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Review
. 2019 Dec 11;132(1):81-95.
doi: 10.1093/bmb/ldz036.

Avian influenza viruses in humans: lessons from past outbreaks

Yao-Tsun Li  1 , Martin Linster  1 , Ian H Mendenhall  1 , Yvonne C F Su  1 , Gavin J D Smith  1   2   3
Affiliations
Review

Avian influenza viruses in humans: lessons from past outbreaks

Yao-Tsun Li et al. Br Med Bull. .

Abstract

Background: Human infections with avian influenza viruses (AIV) represent a persistent public health threat. The principal risk factor governing human infection with AIV is from direct contact with infected poultry and is primarily observed in Asia and Egypt where live-bird markets are common.

Areas of agreement: Changing patterns of virus transmission and a lack of obvious disease manifestations in avian species hampers early detection and efficient control of potentially zoonotic AIV.

Areas of controversy: Despite extensive studies on biological and environmental risk factors, the exact conditions required for cross-species transmission from avian species to humans remain largely unknown.

Growing points: The development of a universal ('across-subtype') influenza vaccine and effective antiviral therapeutics are a priority.

Areas timely for developing research: Sustained virus surveillance and collection of ecological and physiological parameters from birds in different environments is required to better understand influenza virus ecology and identify risk factors for human infection.

Keywords: highly pathogenic avian influenza virus; live-bird markets; pandemics; virus ecology; virus spillover; zoonotic viruses.

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Figures

Fig. 1
Fig. 1
(A) Schematic presentation of the influenza A virus particle. (B and C) Mechanisms of evolution. Antigenic drift results from the accumulation of mutations leading to changes in viral antigenicity, especially on surface proteins (B). Antigenic shift occurs through reassortment that may generate progeny viruses with distinct antigenicity compared to parental strains (C).
Fig. 2
Fig. 2
(A) Transmission of influenza virus from wild bird population to domestic poultry and spillover into humans. (B) Number of reported cases of H5 (red numbers and bars) and H7 (green numbers and bars) infection in humans. (C) Timeline of major outbreak events.
See this image and copyright information in PMC

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