A deadly new strain of mpox that emerged in Central Africa has spread in the continent and beyond. This year's major outbreak started with Democratic Republic of Congo - killing at least 450 people - and spread to other areas in Central and East Africa. The Clade 1B strain that is behind the current outbreak is now spreading its wings to countries outside Africa. Sweden and Pakistan recorded their first cases of the highly infectious form of mpox, earlier known as monkeypox . The World Health Organization has declared the ongoing mpox outbreak in Africa a global health emergency, which is the highest level of alarm under international health law. Before that Africa Centres for Disease Control and Prevention had declared a public health emergency for the continent.
The last time mpox was declared a global health emergency was in the year 2022. There are two main strains of the virus, known as Clade I and Clade II. The 2022 outbreak was caused by clade II, which is endemic in West Africa. The WHO's decision was made after mpox spread to a dozen other African countries, fearing the virus may wreak havoc globally.
Animals to humans
"Human-to-human transmission can occur through close contact, including intimate or sexual contact, with a person who has mpox. This includes touching, hugging, kissing, or sharing utensils and clothing. Additionally, mpox can spread through contact with contaminated materials, such as bedding, towels, or surfaces that have come into contact with the virus, says Dr Nasiruddin G, Consultant-Internal Medicine, Fortis Hospital, Cunningham Road. Dr Laxman Jessani, Consultant Infectious Diseases Apollo Hospitals Navi Mumbai explains how mpox human-to-human transmission happens:
Covid Done, New Virus Emerges: 100s Killed, WHO Declares Global Health Emergency | Mpox Explained
Swedish health officials said Thursday they have identified the first case of a person with the more infectious form of mpox first seen in eastern Congo, a day after the World Health Organization declared the outbreaks there and elsewhere in Africa to be aglobal emergency.
The Swedish public health agency said in astatementthe patient recently sought health care in Stockholm.
In this case a person has been infected during a stay in the part of Africa where there is a major outbreak of (the more infectious mpox), the agency said.
Magnus Gisslen, a state epidemiologist with the Swedish health agency, said the person had been treated and given rules of conduct.
The fact that a patient with mpox is treated in the country does not affect the risk to the general population, Swedish officials said, adding that experts estimate that risk to be very low. They said, however, that occasional imported cases may continue to occur.
Earlier this year, scientists reported theemergence of a new formof the deadlier form of mpox, which can kill up to 10% of people, in a Congolese mining town that they feared might spread more easily. Mpox mostly spreads via close contact with infected people, including through sex.
WHO said there have been more than 14,000 cases and 524 deaths in more than a dozen countries across Africa this year, which already exceed last years figures.
So far, more than 96% of all cases and deaths are in a single country Congo.
Given the resources in Sweden and other rich countries to stop mpox, scientists suspect that if new outbreaks linked to Congo are to be identified, transmission could be stopped relatively quickly.
A new version of the mpox virus has emerged in Central Africa, spreading among children and adults in the Democratic Republic of the Congo and neighboring countries.
Infection with mpox causes a pus-filledskin rash lasting up to fourweeks, which can be very painful.
But what symptoms should we look out for and what can we do to reduce the risk of infection?
You might have heard of mpox with its former name monkeypox. Mpox is an infectious disease caused by the monkeypox virus.
The virus was first discovered in 1958 in Denmark, when an outbreak that resembled smallpox was described in monkey colonies kept for research.
Although it is called "monkeypox virus," the original source of the virus is still unknown. Researchers suggest that rodents or small mammals, like squirrels andprimates,might harbor the virus.
Mpox cases outside regions likeCentral and West Africa,where the virus is endemic, have historicallybeen rare and were usually linked to travel or imported animals.
In the span of two years, however, the WHO has twice declared the spread of mpox a global health emergency.
In 2022, mpoxspread to more than 70 countries that hadn't reported cases previously.
This year, a new mpox variant caused a surge of cases and deaths inCongo and in neighboring countries, causing WHO to again declare the spread of the virus an emergency with international concern.
The virus can enter the body through broken skin, mucous membranes (such as the eyes, mouth and nose) and through the respiratory system.
You can get infected by coming into close contact with people with mpox, such as skin-to-skin contact during kissing, hugging, sex (oral, anal or vaginal) and massages.
Prolonged face-to-face interactions with someone with mpox (like talking or breathing)can cause infection from respiratory droplets carrying the virus.
You can also get mpox from an infected person's body fluids through shared sex toys, bedding or towels. Pregnant people can pass the virus to their baby.
If you are in direct contact with infected animals, you can also contract mpox. This includes skinning, cooking, eating and hunting infected animals or getting bitten or scratched.
An infected person can pass on the virus even before symptoms start, and transmission can continue until all skin lesions are healed and a new layer of skin has formed. This can take weeks.
The viral infection usually begins with a rash that can be located near the anus or genitals, or on the chest, face or mouth. The rashcan then extend to the palms of the hands and soles of the feet and other parts of the body.
The rash can be painful and itchy and resemble pimples or blisters at first, which go through several stages before the scabs fall off.
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Flu-like symptoms can start before or after the rash. Those include fever, headache, swollen lymph nodes, muscle aches or chills. Some people report difficulty peeing and a painful swelling of their anus.
Symptoms usually start within 21 days of exposure to the virus.
Dangerous complications can occur when the lesions become infected, leading to abscesses.
Other complications can include severe dehydration caused by diarrhea or vomiting, pneumonia, inflammation of the brain (encephalitis) or the heart (myocarditis) and others.
People who are immunosuppressed because of medical conditions or medication are at higher risk of complications from mpox.
Sex workers,health care workers and people who have multiple sexual partners are at a higher risk of contracting mpox.
According to the US Centres for Disease Control and Prevention, those at risk also include pregnant people, children younger than one,and people with a history of eczema.
During the 2022 outbreak,manypeople who initially presentedsymptoms were mainly, but not exclusively, men who have sex with men.
However, the World Health Organization has pointedout that anyone who comes in contact with a person infected with mpox can get infected themselves, regardless of sexual orientation.
Most people recover from mpox in two to four weeks. If you or your partner has mpox, avoiding having sex, touching or kissing can reduce the risk of spread.
The Centres for Disease Control and Preventionrecommends avoiding close contact with people who have a visible rash at parties, clubs and festivals, where little clothing is worn, and skin-to-skin contact happens often.
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Having fewer sexual partners and using condoms also reduces the risk of infection. However, condoms don't prevent infection if you come into contact with lesions or body fluids from other parts of the body.
The CDC has also warnedagainst touching objects handled by a person with mpox, including utensils, towels and bedding, and urged frequent hand-washing.
You can also get vaccinated, although this may not be a current option in your region and might depend on your risk of complications and exposure.
In the US for example, people at high risk of infection or complications can get theJynneos smallpox vaccine to help prevent mpox.
Because the mpox and smallpox viruses are genetically similar, vaccines that are used to prevent smallpox can also be administered to protect from mpox infections.
Edited by: Martin Kuebler
Sources:
Amer F, Khalil HES, Elahmady M, et al. Mpox: Risks andapproaches to prevention. Journal of Infection and Public Health. Published June 2023. https://doi.org/10.1016/j.jiph.2023.04.001
Centers for Disease Control and Prevention (CDC). Mpox and Your Health. Published September 13, 2022. https://www.cdc.gov/poxvirus/mpox/your-health/index.html
Robert Koch Institute, Federal Center for Health Education, Berlin, Cologne. Flyer, transmission and prevention of mpox. Published February 13, 2023. https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/Monkeypox/Mpox-Flyer_EN.pdf
van Ewijk CE, Miura F, van Rijckevorsel G, et al. Mpox outbreak in the Netherlands, 2022: public health response, characteristics of the first 1,000 cases and protection of the first-generation smallpox vaccine. Eurosurveillance. PublishedMarch 2023. https://doi.org/10.2807/1560-7917.es.2023.28.12.2200772
World Health Organization (WHO). Mpox questions and answers. Published December11,2023. https://www.who.int/news-room/questions-and-answers/item/monkeypox
EU countries should issue travel advice for areas impacted by mpox, European health authorities said, after the virus outbreak was declared a global emergency.
European health authorities warned on Friday that it is "highly likely" Europe will see more imported cases of mpox due to the virus spread in multiple African countries.
The European Centre for Disease Prevention and Control (ECDC) said, however, that "the likelihood of sustained transmission in Europe is very low" if imported cases are diagnosed quickly and measures are taken to control them.
The change to Europe's risk assessment also came a day after Sweden detected the first case of a new variant, that is likely more transmissible, outside Africa.
"We have seen, a worsening of the epidemiological situation in Africa with transmission occurring in neighbouring countries of the Democratic Republic of the Congo (DRC)," Bruno Ciancio, head of surveillance at the ECDC, told Euronews Health, adding that the number of cases there is likely underestimated.
"This means there is an increased risk that cases coming from Africa are imported into Europe," he added.
"This is basically why we have updated our risk assessment to make sure that we are prepared, that the European Community is prepared, to rapidly identify imported cases and prevent any further transmission".
Mpox has been spreading since last year in the DRC and has been detected in multiple African countries. The virus has so far killed more than 500 people, mostly in the DRC.
The World Health Organization (WHO)declared the mpox outbreak in Africa a global health emergency earlier this week, calling for a coordinated international effort to address the crisis.
In a new risk assessment for Europe on Friday, the ECDC recommended that European Union and European Economic Area (EEA) countries issue travel advice for people visiting areas impacted by mpox.
"The likelihood of infection for people from the EU/EEA travelling to affected areas who have close contact with affected communities is high," the ECDC said in a statement.
"Additionally, there is a moderate risk for close contacts of possible or confirmed imported cases into the EU/EEA," the health agency added.
There are two subtypes of the mpox virus. Clade I, which is endemic in central Africa, is thought to cause more severe illness and higher mortality than clade II, which caused the 2022 global mpox outbreak and continues to circulate in EU countries.
Multiple African countries are currently dealing with an outbreak of clade I and a new strain related to it called clade Ib.
"What we know is that mpox clade I has been circulating in Africa for several decades, but it was only recently that we observed these very large outbreaks around the epicentre and in neighbouring areas and countries. So this may imply a change in the level of transmissibility which may be related to the genetic evolution of the virus," Ciancio told Euronews Health.
He added that while historically clade I has been seen as more severe, it could be that only the severe cases are being tested and that more information about the virus is needed.
Sweden's public health agencyreported the first imported case of clade Ib in Europe this week.
"As a result of the rapid spread of this outbreak in Africa, ECDC has increased the level of risk for the general population in the EU/EEA and travellers to affected areas," Pamela Rendi-Wagner, director of the ECDC, said in a statement.
"Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases".
While European health authorities say that the impact of clade I will be low in Europe, they recommend "high levels of preparedness planning and awareness-raising activities" to handle cases that reach Europe.
This includes effective surveillance, testing, and contact tracing to detect cases of mpox in Europe.
The ECDC also recommends that travellers to areas impacted by mpox look into getting vaccinated.
Clinicians should be made aware of the possibility of seeing mpox cases, according to Ciancio, as the disease is not endemic in Europe.
He highlighted, however, that the risk should not be overestimated.
"We are dealing with a disease that we already know, for which there [is] a vaccine, which has proven effective and safe," he said.
This story has been updated with quotes from an interview with an ECDC expert.
Trupanion, a Seattle-based pet insurance company, is partnering with the Centers for Disease Control and Prevention to create a disease tracking system for pets, the company announced this week. The system will draw on insurance claims submitted to Trupanion in real time when sick dogs and cats visit the veterinarian.
The concept is to proactively detect potential threats to pets and public health, said Dr. Steve Weinrauch, the chief veterinary and product officer at Trupanion.
The effort, which also includes academic scientists and other companies in the pet industry, is still in its early stages. Initially, it will focus on bird flu, a virus that has been spreading through American dairy cows and spilling over into domestic cats.
This is a really important public-private partnership that is going to help fill some important gaps, said Dr. Casey Barton Behravesh, who directs the C.D.C.s One Health Office, which focuses on the connections between human, animal and environmental health.
Its one of several ongoing efforts to address such gaps, which extend far beyond bird flu. Like most other countries, the United States has no comprehensive national system for tracking diseases in pets. While the C.D.C. is charged with protecting human health and the Department of Agriculture focuses on farm animals, companion animals tend to fall through the cracks.
This is a population that is a little bit lost in the shuffle, said Dr. Jennifer Granick, a veterinary internist at the University of Minnesota, who is one of the founders of a separate effort to create a disease surveillance system for pets.
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Status of HPAIv
Understanding the timing and distribution of virus spread is critical for global commercial and wildlife biosecurity management. The current global HPAIv panzootic poses a serious threat to animals and public health, having affected approximately 600 bird and mammal species globally and over 83 million birds across North America as of December 2023. Of particular concern is the transmission of the virus to mammals, including the recent discovery of infections in dairy cattle in the U.S. and the detection of HPAIv in milk, posing a significant human health concern.
While previous studies linked bird migrations to avian flu outbreaks at poultry farms, only one earlier study by USGS authors predicted the virus could spread to cattle. It found wild waterfowl moving between natural wetlands and cattle facilities, likely attracted to supplemental water and food sources when natural resources dwindled along the Pacific Flyway.
The study combined extensive, long-term GPS tracking data from 16 species of wild waterfowl across North America with on-ground, county-level HPAIv surveillance data to understand the overlap of waterfowl and HPAIv detections. The researchers were also able to predict future outbreaks in counties and provincial areas through bird movements using a novel empirical SI (Susceptible-Infected) model, similar to the SIR (Susceptible-Infected-Recovered) model used to model COVID disease dynamics, via exposed migratory waterfowl.
The SI model projected exposure of up to 100% of birds via outbreak exposure in counties with HPAIv occurrence during spring migration, except for Pacific flyway birds, which were predicted to experience widespread arrival of HPAIv via birdbird exposure (up to 100%) during fall migration. The SI model accurately predicted HPAIv arrival in all flyways by migratory waterfowl, raptors, and other birds but was a lagging indicator for commercial facilities, Pelicans, and resident waterfowl/captive species in the Pacific flyway.
The US Centers for Disease Control and Prevention (CDC) late last week published its assessment of the H5N1 avian influenza virus that infected a dairy worker in Texas, putting its risk to the general public as low and its risk as a potential pandemic virus as moderate, similar to that posed by two other recent 2.3.4.4b clade viruses.
Health officials had announced in May that the CDC had started the detailed process of conducting a pandemic risk assessment using its Influenza Risk Assessment Tool (IRAT). With IRAT, CDC scientists' goals are answering two risk assessment questions, one on emergence and the other on public health impact. Health officials use IRAT to gauge the pandemic potential of flu viruses and to guide preparedness measures.
The CDC has published two previous assessments for viruses from the 2.3.4.4b clade, one in July 2023 for the H5N1 virus that triggered an outbreak at a Spanish mink farm and the other in March 2022 fora sample from a wigeon duck collected in South Carolina in 2021 when the virus first began circulating in US wild birds.
Like the other two recent 2.3.4.4b viruses, the subtype that infected the Texas patient is in the moderate risk for both future emergence and public health impact.
CDC experts submitted the scores for the virus from the Texas patient on June 26, which include information from other US cases but not the most recent ones reported in Colorado poultry workers.
The CDC said the Texas virus scored slightly higher on some risk elements, but lower on others compared to other recent 2.3.4.4b strains. The newer virus had a public health impact score similar to the Spanish mink farm virus, but it had a higher emergence score than the other two viruses.
"However, the mean-high and mean-low acceptable score ranges for these viruses overlap, indicating that these viruses remain similar, and their overall risk scores remain 'moderate,' " the group said.
Compared to 15 other viruses on the CDC's IRAT list, the Texas virus has the sixth-highest emergence score and the seventh-highest public impact score.
In other H5N1 developments, the Colorado Veterinary Medical Association recently warned animal health providers about potential infections in cats, even if all the risk factors or clinical signs aren't present.
Of six H5N1 confirmations in Colorado cats so far, only one was directly linked to a dairy farm. Three were indoor cats that had access to the outdoors and could have hunted mice or birds, and two were exclusively indoor cats.
Five had similar symptoms, which started with lethargy and poor appetite and progressed to respiratory and neurologic symptoms. Several were tested for rabies, owing to a similar clinical picture.
DENVER For months, avian influenza better known as bird flu has been detected in cattle and chickens across Colorado but it has now spread to at least six domestic cats, according to the Colorado Department of Public Health and Environment (CDPHE).
One of those infected cats was "directly associated with a known infected commercial dairy facility," two other cases were "indoor only cats with no direct exposure to the virus," and the three remaining were known "indoor/outdoor cats that hunted mice and small birds, but also spent time inside with their owners," the CDPHE said.
At least three of the cats infected with bird flu were in Larimer County, according to the U.S. Department of Agriculture's Animal and Plant Health Inspection Service. A fourth cat case was found in Adams County and a fifth in Morgan County.
Denver7 has followed how the bird flu has developed around Colorado in recent months:
Dr. May Chu, epidemiologist at Colorado's School of Public Health, said the infected cats that spent time both outside and inside could have been infected by other animals.
"It's very likely that the cats who wander off or wander out may have caught a deer mouse or some kind of forage that they go through and they pick up something from an infected rodent," Dr. Chu said.
Dr. Gina Rodriguez, medical director at Evans East Animal Hospital, said symptoms look like a common cold.
"It can be as vague as lethargy, which is just kind of feeling under the weather," she said. "So, sneezing, eye discharge, nose discharge, coughing."
The six domestic cats were only diagnosed after they were tested for rabies first, explained Dr. Rachel Herlihy, state epidemiologist with the CDPHE.
"We know that rabies causes neurologic symptoms, and so that can include things like lack of coordination, inability to stand, tremors, or even seizures might occur in cats and so those are the same types of neurologic symptoms that can be seen in this H5N1 influenza infection," she said.
Dr. Rodriguez said she hasn't seen or heard of any cases in the Denver area, and both Dr. Herlihy and Dr. Chu told Denver7 these infections aren't something cat owners should panic about at the moment.
The cases are rare right now, Dr. Herlihy said, but added that cat owners should stay vigilant, especially for those who work or live near dairy farms.
There has been no transmission from infected cats to humans, she said.
"When we talk about risk to pets, we know that pets have very close contact with humans, so it's important to know that no human cases of this virus have been linked to exposure to infected cats, so we haven't seen cat-to-human transmission, so that's really important to know," she said. "But we do want people who may have contact with a cat that is suspected to have this infection to take the same precautions we are asking workers on farms to take, and so that's going to include things like PPE wearing masks, gloves, eye protection."
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For a little over three years now, scientists have been tracking a genetically distinctinfluenza virus, originally affecting birds (avian influenza) and mammals in the Americas (Figure 1), that is now causing a widespread outbreak in cattle across the United States (US). Reports of 13 human cases from close contact with dairy animals in the US have cast a spotlight on the evolving nature and zoonotic potential of avian influenza viruses. These reports have also raised an alert in organisations working on pandemic preparedness across the world, advocating close monitoring and assessment of current threat levels. While the current avian influenza outbreak in the US poses a low public health threat due to limited human-to-human transmission, we should be attentive to the potential of this zoonotic virus to cause significant disruptions.
A salient feature that puts this family of influenza viruses in the pandemic watchlist is their ability to cross-species boundaries and mix up their genomes, while continuing to accumulate mutations. These changes can result in viruses that are so different from the circulating/past influenza viruses that previous exposures or vaccinations may no longer work, or the virus may even be able to infect a completely new host with no existing immunity to this virusresulting in outbreaks and the threat of a pandemic.
Figure 1: Avian Influenza detected in mammalian species across the world
Source: WOAH
Since early 2022, numerous mammalian species around the world have succumbed to avian influenza, caused by the Highly Pathogenic Avian Influenza (HPAI) H5N1 sub-type of Influenza A viruses. While the primary targets/hosts of HPAI H5N1 (one of the types of the avian influenza virus) are birds, massive deaths of elephant seals and sea lions as a result of an H5N1 outbreak were reported from South America in 2023. As the virus continues to mutate and adapt, monitoring these cross-species transmissions becomes ever more critical.
Figure 2: Countries that reported human Avian Flu H5N1 cases to WHO between 2022-2024
Source: WHO andCDC
The transmission of the H5N1 virus to humans is rare (Figure 2), typically requiring close contact with infected birds or animals and their secretions. In the 2024 outbreak of bovine HPAI H5N1 affecting 171 cattle herds across 13 states in the USA only 13 cases have been confirmed, and there has been continuous monitoring of people who have interacted closely with animals. The detection of the virus in unpasteurised/raw milk has added another layer of complexity. Although this might sound alarmingheat inactivates the virus in milk, making pasteurisation an effective safeguard.
Another intriguing feature of the bovine HPAI H5N1 outbreak in the USA is its genetic distinctiveness. The virus strain causing the outbreak in the Americas belongs to clade 2.3.4.4b, setting it apart from its Southeast Asian counterparts. The expansion of this strain likely began with a single introduction from an infected bird in late 2023 or early 2024. This genetic insight has real-world implications for tracking and controlling outbreaks.
Genetic sequencing of viruses from the human cases of bovine HPAI H5N1 would help address these questions.
Since the range of animals that can be infected by a virus depends on whether or not they have the right binding partner for the virus, changes in what a virus binds to are important to monitor for understanding receptor affinity. A study published in July 2024 found that a HPAI H5N1 virus isolated from a cow from the US 2024 cattle outbreak, was able to bind to the sialic acids expressed in the human upper respiratory tract. If this change is seen frequently it could have implications for human infections. It is also important to monitor the genomes of bovine HPAI H5N1 viruses for emergence and expansion of other mutations that facilitate replication and transmission in mammals. Genetic sequencing of viruses from the human cases of bovine HPAI H5N1 would help address these questions.
From a preparedness standpoint, many countries do have stock-piles of the H5N1 vaccine. A study published in July 2024 confirmed that these vaccines, derived from earlier strains of HPAI H5N1, generated cross-neutralising antibodies against the circulating H5N1 clade 2.3.4.4b viruses, with seroconversion rates of 60-95 percent in vaccinated individuals after 2 or 3 doses of the vaccines. This suggests that these stockpiled vaccines could serve as bridging vaccines until updated H5N1 vaccines become available. Not all countries have a national stockpile nor is the global capacity currently sufficient for scaling emergency vaccine production and equitable distribution. As part of the Pandemic Influenza Preparedness Framework, the WHO has launched an initiative to advance mRNA vaccine development against human avian influenza. Additionally, Oseltamivir (brand name Tamiflu) which has been used in the treatment of human influenza viruses, is currently being recommended for both the treatment and post-exposure prophylaxis of HPAI H5N1 in the US.
The limited availability of genetic data from these outbreaks hampers our ability to understand the local circulation of the virus and monitor its evolution.
Globally, avian influenza outbreaks in birds are a regular occurrence. In India several states, including Andhra Pradesh, Maharashtra, Kerala, and Jharkhand, are grappling with ongoing outbreaks in birds. While there have been no human cases of H5N1 reported in India, a case, of H9N2 was recently confirmed in West Bengal. The limited availability of genetic data from these outbreaks hampers our ability to understand the local circulation of the virus and monitor its evolution. This gap in data means that we do not know if the avian influenza H5N1 clade 2.3.4.4b is present in India nor do we have adequate genomic surveillance in place to monitor introduction and spread.
On the other hand, India is a long-standing contributor to WHO's Global Influenza Surveillance and Response System (GISRS), with National Institute of Virology recognised as a WHO National Influenza Centre (NIC) since 1980. India also has at least three (as of 2019) manufacturers of influenza vaccines and multiple companies that produce generic versions of Tamiflu.
A key gap for a public health response is going to be the absence of timely surveillance data signalling a local outbreak. This is primarily due to two reasons, one being the non-availability of H5N1 diagnostic kit and the other being delays in genomic sequencing. India does have an Action Plan for Prevention, Control and Containment of Avian Influenza (2021) with a focus on animals. Towards the end of 2023, the WHO organised a regional workshop on Preparedness and Resilience for Emerging Threats (PRET) Initiative. Subsequently India initiated the development of a National Preparedness Plan for Respiratory Viruses in alignment with WHO-PRET. If the technical packages and proposed networks assist with simulations and drills for testing the system, it could prove to be an invaluable framework helping the country address gaps in preparedness.
India does have an Action Plan for Prevention, Control and Containment of Avian Influenza (2021) with a focus on animals.
Indias pandemic threat level from bovine HPAI H5N1 does seem low from the available data. However, India has one of the largest livestock populations in the world. Consequently, the situation across the world does warrant a call for an integrated effort with transparent data sharing among stakeholders both in animal health and public health. Multiple initiatives such as the One Health framework being formed in are key in developing tools and strategies for early detection of an outbreak, preventive measures and an outbreak response that spans/considers multiple species.
Chitra Pattabiraman is a virologist/molecular biologist who consults with multiple organizations on projects related to infectious disease, diagnostics, emerging infections, environmental surveillance, animal health and public health in India.
Siva Athreya is a Professor at the International Centre for Theoretical Sciences-TIFR.
