H5N1–The Most Successful Virus In History?

This will be a brief report from the Tracy Arm—Terror Wilderness of Alaska, without benefit of internet and very limited cell service. Public Health authorities in Michigan today released word that a third US dairy worker has been confirmed with Avian Influenza H5N1. This individual has respiratory symptoms with cough in addition to the conjunctivitis seen in the previous two cases. Versions of this Avian influenza virus have infected about 900 humans over the last 20 years with a reported mortality of 50%. The sample size of the current dairy farm human outbreak of course is tiny, but one might be tempted to wonder why such a virulent virus has caused three cases of mild disease so far. The most likely explanation is that the majority of human Avian Influenza cases reported to date have occurred in Asia, among people living in areas with limited access to high tech medicine and robust Public Health surveillance. It seems quite likely to me that there have been many cases of asymptomatic or mildly symptomatic infection which have never been diagnosed. That situation leads to overestimation of the mortality rate—similar to what we saw in the early stages of the SARS2-CoV19 Pandemic when only folks with moderate to severe illness were recognized and counted. It is logical to assume also that there may have been many asymptomatic or mildly symptomatic human infections on dairy and poultry farms, particularly in view of the two cases with conjunctivitis as the only manifestation. The only way to understand the transmission dynamics of the virus is to sample random asymptomatic people in the at risk group (dairy and poultry workers) for evidence of prior infection. That effort should have started as soon as the first human case on a dairy farm was diagnosed—or with more pro-active thinking much earlier with human cases related to poultry exposure.

With our anthropocentric view of the world H5N1 would need to acquire the ability to infect large numbers of humans, to be recognized as an incredibly serious threat. There is circumstantial evidence that intra-species spread has occurred among some marine mammals, and it certainly is occurring among cows on our dairy farms. The exact mechanism by which the virus is transmitting between cows isn’t known yet, and direct contact rather than respiratory spread may be the major route. Experiments are currently underway to determine if this clade of H5N1 can cause respiratory transmission between ferrets—mammals which are particularly susceptible and useful in defining the dynamics of viral spread. In order to claim the title of “world’s most successful virus” H5N1 will need to develop efficient respiratory spread among humans. Many other Influenza A strains are quite adept at this and readily infect pigs in particular. Given the number of pigs in the world, and what I consider their likely eventual infection, the resulting nearly unlimited opportunities for these different influenza viruses to re-assort and exchange genetic information gives the virus quite an advantage. It also is clear that human illness with coughing and other respiratory symptoms offers the virus more opportunity for mischief than a case of pink eye. The quest for the top virus title requires H5N1 to infect as many living organisms as possible, and ALSO demonstrate staying power over time. So far in the last nearly three years this new version of H5N1 has spread around the entire world, killing hundreds of millions of wild birds, many tens of millions of domestic poultry, infecting a wider range of mammals than any other virus I am aware of (with mass death events among marine mammals), infected our dairy cows, plus a few humans—an impressive showing, and one that now seems to have the full attention of the CDC.

Anyone who has been following my articles for some time knows that I have been highly critical of the continued use of live oral polio vaccine in the attempt to eradicate the tiny number of natural polio virus cases occurring in the world. This past week an official report of the GPEI (Global Polio Eradication Initiative) finally admitted the terrible mistakes they have made. After it became clear that almost all the cases of polio still paralyzing children were due to mutated forms of the live polio virus from the oral vaccine, the GPEI and WHO decided in 2016 to remove the Type 2 polio virus from the vaccine. They reasoned that many of the cases of vaccine derived polio were due to circulating vaccine Type 2, and that natural Type 2 Polio had been eradicated. It is now clear that vaccine derived Type 2 Polio continues to circulate in Africa unabated—and by GPEI estimates has paralyzed 3300 children. This of course is Africa so we can assume the toll is much higher. The response thus far from the WHO/GPEI has been to throw gasoline on the fire which they created, by responding to outbreaks of vaccine derived Polio by distributing millions of more doses of oral Polio vaccine. It is important to recognize that there is a fundamental difference between cases of a rare vaccine side effect which damages a few people, and the creation of a new disease as an unintended consequence of a vaccine. That is exactly the situation here—they have unleashed a new virus, the Mutated Type 2 Vaccine Polio Virus, into the world, which continues to circulate freely infecting both unvaccinated and some vaccinated children. The inactivated injectable Salk vaccine—the only one available in the US—never causes this problem.

Unqualified failure’ in polio vaccine policy left thousands of kids paralyzed https://www.science.org/content/article/unqualified-failure-polio-vaccine-policy-left-thousands-kids-paralyzed

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