An elderly man in the US state of Louisiana died on Monday of bird flu contracted from exposure to sick and dead chickens in his backyard flock, becoming the country’s first fatality from the disease.
But what has really set the alarm bells ringing is that samples collected from him suggested that the virus may have acquired the ability to attach itself to cells in the human upper airway. And the New England Journal of Medicine has just reported that a similar mutation had been found in a desperately ill 13-year-old girl in hospital in Vancouver, Canada.
This could mark the first stage in something that scientists have long dreaded: the bird flu virus evolving to pass easily between people.
For if that happens, we face a pandemic likely to dwarf the death toll wreaked by Covid-19.
The last time there was a bird flu scare was in 2004 when an 11-year-old Thai girl passed the virus to her mother and aunt in the first known human transmission, the British cabinet was officially informed that it posed as great a threat as terrorism.
Emergency services were quietly told to prepare for 750,000 deaths and scoured the country for sites that could serve as mass mortuaries.
Poultry has been badly hit in North America where the new threat originates. And the virus has also spread widely among mammals: mice, mink, squirrels, goats, foxes, otters, bears, mountain lions, seals, dolphins and domestic cats are among those infected.
Zoos have been hammered too. Just two weeks ago over half the big cats in a Washington sanctuary died.
Cows infected with birdflu lie dead at a farm in Tulare County, California
A scan of the virus which killed an elderly man in the US state of Louisiana on Monday
Worse, the flu is now out of control among cattle. Some 900 herds across 16 US states have tested positive and California has just declared a state of emergency.
Meanwhile, as the Daily Mail reported last month, 66 Americans have been found with the disease – up from just two in the previous two years.
The good news is that almost all were infected directly by hens or cattle, rather than fellow humans, with exceptionally mild disease.
But our luck may be running out, thanks to the mutations found in the Louisiana pensioner and the Vancouver teenager – who has been in hospital since November after contracting bird flu from an as yet unknown source.
The virus needs to continue to evolve before it becomes an existential threat but its progress is already causing grave concern.
Professor Michael Osterholm of the University of Minnesota, one of the world’s leading flu experts, likens it to unlocking a door. The virus may not yet be in a position to open it but it has now made a key that fits into the lock but does not turn.
Fortunately, the latest mutation appears to have happened inside both patients and so, experts hope, is not out in the wild, infecting others.
But it has proved that the virus can change in ways that bring a human pandemic closer. And the more people that catch it, the more likely it is that the further mutations needed to bring it about will occur.
Poultry has been badly hit in North America where the new birdflu threat originates
The spread of the virus among American cattle multiplies the danger sevenfold, experts say. The virus gets into cows’ milk in what normally sober scientists call ‘mindblowing’ and ‘astronomically high’ amounts.
Pasteurisation kills it, but raw milk has become increasingly fashionable in the US, with 2.5million people drinking it weekly. Cats have already suffered brain damage and died from consuming it.
And the risks rise enormously during a normal flu season, as is now raging, when bird flu could combine with the seasonal disease, gaining its virulent infectivity through coughs and sneezes.
Once a pandemic begins it is extremely hard to stop. No-one knows how deadly it would be, but the signs so far are ominous. Nearly half of the 900 people to have caught bird flu worldwide have died.
That appalling death rate would doubtless drop as infections spread, not least because the virus would need to leave enough people alive to pass it on. Perhaps we would be lucky. But some scientists fear a death rate of 25-30 per cent. By comparison, Covid’s was just 1 per cent.
The consequences in terms of human lives, health services and national economies would be so massive that you might think governments worldwide would be rushing to take precautions. Nothing could be further from the truth.
The Biden administration has been asleep at the wheel during the US cattle crisis. It failed to tackle the virus when it was confined to a few farms and only began testing milk this month, almost a year after the outbreak began.
And, although a vaccine offering partial protection exists, the authorities have refused to immunise farmworkers – the section of the population most at risk. Dr Deborah Birx who coordinated the Trump administration’s Covid response, says the US has ‘its head in the sand’.
Mind you, the incoming Trump team looks even more complacent. Robert F Kennedy Jr, his pick for the health portfolio, has sworn to make raw milk more available (he says it’s the only kind he drinks himself) and promised to take ‘a break’ from focusing on infectious disease for eight years. He adds that he will not prioritise vaccines in the event of a new pandemic.
Meanwhile the incoming president has vowed to axe the White House preparedness office.
Internationally, there is no surveillance that could pick up human outbreaks in time, and negotiations on strengthening health systems against a pandemic have stalled. Experts say the world is now less prepared than before Covid.
At least Britain bought over five million doses of the bird flu vaccine last month, but that is far from enough, while the Covid inquiry has exposed vast gaps in our pandemic defences.
Sir Keir Starmer has lost the trust needed to rally the nation, while Health Secretary Wes Streeting is beginning to gain a reputation for putting off important decisions after kicking the social care can almost out of sight down the road.
Governments now need to develop better vaccines, stockpile several antiviral drugs (since the virus may become immune to one), and work out how to distribute them fast – while laying in tests and PPE in advance.
The last time a virulent flu virus swept the world, in 1918, it killed 50million, around one in every 35 of the Earth’s population.
Experts agree that another bad one is overdue and this time it won’t make its stately way around the globe by ship. Air travel lets viruses circle the world at jet speed, reaching virtually every corner of the planet in hours rather than weeks. The death toll, in a quadrupled population since 1918, might reach hundreds of millions.
This autumn, the Global Preparedness Monitoring Board, the top international body charged with getting ready for pandemics, warned that the next one will probably ‘catch the word napping’.
Given that experts such as Dr Robert Redfield, a recent head of the US Centres for Disease Control and Prevention, now say that it is a case of when, rather than if, a bird flu pandemic sweeps around the globe, it may well turn out to be right.
