Abstract
The risk of zoonotic avian influenza (AIV) infection to humans is challenging to estimate as many human avian influenza virus infections are undetected because infections may be asymptomatic, symptomatic but not tested, and difficult to identify through contact tracing, as human-to-human transmission is rare. We derive equations that consider the evolutionary mechanisms that give rise to pandemics and are parameterized to be consistent with records of past pandemics. We estimate that thousands of human infections with AIVs possessing pandemic potential occur worldwide in an average year. Combining these estimates with H5N1 fatality data, we estimate a historical average infection fatality ratio of 32 (95% uncertainty interval: 9.6-75) deaths per 10,000 infections. This estimate is comparable to SARS-CoV-2 during the recent pandemic and higher than seasonal human influenza. We estimate that preventing animal-to-human influenza spillovers would delay pandemic emergence by several years. Preventing human infections with AIVs is necessary given the high risk of severe outcomes to individuals and to reduce the risk of pandemics occurring in the future.
Competing Interest Statement
The authors have declared no competing interest.
Source:
Link: https://www.medrxiv.org/content/10.64898/2026.01.21.26344526v3
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