Post by Nadica (She/Her) on Jul 12, 2024 0:32:33 GMT
H5N1 avian influenza: tracking outbreaks with real-time epidemiological data - Published July 9, 2024
The avian influenza A(H5N1) virus was first identified in southern China in 1996, leading to substantial outbreaks among poultry in Hong Kong in 1997, which resulted in 18 human infections. Although the 1997 avian epidemic was controlled, the A(H5N1) virus persisted in birds and resurfaced in 2003, spreading extensively among birds throughout Asia and subsequently reaching Africa, Europe, and the Middle East, where it caused poultry outbreaks and sporadic human infections. Since 2003, more than 22 countries have reported more than 900 sporadic human cases of A(H5N1) infection to WHO (figure). The currently circulating avian influenza A(H5N1) viruses in wild birds and poultry worldwide are genetically distinct from earlier strains and became the predominant highly pathogenic avian influenza (HPAI) H5 subtype in the autumn of 2021,1 whereas the earlier strains continue to circulate at lower frequencies in several countries with few sporadic human cases globally reported. However, the clinical manifestations in humans from all avian influenza virus infections have varied widely in severity, ranging from asymptomatic2 or mild illness to severe disease resulting in death.3
The WHO guidelines4 for influenza at the human–animal border include several key recommendations. These include enhanced surveillance in human populations potentially exposed to influenza A viruses, the use of the Tool for Influenza Pandemic Risk Assessment for detailed risk assessment associated with zoonotic influenza viruses, the recommendation to avoid contact with sick or dead animals and proper cooking of poultry products, and the importance of collaboration with influenza centres of reference and timely sharing of information on viruses with pandemic potential for the development of vaccines and other public health measures.
To support global response efforts, our team created an open-access database to track avian influenza cases in different countries. We collected data from various public sources to compile a detailed list of cases, including: first, Disease Outbreak News (DON), which is the official online reporting system operated by WHO; second, reliable news websites specialising in public health and infectious disease news such as CIDRAP News or news aggregators such as BNO News, which provide flash alerts on relevant news; and third, peer-reviewed scientific papers published in high-impact journals. These data include information such as age, gender, dates of symptom onset, and laboratory confirmation, reported symptoms, geographical locations, travel history, and additional metadata defined by our data dictionary. Each potential data source is meticulously evaluated in terms of: first, credibility (ie, the source must have a proven track record of accurate and reliable reporting, for example, DON is considered highly credible owing to its rigorous verification processes); second, accuracy (ie, information must be detailed and specific, providing the complete data needed for our epidemiological monitoring, for example, peer-reviewed studies often include detailed methodologies and robust datasets that improve the quality of our database); and third, relevance (ie, information must be directly related to avian influenza outbreaks and human infections; reports that provide specific details on new cases, geographical spread, and health impact are prioritised for inclusion).
Our research team, composed of members with diverse backgrounds and expertise including epidemiologists, statisticians, bioinformatics geneticist, and researchers experienced in data analysis and management, applies a rigorous quality control process. Each set of data undergoes a two-step verification process before being made publicly available. Initially, data are reviewed by analysts for accuracy and consistency. Next, the team interviews the appropriate experts and cross-checks the data to validate them. Any discrepancies are resolved through group discussions to ensure the highest quality of data entry. In addition, periodic database audits are done to maintain data integrity.
Having a centralised and publicly accessible database facilitates data sharing and collaboration among the different actors involved in emergency response activities. This can contribute to a better understanding of the epidemiology of avian influenza, the early identification of outbreaks and trends, and the development of more effective prevention and control strategies. However, it is important to emphasise that this example is only one step in a long journey towards understanding and managing emerging and re-emerging infectious threats. This work is based on the solid background of research from our team, which was developed for epidemic control and pandemic preparedness of other infectious diseases5, 6, 7 and is part of a larger initiative.8 Our database is a contribution to the Global Avian Influenza Surveillance Network, which aims to offer an additional tool for researchers, health professionals, and policy makers to complement other resources such as the World Organisation for Animal Health (formerly Office International des Epizooties), the Centers for Disease Control and Prevention, and the Global Initiative on Sharing All Influenza Data. We hope that our efforts can serve as a basis for future studies and actions to prevent and mitigate the effect of outbreaks of avian influenza and other infectious diseases, and to improve surveillance and health responses for the protection of public health globally.
FB: conceptualisation, formal analysis, investigation, resources, data curation, writing—original draft, review, and editing. MC: conceptualisation, validation, supervision, writing—original draft, review, and editing. FS: formal analysis, investigation, resources, data curation, writing—original draft, review and editing. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
References
1.Adlhoch C Fusaro A Gonzales JL et al.
Avian influenza overview September–December 2021.
EFSA J. 2021; 19e07108
2.WHO
Disease outbreak news; avian influenza A (H5N1) – United Kingdom of Great Britain and Northern Ireland.
www.who.int/emergencies/disease-outbreak-news/item/2023-DON468
Date: May 30, 2023
Date accessed: June 4, 2024
r
3.WHO
Disease outbreak news; avian influenza A(H5N1)–Viet Nam.
www.who.int/emergencies/disease-outbreak-news/item/2024-DON511
Date: April 2, 2024
Date accessed: June 2, 2024
4.WHO
Influenza at the human–animal interface summary and risk assessment, from 29 March to 3 May 2024.
cdn.who.int/media/docs/default-source/influenza/human-animal-interface-risk-assessments/influenza-at-the-human-animal-interface-summary-and-assessment-from-29-march-to-3-may-2024.pdf?sfvrsn=e9ab83e2_3&download=true
Date accessed: June 10, 2024
5.Mingione M Branda F Maruotti A Ciccozzi M Mazzoli S
Monitoring the West Nile virus outbreaks in Italy using open access data.
Sci Data. 2023; 10: 777
r
6.Branda F Mahal A Maruotti A Pierini M Mazzoli S
The challenges of open data for future epidemic preparedness: the experience of the 2022 Ebolavirus outbreak in Uganda.
Front Pharmacol. 2023; 141101894
7.Branda F Nakase T Maruotti A et al.
Dengue virus transmission in Italy: surveillance and epidemiological trends up to 2023.
medRxiv. 2023; (published online Dec 21.) (preprint).
doi.org/10.1101/2023.12.19.23300208
View in Article
Google Scholar
8.Branda F Scarpa F Petrosillo N Ciccozzi M
A one health platform for future epidemic preparedness.
Infect Dis Rep. 2024; 16: 281-288
The avian influenza A(H5N1) virus was first identified in southern China in 1996, leading to substantial outbreaks among poultry in Hong Kong in 1997, which resulted in 18 human infections. Although the 1997 avian epidemic was controlled, the A(H5N1) virus persisted in birds and resurfaced in 2003, spreading extensively among birds throughout Asia and subsequently reaching Africa, Europe, and the Middle East, where it caused poultry outbreaks and sporadic human infections. Since 2003, more than 22 countries have reported more than 900 sporadic human cases of A(H5N1) infection to WHO (figure). The currently circulating avian influenza A(H5N1) viruses in wild birds and poultry worldwide are genetically distinct from earlier strains and became the predominant highly pathogenic avian influenza (HPAI) H5 subtype in the autumn of 2021,1 whereas the earlier strains continue to circulate at lower frequencies in several countries with few sporadic human cases globally reported. However, the clinical manifestations in humans from all avian influenza virus infections have varied widely in severity, ranging from asymptomatic2 or mild illness to severe disease resulting in death.3
The WHO guidelines4 for influenza at the human–animal border include several key recommendations. These include enhanced surveillance in human populations potentially exposed to influenza A viruses, the use of the Tool for Influenza Pandemic Risk Assessment for detailed risk assessment associated with zoonotic influenza viruses, the recommendation to avoid contact with sick or dead animals and proper cooking of poultry products, and the importance of collaboration with influenza centres of reference and timely sharing of information on viruses with pandemic potential for the development of vaccines and other public health measures.
To support global response efforts, our team created an open-access database to track avian influenza cases in different countries. We collected data from various public sources to compile a detailed list of cases, including: first, Disease Outbreak News (DON), which is the official online reporting system operated by WHO; second, reliable news websites specialising in public health and infectious disease news such as CIDRAP News or news aggregators such as BNO News, which provide flash alerts on relevant news; and third, peer-reviewed scientific papers published in high-impact journals. These data include information such as age, gender, dates of symptom onset, and laboratory confirmation, reported symptoms, geographical locations, travel history, and additional metadata defined by our data dictionary. Each potential data source is meticulously evaluated in terms of: first, credibility (ie, the source must have a proven track record of accurate and reliable reporting, for example, DON is considered highly credible owing to its rigorous verification processes); second, accuracy (ie, information must be detailed and specific, providing the complete data needed for our epidemiological monitoring, for example, peer-reviewed studies often include detailed methodologies and robust datasets that improve the quality of our database); and third, relevance (ie, information must be directly related to avian influenza outbreaks and human infections; reports that provide specific details on new cases, geographical spread, and health impact are prioritised for inclusion).
Our research team, composed of members with diverse backgrounds and expertise including epidemiologists, statisticians, bioinformatics geneticist, and researchers experienced in data analysis and management, applies a rigorous quality control process. Each set of data undergoes a two-step verification process before being made publicly available. Initially, data are reviewed by analysts for accuracy and consistency. Next, the team interviews the appropriate experts and cross-checks the data to validate them. Any discrepancies are resolved through group discussions to ensure the highest quality of data entry. In addition, periodic database audits are done to maintain data integrity.
Having a centralised and publicly accessible database facilitates data sharing and collaboration among the different actors involved in emergency response activities. This can contribute to a better understanding of the epidemiology of avian influenza, the early identification of outbreaks and trends, and the development of more effective prevention and control strategies. However, it is important to emphasise that this example is only one step in a long journey towards understanding and managing emerging and re-emerging infectious threats. This work is based on the solid background of research from our team, which was developed for epidemic control and pandemic preparedness of other infectious diseases5, 6, 7 and is part of a larger initiative.8 Our database is a contribution to the Global Avian Influenza Surveillance Network, which aims to offer an additional tool for researchers, health professionals, and policy makers to complement other resources such as the World Organisation for Animal Health (formerly Office International des Epizooties), the Centers for Disease Control and Prevention, and the Global Initiative on Sharing All Influenza Data. We hope that our efforts can serve as a basis for future studies and actions to prevent and mitigate the effect of outbreaks of avian influenza and other infectious diseases, and to improve surveillance and health responses for the protection of public health globally.
FB: conceptualisation, formal analysis, investigation, resources, data curation, writing—original draft, review, and editing. MC: conceptualisation, validation, supervision, writing—original draft, review, and editing. FS: formal analysis, investigation, resources, data curation, writing—original draft, review and editing. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
References
1.Adlhoch C Fusaro A Gonzales JL et al.
Avian influenza overview September–December 2021.
EFSA J. 2021; 19e07108
2.WHO
Disease outbreak news; avian influenza A (H5N1) – United Kingdom of Great Britain and Northern Ireland.
www.who.int/emergencies/disease-outbreak-news/item/2023-DON468
Date: May 30, 2023
Date accessed: June 4, 2024
r
3.WHO
Disease outbreak news; avian influenza A(H5N1)–Viet Nam.
www.who.int/emergencies/disease-outbreak-news/item/2024-DON511
Date: April 2, 2024
Date accessed: June 2, 2024
4.WHO
Influenza at the human–animal interface summary and risk assessment, from 29 March to 3 May 2024.
cdn.who.int/media/docs/default-source/influenza/human-animal-interface-risk-assessments/influenza-at-the-human-animal-interface-summary-and-assessment-from-29-march-to-3-may-2024.pdf?sfvrsn=e9ab83e2_3&download=true
Date accessed: June 10, 2024
5.Mingione M Branda F Maruotti A Ciccozzi M Mazzoli S
Monitoring the West Nile virus outbreaks in Italy using open access data.
Sci Data. 2023; 10: 777
r
6.Branda F Mahal A Maruotti A Pierini M Mazzoli S
The challenges of open data for future epidemic preparedness: the experience of the 2022 Ebolavirus outbreak in Uganda.
Front Pharmacol. 2023; 141101894
7.Branda F Nakase T Maruotti A et al.
Dengue virus transmission in Italy: surveillance and epidemiological trends up to 2023.
medRxiv. 2023; (published online Dec 21.) (preprint).
doi.org/10.1101/2023.12.19.23300208
View in Article
Google Scholar
8.Branda F Scarpa F Petrosillo N Ciccozzi M
A one health platform for future epidemic preparedness.
Infect Dis Rep. 2024; 16: 281-288