remaining antiviral medications (oseltamivir and zanamivir) that should still be effective against currently circulating strains of H5N1 virus. Efforts to produce vaccine candidates that would be effective against avian influenza A (H5N1) viruses are under way. However, it will likely require many months before such vaccines could be mass produced and made widely available.