Avian Influenza: keeping careful watch to keep the EU safe

Avian influenza is in the news again. Should we be worried?   

Francisco: The avian influenza virus is now being found in many parts of the world, also where it was never seen before, like Antarctica. And in areas where it has historically created problems for poultry farmers, like in the USA and in Europe, it is not following its usual seasonal pattern. This warrants close attention. 

In Europe, however, we are actually seeing less circulation of the virus. Our experts  at the European Centre for Disease Prevention and Control  (ECDC), the European Food Safety Authority (EFSA) and the European Union Reference Laboratories (EURL) reported significantly fewer inflected wild birds last season, and much fewer infected poultry farms, thanks to enhanced preparedness and prevention.  

The specific strain (H5N1 HPAI virus) now seen only in the US has infected wild birds, poultry and has also affected mammals. In close cooperation with the US authorities, we are carefully monitoring this strain, and our EU Reference Laboratory has analysed its genetic characteristics. Although this strain has spread in the US, it has never been detected in the EU.    

That said, we have to remain vigilant. But we also have reason to remain optimistic. The EU is well equipped, legally and operationally, to react if and when avian influenza viruses pose any risks for animal or public health.   

What is the Commission’s stance on the vaccination of birds and animals in the EU?  

Francisco: In 2023, the Commission provided to the legal instrument enabling vaccination of birds against HPAI, enlarging the EU disease prevention and control “toolbox” to ensure that Member States have the best science-based options available to respond to their epidemiological situation and local circumstances. The EFSA recently published a new scientific opinion on vaccination against HPAI, which further helps us to adapt our vaccination strategies to be even more efficient and effective.  

France, the Netherlands and Spain have already made use of vaccination to address their specific needs, and all Member States have even more options now that the European Medicines Agency has granted more marketing authorisations for new vaccines for use in birds.     

How do you assess the risk of highly pathogenic avian flu (HPAI) to EU citizens? How has the EU responded to the human cases reported in the USA?

Ingrid: The risk for the EU/EEA is assessed by the ECDC, which considers it at the moment to be low for the general population and low-to-moderate for individuals who may be directly exposed to infected animals, such as farmers. The ECDC monitors the situation continuously and updates its risk assessments accordingly.  

Close monitoring is essential. Well-functioning, integrated surveillance among humans, animals and the environment, following a One Health approach, is vital to allow early warning. Sporadic cases of avian flu in humans have been reported over the years across the world, with symptoms ranging from very mild to very severe, and half of all cases have been fatal. To date, there have been no confirmed cases of A(H5N1) avian flu infection in humans in the EU/EEA.  

Just recently, we invited the U.S. authorities, as well as WOAH and WHO, to present their testing and preparedness activities at the joint meeting of the EU Health Security Committee and EU Chief Veterinary Officers on 24 May. So far, thankfully, the three human cases reported in the U.S. were very mild, but we continue to monitor the situation very closely. ECDC is advising that testing can be considered for all people exposed to potentially infected animals, not only those who then develops conjunctivitis or respiratory symptoms.  

What is the best way to respond to any threat of HPAI?  

Ingrid: Last December, the EU Health Security Committee adopted the Opinion on zoonotic avian influenza, which gives clear direction on what actions to take. The most important is to strengthen early warning surveillance systems to detect any signal which might suggest HPAI has become transmissible to humans, especially if it has spread person-to-person. That’s why the ECDC released updated guidance for surveillance last summer. We are following up with Member States in the EU Health Security Committee, in cooperation with the WHO Regional office for Europe, on its implementation.  

Another key tool under the One Health framework is the rapid exchange of information on HPAI cases in animals, including mammals, needed to perform genomic surveillance. We need to be able to identify any mutation that might be able to spread to  humans and any associated resistance to antivirals or vaccines. Since people exposed to the virus due to their occupation are at greatest risk, the ECDC guidance recommends considering active surveillance, like testing exposed individuals even if they are asymptomatic, taking preventative measures such as post-exposure prophylaxis, like administering antivirals even if no infection has been detected, and/or using vaccination among risk groups.  

A valuable addition to this toolbox is a new Global Health Security Initiative working group on respiratory infections with pandemic potential that is making it easier for G7 countries to exchange information quickly.   

What cooperative  measures are taking place globally?

Ingrid & Francisco: Avian Influenza is constantly monitored  by the World Organisation for Animal Health (WOAH)/Food and Agriculture Organization of the United Nations (FAO) global network of expertise on animal influenza. 

Last month, WOAH and the FAO launched the Global Strategy for the Prevention and Control of High Pathogenicity Avian Influenza (2024-2033), developed under the Global Framework for the Progressive Control of Transboundary Animal Diseases. This strategy, an update of its 2008 precursor, presents the animal health sector component of a wider One Health approach and complements the WHO Global Influenza Strategy 2019-2030. 

The strategy aims to substantially reduce impacts of HPAI on poultry, make poultry agrifood systems more resilient, and protect domestic animal, wildlife and human health. It envisions a world with effective HPAI prevention and control along poultry value chains that supports protection of humans, animals, and the environment, and aligns with the sustainable transformation of agrifood systems.