UH Mānoa duck tests preliminarily positive for Avian Influenza

On October 14, the Hawaiʻi Department of Health announced that a duck found on the UH Mānoa campus had preliminarily tested positive for H5N1 — a variant of Avian Influenza.

The sick duck was quickly removed from the campus to prevent other animals and the public from possible exposure. Sadly, the bird did not survive; the remains are being kept for further testing according to the Department of Health.

H5N1 Avian Influenza is very contagious among wild birds and poultry, however transmission from birds to humans is still rare. Most bird-to-human cases have occurred in individuals who had come in direct contact with an infected animal.

One unusual trait of this type of Avian Influenza, according to Virginia S Hinshaw Ph.D., a University of Hawaiʻi professor with over 20 years of experience researching influenza viruses, is the virus’s broad host range, including over 170 avian species, as well as farm animals, pets, wild mammals, and marine mammals.

2022 saw the first confirmed human case in the United States. Since then, there has been 70 confirmed cases around the country and 1 death, according to the CDC.

Hawaiʻi Department of Health Deputy State Epidemiologist, Dr. Nathan Tan described one of his worries, “it's not a subtype of flu virus that we see commonly circulating. We don't have H5N1 circulating within humans. So if it were to gain the ability to transmit amongst humans, we probably wouldn't have immunity to it.”

Additionally, The Deputy State Epidemiologist warned of the potency of the virus “The rare cases in which they (humans) get infected, there's a high proportion, there's a large number of people that get severely ill or die.”

Although H5N1 can cause infection in humans it does not spread easily and has not shown human-to-human transmission capabilities.

Professor Hinshaw described another concern of the virus, “Influenza is a champion of change. The virus itself mutates a lot; it's a very sloppy virus, and mutants tend to come out fairly readily, and that's just genetic mutations as often as it replicates, and that's the problem. It's not unlike COVID in that regard — it mutates a lot.”

Furthermore, a process known as genetic reassortment occurs as influenza viruses spread between species. In the rare circumstance that a host is infected by both Influenza and another virus in the same cell, the viruses can swap genes, producing a different genetic combination. If the new combination includes a gene that humans do not have immunity to, it could gain the ability to transmit efficiently between humans.

At the moment, the current risk to the public of H5N1 is considered low. Deputy State Epidemiologist Dr. Nathan Tan explained the reason being due to the limited number of infections worldwide, the lack of human-to-human transmission and analyses of the genomic makeup not indicating high transmissibility between humans.

However, certain groups may face a higher risk. Those who work in poultry operations or are often in close contact with birds should be aware of the proper procedures to take when coming in contact with these ailing birds.

Although the general publicʻs risk level is low at this time, it's important to stay vigilant. “Now, if we got reports worldwide in which there was sustained human to human transmission, that would change the risk. That would certainly change the risk profile, but we donʻt have that signal.” Dr. Nathan Tan said.

He further ensured that although the risk is low, the Department of Health is working hard to protect the public, and keeping a close eye on viruses that have potential to be a major public health threat in the future.

Surveillance is a critical tool in preventing the progression of the virus. Professor Virginia Hinshaw spoke on the key to curtailing the virus. “We have to monitor the populations that are exposed, and of course certainly look if we have any humans exposed to monitor people in contact with them and I personally think they should prepare a vaccine for prevention purposes.”

Although there is currently not a vaccine for H5N1, Dr. Nathan Tan of the Department of Health is confident that “if this were to become a more significant public health issue, that within short order, a vaccine could be available for the public.”

Another concern for local residents is the safety of our native bird population. Professor Hinshaw spoke on the risk to local bird populations. “What's worrisome is that it's shown up in these mallards on our islands and they aren't migrants, they live here. So you worry about it getting established in the bird population here, and then that exposes our migrant birds and our native birds and that would be the worry”

Between mid-September to mid-December is the seabird fallout season. A time when young seabirds leave their nests for the first time. This might be a time where people are more likely to come across an ill Seabird warns Dr. Tan, “we want to try to give them the best chance to get you know, to make it. And so you can contact the Department of Land and Natural Resources to get advice about how best to help those little, those young seabirds”

It is recommended to not touch any sick or dead bird with bare hands. If there are unusual circumstances or multiple sick or dead birds the Department of Agriculture and Biosecurity should be contacted for further guidance.

Deputy State Epidemiologist Dr. Nathan Tan ensured that “Avian influenza is certainly a public health concern and the Health Department is prioritizing identifying potential infections and responding to it and controlling it so that it does not pose a greater threat to the community.”

However, he encouraged the public not to worry as the current risk level remains low. “Its something to be aware of, but it's not something to lose sleep over.”

Professor Virginia S. Hinshaw shared a similar sentiment promoting awareness, “I want them (the public) to know that it is a risk, and we have to continue to do surveillance and research to hopefully prevent a human pandemic.”