Avian alert, the virus infects a 2-year-old girl in Australia. Maxi EU contract for the vaccine

The H5N1 avian flu also affects Australia, so far “free” from the virus. You infected a 2 and a half year old girl, who tested positive, and was treated in intensive care in an Australian hospital after she returned from a trip to India. This was announced by the World Health Organization (WHO), explaining: “This is the first time in which an avian influenza virus infection in a human being has been confirmed. Even if the origin of the virus in this case is not is known, the exposure probably occurred in India”, where the little girl had travelled, and where this strain of “virus has been detected in the past in birds”.

The current risk posed by the virus for the human population is assessed as “low” by the WHO itself. The little girl had been in Calcutta from 12 to 29 February, where, however, she had not had contact with sick people or animals. She returned to Australia on March 1 and was admitted to hospital the following day. On March 4 she was transferred to intensive care in Melbourne for a week and discharged after two and a half weeks. That she was positive for avian influenza was confirmed while she was hospitalized, but further investigations were subsequently carried out, which verified that the virus was of a subtype circulating in South-East Asia. Now the little girl has recovered and none of her entourage has developed symptoms of the infection.

The EU signs a maxi-contract for the vaccine

Meanwhile, the EU is taking precautions against the advance of the H5N1 virus. Hera, the operational arm of the European Commission, has signed a contract with the English pharmaceutical company Seqirus for the supply of 665 thousand doses of vaccine for human use against the transmission of influenza
avian. The vaccines, we read in a note from the Commission, are intended for the people most exposed to the risk of transmission, primarily those who work on poultry farms and veterinarians. The contract, which lasts 4 years, provides for the possibility of providing another 40 million doses.

But Italy is not among the countries for which Hera has signed the joint agreement. The fifteen states for which it was done “are Denmark, Latvia, France, Cyprus, Lithuania, Malta, the Netherlands, Austria, Portugal, Slovenia, Finland, Greece, Ireland, Iceland and Norway”, explains a spokesperson for the EU Commission. Joint procurement offers member states additional capacity to purchase vaccines. Countries obviously remain free to obtain supplies through their own national procedures, regardless of participation in joint procurement.

The avian risk for the population

The question many are now asking is how high the avian risk is for the population. In this regard, the WHO reiterated that “it currently remains low”. However, global alert is growing due to the reporting of new cases of A-H1N1 in humans, with the possibility that the virus triggers, with a jump in species, human-to-human contagion. Even Australia, so far “unscathed”, has communicated to the WHO a first case of human infection, while in Italy, where no human infections have been recorded to date, an updated pandemic plan is currently missing.

The Australian girl, presumed infected in India, had not had, the WHO specifies, “any known contact with sick people or animals while she was in that country”. And the fact that little girl did not have direct contact with infected animals explains Gianni Rezzaprofessor of Hygiene at the San Raffaele University of Milan and former director of Prevention at the Ministry of Health, “certainly raises the level of concern”.

“Human cases of the A-H1N1 virus have, in fact, been around for years, but contagion has always occurred from animals – continues Rezza -. Instead, human-to-human transmission has been very rare. The most evident case was in 2006 in Sumatra where a woman infected 6 family members and one of these infected another person, but the outbreak was limited. Since then, human-to-human cases have been very rare because the virus has not yet adapted to humans to the point of transmitting from individual to individual. individual with the danger of a pandemic. In the case of the man recently infected in Mexico by the different A-H5N2 strain, no contact with infected animals has been reported: these are sporadic cases but not to be underestimated”.

Jump in species, cases and symptoms

So far, the expert recalls, “the jump of the virus from birds, which are its first reservoir, to some mammals, felines, cetaceans, mink, cows and recently also mice has been confirmed”. And he specifies: “Obviously the alert is greater when the animal carrying the virus is in greater contact with humans, as in the case of infected cows on farms in the USA”.

Bird flu infections in humans can cause from mild respiratory tract disorders to more serious and fatal illnesses. From 2003 to 22 May 2024, 891 cases of human infections with the A-H5N1 virus, including 463 deaths, were reported to WHO from 24 countries. Human infection therefore has a high mortality rate. At the moment, however, Rezza specifies, “there is no alarm because there is no evidence of human-to-human transmission of the virus, but the fact that various avian viruses are circulating in animals to which humans are exposed and the fact that we have of cases in which the exposure is not traced back to direct contact with the infected animal, it is therefore essential to monitor, not underestimate the signs and be prepared.”

In Italy there is no pandemic plan

No human case of A-H5N1 avian influenza has been recorded in Italy, but it would be risky to lower one’s guard: “There are currently two pre-pandemic vaccines for humans based on H5N1, one of which has already been optioned by Italy and in the event of a pandemic, even if the vaccine were to be adapted to a new strain, this would still require little time since we know flu viruses well and it is a very different situation compared to Covid”, explains Rezza.

However, the new Pandemic Plan is still missing. It has been updated for the three-year period 2024-28 but, underlines the expert, “it has not yet been approved at the State-Regions conference and I think that one of the problems is linked to the financing of the plan itself”. This is worrying, even if today there would certainly be greater preparation in the event of a pandemic and flexibility in increasing, for example, places in intensive care. According to Rezza, it is also the state of crisis of the NHS “which may not be able to withstand a new emergency”. Therefore, he concludes, “we need to strengthen surveillance systems and be prepared in the response”.

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