Under the radar | Are we getting closer to another pandemic?

Teenager intubated, fighting for his life in a British Columbia hospital. Chickens slaughtered by the millions in Canada and the United States. Seals found dead in the St. Lawrence Valley. Hundreds of contaminated dairy cow farms in the United States…

The constant news about the avian flu epidemic is not reassuring. However, they tend to fly under the radar. Perhaps because they awaken the specter of a pandemic that we do everything we can to forget.

“It’s certain that we’re all fed up, even those of us who work in the field,” admits Caroline Quach-Thanh, an infectious disease specialist at CHU Sainte-Justine who became a well-known figure among Quebecers during the COVID-19 crisis. A period which she does not miss in the least. “Give me three years before another pandemic. I don't want to hear about it anymore! »

And yet, we have to talk about it, a little. Calmly, without giving in to panic. We must be able to say that, although the H5N1 avian flu virus currently represents a low risk for humans, it does indeed have the potential to mutate and cause the next pandemic.

Since the outbreak of the avian flu epidemic in February 2022, around sixty people have contracted the virus, most of them American agricultural workers infected by contaminated livestock. There were few illnesses, with the exception of a teenager in British Columbia – who caught a different strain of the H5N1 virus – and a 61-year-old man in Louisiana, who both required hospitalization.

The good news is that the virus is not transmitted between humans, at least not yet. “It takes several genetic mutations before the virus is able to better attach itself to human cells,” explains the D^re Quach-Thanh.

The bad news is that if the virus successfully mutates, it will become extremely difficult to contain. However, according to the results of a study published on December 5 in the journal Science¹, the H5N1 strain spreading in the United States is just one mutation away from binding more easily to human cells.

The next step would be the pandemic.

What worries more and more epidemiologists, in the United States and elsewhere, is that Americans are burying their heads in the sand.

They do not, or not enough, test cows and farm workers, which would allow sick animals and people to be isolated. The state most severely affected by the crisis – California, with 600 herds and 34 infected people – only declared a state of emergency on December 18.

As a result, the H5N1 virus continues to spread – which increases the risk of genetic mutations.

Experts' anxiety levels rose a notch in November with the discovery of an infected pig in Oregon, with pigs considered good receptacles for mixing various strains of the virus.

In Canada, herds are much better monitored, underlines the D^re Quach-Thanh. So far, public health authorities have managed to keep the H5N1 virus at bay from Canadian dairy cows. So much the better.

In the United States, however, things are not likely to get better any time soon. Especially not with the upcoming arrival of Robert F. Kennedy Jr. as head of the Department of Health and Human Services.

While still a presidential candidate, before siding with Donald Trump, RFK Jr. promised to furlough scientists from the U.S. government. “We are going to give infectious diseases a break for about eight years,” he said.

Unfortunately, viruses don't take a break.

It's sad to say, but the future Secretary of Health of the United States does not believe in research or mass vaccination in the event of a pandemic. Rather, he advocates the virtues of raw milk for staying in shape, which is not scientific.

Let's hope RFK Jr. doesn't make drinking raw milk a national policy, because that from infected cows contains astronomical levels of H5N1 virus, making it a vector for transmission to humans.

If news about the H5N1 virus goes under the radar, it may also be because epidemiologists have been warning us since this virus was detected in humans in Hong Kong in 1997.

We have been told for almost 30 years that a bird flu pandemic was coming. She still hasn't arrived. Inevitably, people end up feeling like they did in the story of the little boy who cried wolf.

But above all they suffer from very, very great post-COVID-19 fatigue. “It’s clear that the population is still in shock about the pandemic,” says Caroline Quach-Thanh. It disrupted our lives so much. »

No one wants to hear about a pandemic, because no one wants to revive the memory of those painful years. We are still, collectively, in a state of post-traumatic shock.

But that's no reason to ignore experts' warnings or let the H5N1 virus spread among animals and hope it will simply disappear. Better to prepare for the worst, hoping for the best.

1. Consult the study on the H5N1 strain of avian flu published in Science (in English)