
==== Front
New Microbes New Infect
New Microbes New Infect
New Microbes and New Infections
2052-2975
Elsevier

S2052-2975(24)00260-9
10.1016/j.nmni.2024.101476
101476
Letter to the Editor
First human fatality from H5N2 virus: Have we learnt lessons in pandemic preparedness?
Daniel Faithful Miebaka dandfaithful@gmail.com
⁎
Community and Clinical Research Division, First On-Call Initiative, No. 4 Freedom Square, Kharkiv, Ukraine
Community and Clinical Research Division, First On-Call Initiative, Port Harcourt, Nigeria
London School of Hygiene and Tropical Medicine, University of London, England
Emeruwa Victoria Ezinne
Daopuye Lydia
Community and Clinical Research Division, First On-Call Initiative, Port Harcourt, Nigeria
⁎ Corresponding author. Community and Clinical Research Division, First On-Call Initiative, No. 4 Freedom Square, Kharkiv, Ukraine. dandfaithful@gmail.com
31 8 2024
12 2024
31 8 2024
62 1014766 6 2024
29 8 2024
© 2024 The Authors
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Handling Editor: Patricia Schlagenhauf
==== Body
pmcDear Editor,

The World Health Organisation announced the first laboratory-confirmed human case of novel influenza type A (H5N2) on June 5, 2024 [1]. The index patient, a 59-year-old male with coexisting renal, diabetic, and hypertensive comorbidities, died on April 24, the same day he presented at a hospital in Mexico City, with symptoms of fever, shortness of breath, diarrhoea, and nausea [1]. Although the WHO has stated that the current risk to the general population is low, concerns have been raised due to the persistence of H5 viruses as zoonotic pathogens since 1997. These viruses are notable for their spillovers to mammalian populations and their ability to cause outbreaks with significant mortality, such as the 2021 Influenza A (H5N6) outbreak in China [2]. In the United States, the outbreak of Influenza A (H5N1) in dairy farms among cattle and, to a lesser extent, in humans is particularly alarming [2]. Some experts warn that H5N1 could be the next pandemic threat due to its high pathogenicity, sporadic transmission to humans through direct contact, and potential for human-to-human transmission [2]. It is crucial that the WHO, partner countries and the scientific community proactively address every threat, learning from the COVID-19 pandemic to demonstrate that the world has truly learned its lessons.

Pandemic preparedness has become crucial after the devastating COVID-19 (SARS-CoV-2) pandemic. Many regions are still recovering from disruptions to daily life, economies, healthcare access, and agricultural development [3]. Years of progress towards the 2030 Sustainable Development Goals (SDG) were erased as resources were diverted to combat the pandemic. The loss of human lives and the emergence of long-term complications still being understood, emphasise the importance of readiness for future pandemics.

Reasonable efforts have been made to monitor and control variants of the H5 virus, with serological findings among contacts of the index (H5N2) patient returning negative. However, the source of the infection remains unknown [1]. The WHO must strengthen the capacity of low- and middle-income countries for disease surveillance, vaccine development, and disaster preparedness, as these nations were left particularly vulnerable during the COVID-19 pandemic. Furthermore, addressing inequities in healthcare access and vaccine distribution is crucial for a comprehensive and practical pandemic response [4]. The WHO member states must work towards full implementation of the Pandemic Influenza Preparedness (PIP) Framework adopted in 2011, which details how these influenza vaccines and antivirals would be available to those in need. Social media has emerged as a double-edged sword, enabling rapid dissemination of information while also becoming a vector for misinformation, even from licensed healthcare workers [3]. Vaccine misinformation has gained traction, significantly after AstraZeneca halted COVID-19 vaccine production [3]. Some persons have falsely attributed this discontinuation to an acknowledgement of the harmful effects of the vaccine. Misinformation remains a significant challenge in pandemic response efforts. The spread of false information, particularly regarding vaccines, can hinder public health interventions. We recommend expanding free access to credible health websites by telecommunication operators, avenues to flag posts about health misinformation, and disciplinary actions against healthcare practitioners who share unwholesome or harmful health information that can be considered a breach of medical ethics. Furthermore, public health initiatives can lower the risk of zoonotic transmission by educating people about hygiene practices and the dangers of coming into contact with sick birds, improving biosecurity measures and farming practices, and addressing food insecurity in low- and middle-income countries (LMICs) [4].

Genetic vigilance is crucial for effectively controlling influenza outbreaks, enabling timely detection of genetic alterations that enhance infectivity, virulence, and severity. WHO member states must eliminate political barriers to pandemic-related data collection and ensure early reporting of disease-related events with potential for international spread [5]. The World Health Assembly's extension of the May 2024 deadline to draft a pandemic treaty highlights the pertinent need to revise the 2005 International Health Regulations for equitable and timely access to medical supplies and incentivise data exchange by 2025. []. Despite financial challenges to actualising the objectives of a new treaty, the WHO's first investment drive to raise $7 billion in four years for sustainable health financing is a step in the right direction. Mitigation strategies are summarised in Table 1.Table 1 Selected Pandemic Mitigation Strategies

Table 1Pandemic Mitigation Measures	
Enhanced Surveillance	
Regular testing of poultry farms and markets; monitor individuals in close contact with birds.	
Public Awareness Campaigns	
Educate on hygiene practices, avoiding sick birds, and reporting unusual bird deaths.	
Biosecurity Measures	
Enforce strict protocols in poultry farms, including access control and disinfection.	
Vaccination Programs	
Develop and distribute vaccines for poultry and high-risk human populations.	
International Collaboration	
Share information and resources among health organisations, governments, and research institutions.	
Rapid Response Teams	
Establish teams equipped to manage and contain outbreaks swiftly.	
Preventive Measures	
Encourage wearing masks, handwashing, and getting vaccinated to break the chain of infection.	
Healthcare Response	
Ensure hospital care and vaccination campaigns to manage and contain the outbreak.	

The first confirmed human fatality from H5N2 reminds us of the ongoing threat posed by zoonotic influenza viruses and the critical need for enhanced global pandemic preparedness. While the current risk to the general population is low, the potential for H5N2 to evolve into a more transmissible and virulent strain cannot be overlooked. The world must learn from past pandemics and take proactive steps to mitigate future threats. Strengthened global cooperation and robust preparedness measures are essential to safeguard public health.

CRediT authorship contribution statement

Faithful Miebaka Daniel: Conceptualization, Data curation, Supervision, Writing – original draft, Writing – review & editing. Victoria Ezinne Emeruwa: Writing – original draft, Writing – review & editing. Lydia Daopuye: Writing – original draft, Writing – review & editing.

Declaration of competing interest

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.
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References

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2 Al-Tawfiq J.A. Tirupathi R. Temsah M.H. Feathered fears: could avian H5N1 influenza be the next pandemic threat of disease X? New Microbes New Infect 59 2024 101416
3 Sendra A. Torkkola S. Parviainen J. AstraZeneca vaccine controversies in the media: theorizing about the mediatization of ignorance in the context of the COVID-19 vaccination campaign Health Commun [Internet] 39 3 2024 541 551 Available from: https://www.tandfonline.com/doi/abs/10.1080/10410236.2023.2171951 36703490
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