Apr 16
The Looming Threat of Avian Flu: Are We Ready for Another Pandemic?
Introduction

Think back to 2020. The sudden emergence of a novel virus gripped the world, leading to unprecedented changes in our daily lives due to the global pandemic, COVID-19. Today, another infectious disease is capturing global attention: Avian Influenza, commonly known as bird flu. While it primarily infects birds, the potential for certain strains to cross over to humans and trigger a pandemic is a serious concern globally. Just like the influenza viruses that caused devastating pandemics in the past (Spanish Flu of 1918 and Swine Flu of 2009), avian flu viruses can mutate and evolve. Recent outbreaks in birds and, more worryingly, in mammals such as dairy cattle in the United States are a stark reminder of the ever-present threat of zoonotic diseases. So, the crucial question looms: are we on the brink of another global health crisis originating from the avian world? This post will delve into the complexities of avian flu, explore the current global situation, and discuss what this potential threat means for us.
Understanding Avian Influenza: Strains, Transmission, and Virulence
Avian influenza viruses are broadly categorised based on their ability to cause disease in poultry: Low Pathogenicity Avian Influenza (LPAI) and Highly Pathogenic Avian Influenza (HPAI). LPAI viruses typically cause mild or no illness in birds, while HPAI strains can lead to severe disease and high mortality rates in bird populations, sometimes reaching up to 90-100% within 48 hours for certain strains in chickens.
Of particular concern for humans are the HPAI viruses of the H5 and H7 subtypes, such as H5N1, H7N9, H5N6, and H5N8. These subtypes have been responsible for most human infections with avian influenza.
Transmission of avian influenza from birds to humans usually occurs through direct contact with infected birds, their saliva, mucous, or faeces, or through contaminated environments. The virus can enter the human body through the eyes, nose, or mouth, or by inhaling contaminated droplets or dust. Interestingly, consumption of raw foods, including raw milk from infected animals, also poses a potential transmission risk.
The virulence of avian flu in humans, or how severe the illness becomes, depends on several factors. One key factor is the virus's ability to attach to specific receptors on human cells. Avian influenza viruses prefer to bind to α–2,3–linked sialic acid receptors, which are predominantly found in the lower respiratory tract of humans. This could explain why human avian flu can lead to severe pneumonia. In contrast, human seasonal flu viruses typically bind to α–2,6–linked sialic acid receptors, which are more commonly found in the upper respiratory tract, thus more easily spread to others by coughing and sneezing.
Noteworthy strains like H5N1 have historically shown a high case fatality rate in humans, around 52% based on WHO data from 2003 to 2023, with 878 reported cases and 458 deaths. H7N9, primarily seen in China since 2013, also has a high fatality rate of approximately 40%.
Of particular concern for humans are the HPAI viruses of the H5 and H7 subtypes, such as H5N1, H7N9, H5N6, and H5N8. These subtypes have been responsible for most human infections with avian influenza.
Transmission of avian influenza from birds to humans usually occurs through direct contact with infected birds, their saliva, mucous, or faeces, or through contaminated environments. The virus can enter the human body through the eyes, nose, or mouth, or by inhaling contaminated droplets or dust. Interestingly, consumption of raw foods, including raw milk from infected animals, also poses a potential transmission risk.
The virulence of avian flu in humans, or how severe the illness becomes, depends on several factors. One key factor is the virus's ability to attach to specific receptors on human cells. Avian influenza viruses prefer to bind to α–2,3–linked sialic acid receptors, which are predominantly found in the lower respiratory tract of humans. This could explain why human avian flu can lead to severe pneumonia. In contrast, human seasonal flu viruses typically bind to α–2,6–linked sialic acid receptors, which are more commonly found in the upper respiratory tract, thus more easily spread to others by coughing and sneezing.
Noteworthy strains like H5N1 have historically shown a high case fatality rate in humans, around 52% based on WHO data from 2003 to 2023, with 878 reported cases and 458 deaths. H7N9, primarily seen in China since 2013, also has a high fatality rate of approximately 40%.
The Pathway to a Pandemic: Mutation and Human-to-Human Transmission
The biggest worry surrounding avian influenza is the virus’s potential to evolve and gain the ability for efficient and lasting human-to-human transmission, which is the distinguishing characteristic of a pandemic. This evolution usually happens through genetic changes to the virus, mainly with mutations and reassortment.
Mutations are changes in the virus's genetic code that can alter its characteristics, such as its ability to bind to different receptors or replicate more effectively in a new host. For example, a single amino acid mutation in a protein of H5N1 has been shown to improve its ability to bind to human-type receptors (α-2,6 linked sialic acids), a crucial step toward human transmissibility. Similarly, other mutations can enhance the virus's ability to replicate efficiently in the cells of mammals. Recent identification of certain mutations in H5N1 viruses from US dairy cattle is very concerning, as they can enhance replication in both bovine and human airway cells. Another mutation has also emerged, further increasing polymerase activity in mammalian cells.
Reassortment is another process where an avian influenza virus can exchange genetic material with a circulating human influenza virus, like seasonal flu, if a person or animal is co-infected with both. This could result in a novel virus of great concern, combining the high virulence of the avian strain with the easy human transmissibility of the seasonal strain. Pigs are often referred to as potential "mixing vessels" because they can be infected by both avian and mammalian influenza viruses. Currently, the risk of sustained human-to-human transmission for circulating avian influenza strains is thankfully considered low by organisations like the CDC and WHO. While limited person-to-person spread has occurred in the past, it hasn't continued. However, the recent detection of mutations in human H5N1 cases and the increasing number of infections in other mammals suggest the virus is adapting and that the risk could easily increase. This includes the novel spread of the virus to US dairy cattle and the spread from humans to domestic cats.
Mutations are changes in the virus's genetic code that can alter its characteristics, such as its ability to bind to different receptors or replicate more effectively in a new host. For example, a single amino acid mutation in a protein of H5N1 has been shown to improve its ability to bind to human-type receptors (α-2,6 linked sialic acids), a crucial step toward human transmissibility. Similarly, other mutations can enhance the virus's ability to replicate efficiently in the cells of mammals. Recent identification of certain mutations in H5N1 viruses from US dairy cattle is very concerning, as they can enhance replication in both bovine and human airway cells. Another mutation has also emerged, further increasing polymerase activity in mammalian cells.
Reassortment is another process where an avian influenza virus can exchange genetic material with a circulating human influenza virus, like seasonal flu, if a person or animal is co-infected with both. This could result in a novel virus of great concern, combining the high virulence of the avian strain with the easy human transmissibility of the seasonal strain. Pigs are often referred to as potential "mixing vessels" because they can be infected by both avian and mammalian influenza viruses. Currently, the risk of sustained human-to-human transmission for circulating avian influenza strains is thankfully considered low by organisations like the CDC and WHO. While limited person-to-person spread has occurred in the past, it hasn't continued. However, the recent detection of mutations in human H5N1 cases and the increasing number of infections in other mammals suggest the virus is adapting and that the risk could easily increase. This includes the novel spread of the virus to US dairy cattle and the spread from humans to domestic cats.

Current Global Bird Flu Situation: Outbreaks and Human Cases
The world is currently experiencing widespread avian influenza outbreaks in wild birds, poultry, and various other animals, with a significant surge in H5N1 infections since 2022. This sustained and wide circulation globally increases the chances of the virus spilling over into humans and other mammals and also provides more opportunities for genetic changes. Consequently, there have been reported human cases of avian influenza. In the United States alone, over 70 cases of H5N1 infection have been seen since 2022. A notable portion of these recent cases has been linked to exposure to sick dairy cows, marking a new transmission route and an international concern. While most of these infections have presented with mild symptoms like conjunctivitis and mild respiratory issues, it is possible that severe illness or death could occur. For example, the first reported US death from H5N1 occurred recently, in January 2025, in Louisiana. Canada also reported a severe human H5N1 case in British Columbia in November 2024. China continues to report human cases of various subtypes, but importantly, there has been no observed human-to-human transmission to date.
Several concerning trends are emerging, though. There has been an increase in avian influenza infections reported in various mammals, including dairy cattle, domestic cats, and marine mammals, in addition to domestic poultry. Furthermore, genetic analysis of H5N1 viruses from human cases has revealed worrying mutations suggesting there is adaptation towards human hosts. For instance, there is a mutation identified in the H5N1 virus currently circulating in US dairy cows, which could increase its ability to bind to human cell receptors – a critical step for potential human-to-human transmission. These trends highlight the dynamic nature of the avian influenza virus and the urgent need for heightened surveillance and to be prepared, especially if human-to-human infection occurs.
Several concerning trends are emerging, though. There has been an increase in avian influenza infections reported in various mammals, including dairy cattle, domestic cats, and marine mammals, in addition to domestic poultry. Furthermore, genetic analysis of H5N1 viruses from human cases has revealed worrying mutations suggesting there is adaptation towards human hosts. For instance, there is a mutation identified in the H5N1 virus currently circulating in US dairy cows, which could increase its ability to bind to human cell receptors – a critical step for potential human-to-human transmission. These trends highlight the dynamic nature of the avian influenza virus and the urgent need for heightened surveillance and to be prepared, especially if human-to-human infection occurs.
Implications for the Aged Care Sector
A bird flu outbreak with pandemic potential could have profound and severe impacts, particularly on vulnerable populations like those in aged care facilities or the elderly in general. Older adults are especially susceptible to influenza viruses due to age-related changes in their immune systems, or immunosenescence. As we age, our immune systems become less effective at recognising and fighting off new infections, and our response to vaccines may also be weaker. Moreover, older adults are more likely to have underlying chronic health conditions such as heart disease, lung disease, and diabetes, which will significantly increase their risk of developing severe complications from influenza. During seasonal influenza epidemics, older adults bear the heaviest burden of severe disease, accounting for a disproportionately high number of hospitalisations and deaths.
If we consider a potential bird flu pandemic, the aged care sectors in Australia and New Zealand face significant challenges. Aged care facilities house a large number of individuals with advanced age and complex health needs, residing in a communal environment.
If we consider a potential bird flu pandemic, the aged care sectors in Australia and New Zealand face significant challenges. Aged care facilities house a large number of individuals with advanced age and complex health needs, residing in a communal environment.
- Australia's aged care system includes residential care, home support, and home care services, heavily regulated by government bodies. A significant proportion of individuals entering permanent residential aged care in Australia are aged 85 years and over.
- New Zealand's system primarily involves privately provided residential care at different levels, funded through government subsidies. Most individuals entering aged residential care in New Zealand are over 80 years of age.
Both countries face ongoing challenges in attracting and retaining qualified staff. If a highly pathogenic avian influenza strain were to spread easily within these facilities, the potential for high mortality rates among residents would be substantial. Implementing effective infection control measures would be difficult, potentially exceeding capacity for isolation space and straining PPE supplies. Staffing shortages due to illness would be a major concern, and facility lockdowns could negatively impact residents' well-being. Historical influenza pandemics serve as grim reminders of the devastating mortality that can occur. For example, the 1918 Spanish Flu pandemic caused an estimated 20 to 50 million deaths worldwide.
Preparedness and Response: Protecting Ourselves and Vulnerable Populations
To strengthen preparedness and response in the face of a potential bird flu pandemic, several key measures are critical, particularly within aged care settings in Australia and New Zealand. Vaccinations for both residents and staff against seasonal influenza are of primary concern, as they can reduce the overall facility burden of respiratory illness and potentially offer some cross-protection from a new virus. Strict infection prevention and control measures, including meticulous hand hygiene, proper use of personal protective equipment (PPE), and thorough environmental cleaning, are essential. Timely administration of antiviral medications like oseltamivir can be significant, especially when started early in the course of illness. Clear guidelines and protocols for managing outbreaks, including early detection, isolation of cases, and visitor restrictions, when necessary, must be in place and regularly included in training. Clear and consistent communication with residents, families, and public health authorities is also vital during an outbreak.
Beyond aged care, there are actionable steps we can all take:
Beyond aged care, there are actionable steps we can all take:
- Stay informed: Follow updates from reliable sources such as the World Health Organisation (WHO) and the Centres for Disease Control and Prevention (CDC).
- Practice good hygiene: Wash your hands frequently with soap and water, especially after being in public places or around animals. Avoid touching your face.
- Get your seasonal flu vaccine: While it won't protect against bird flu, it can reduce your risk of seasonal influenza, which could help prevent co-infections with a different strain of virus. This will also reduce the strain on healthcare systems.
- Be aware of animal health: If you are around birds or other animals, practice biosecurity measures and report any signs of illness to the appropriate authorities.
Ongoing surveillance of avian influenza in both animal and human populations is critical to detect any changes in the virus that could increase its pandemic potential. International collaboration and the sharing of information are also essential for global preparedness.

Conclusion: Vigilance and Preparedness in an Evolving Threat
In conclusion, the threat of avian influenza as a potential pandemic remains a significant concern due to its zoonotic nature and the demonstrated severity of certain strains like H5N1 and H7N9 in humans. The ongoing evolution of avian influenza viruses, particularly the potential for mutations enabling human-to-human transmission, is the primary factor health experts are closely monitoring. While current global outbreaks primarily affect animals, human infections are sporadic with no sustained human spread. However, the increasing number of spillover events in other mammals underscores the changing nature of this threat. Given the vulnerability of populations like the elderly in aged care settings, preparedness and vigilance are vital. As this evolving landscape continues, what role do you think proactive measures and global collaboration play in safeguarding against a potential avian influenza pandemic?
Dive deeper into this critical topic by exploring the related articles and blogs on the HUB. Or ask EVE for a quick response to your query.
💡 For more insights on IPC surveillance and best practices, explore our extensive IPS library of training courses and resources.
Visit the HUB for more IPC insights
Dive deeper into this critical topic by exploring the related articles and blogs on the HUB. Or ask EVE for a quick response to your query.
💡 For more insights on IPC surveillance and best practices, explore our extensive IPS library of training courses and resources.
Visit the HUB for more IPC insights
Lyndon Forrest
Managing Director | CEO
I am a passionate and visionary leader who has been working in the field of infection prevention and control in aged care for almost 30 years. I am one of the co-founders and the current Managing Director and CEO of Bug Control New Zealand and Australia, the premium provider of infection prevention and control services in aged care. I lead a team that is driven by a common purpose: to help aged care leaders and staff protect their residents from infections and create a healthier future for them.
I am building a business that focuses on our clients and solving their problems. We are focused on building a world-class service in aged care. We focus on being better, not bigger, which means anything we do is for our clients.
I am a passionate and visionary leader who has been working in the field of infection prevention and control in aged care for almost 30 years. I am one of the co-founders and the current Managing Director and CEO of Bug Control New Zealand and Australia, the premium provider of infection prevention and control services in aged care. I lead a team that is driven by a common purpose: to help aged care leaders and staff protect their residents from infections and create a healthier future for them.
I am building a business that focuses on our clients and solving their problems. We are focused on building a world-class service in aged care. We focus on being better, not bigger, which means anything we do is for our clients.
Erica Leadley
Manager, Marketing and Sales
Erica Leadley is a dedicated professional with a rich background in agriculture and nutrient management. Growing up on her family's farm in Mid Canterbury, she developed a deep passion for farming. She currently resides on her partner's arable property in South Canterbury.
In 2017, Erica joined the Farm Sustainability team, focusing on nutrient management and environmental stewardship. In February 2024, she became the Manager of Marketing and Sales at Bug Control New Zealand - Infection Prevention Services, where her passion now includes improving infection prevention outcomes.
Outside of work, Erica loves cooking and traveling, often combining her culinary interests with her explorations in Italy and Vietnam. She enjoys entertaining family and friends and remains actively involved in farm activities, especially during harvest season.
Erica Leadley is a dedicated professional with a rich background in agriculture and nutrient management. Growing up on her family's farm in Mid Canterbury, she developed a deep passion for farming. She currently resides on her partner's arable property in South Canterbury.
In 2017, Erica joined the Farm Sustainability team, focusing on nutrient management and environmental stewardship. In February 2024, she became the Manager of Marketing and Sales at Bug Control New Zealand - Infection Prevention Services, where her passion now includes improving infection prevention outcomes.
Outside of work, Erica loves cooking and traveling, often combining her culinary interests with her explorations in Italy and Vietnam. She enjoys entertaining family and friends and remains actively involved in farm activities, especially during harvest season.
Toni Sherriff
Clinical Nurse Specialist
Toni is a Registered Nurse with extensive experience in Infection Prevention and Control. Her career began as a kitchen hand and caregiver in Aged Care facilities, followed by earning a Bachelor of Nursing.
Toni has significant experience, having worked in Brisbane’s Infectious Diseases ward before returning home to New Zealand, where she continued her career as a Clinical Nurse Specialist in Infection Prevention and Control within Te Whatu Ora (Health NZ).
Toni brings her expertise and dedication to our team, which is instrumental in providing top-tier infection prevention solutions to our clients.
Toni is a Registered Nurse with extensive experience in Infection Prevention and Control. Her career began as a kitchen hand and caregiver in Aged Care facilities, followed by earning a Bachelor of Nursing.
Toni has significant experience, having worked in Brisbane’s Infectious Diseases ward before returning home to New Zealand, where she continued her career as a Clinical Nurse Specialist in Infection Prevention and Control within Te Whatu Ora (Health NZ).
Toni brings her expertise and dedication to our team, which is instrumental in providing top-tier infection prevention solutions to our clients.
Julie Hadfield
Accounts & Payroll
Julie is experienced in Accounts & Payroll Administration & after a long career in both the Financial & Local Government Sectors, is now working with our team. Julie brings her strong time management & organisational skills to our team, which is important to keep the company running in the background to enable the rest of our team to provide top notch service to all of our clients.
Julie is experienced in Accounts & Payroll Administration & after a long career in both the Financial & Local Government Sectors, is now working with our team. Julie brings her strong time management & organisational skills to our team, which is important to keep the company running in the background to enable the rest of our team to provide top notch service to all of our clients.
Andrea Murray
Content Editor
I attended Otago University in NZ and graduated as a Dental Surgeon. After 40 years in the profession, I retired in 2022. Infection prevention knowledge was part of everyday practice, dealing with sterilisation, hand hygiene, and cleaning.
Before retiring, I began doing some editing and proofreading for Bug Control as I am interested in the subject and in the English language. During the COVID-19 lockdown, I attended the ACIPC course "Introduction to Infection Prevention and Control", which increased my interest in the subject. I now work part-time as the Content Editor for the company.
I attended Otago University in NZ and graduated as a Dental Surgeon. After 40 years in the profession, I retired in 2022. Infection prevention knowledge was part of everyday practice, dealing with sterilisation, hand hygiene, and cleaning.
Before retiring, I began doing some editing and proofreading for Bug Control as I am interested in the subject and in the English language. During the COVID-19 lockdown, I attended the ACIPC course "Introduction to Infection Prevention and Control", which increased my interest in the subject. I now work part-time as the Content Editor for the company.
Personally, I lived in the UK for 10 years. My two children were born in Scotland, and now both are living in Europe, one in Amsterdam, Netherlands, and the other in Edinburgh, Scotland. I live close to Fairlie on the South Island of NZ, a beautiful part of the country, and I love being out of the city.
Princess
Customer Support
Princess began her career as a dedicated Customer Service Representative, honing her communication and problem-solving skills. She later transitioned into a Literary Specialist role, where she developed a keen eye for detail. Her journey then led her to a Sales Specialist position, where she excelled in client relations.
Now, as a Customer Support professional in Infection Prevention Services. Princess focuses on ensuring customer satisfaction, building loyalty, and enhancing the overall customer journey.
Princess began her career as a dedicated Customer Service Representative, honing her communication and problem-solving skills. She later transitioned into a Literary Specialist role, where she developed a keen eye for detail. Her journey then led her to a Sales Specialist position, where she excelled in client relations.
Now, as a Customer Support professional in Infection Prevention Services. Princess focuses on ensuring customer satisfaction, building loyalty, and enhancing the overall customer journey.
Dianne Newey
Senior Infection Prevention and Control Consultant
With over 35 years of experience as a Registered Nurse, I'm now applying all my experience and skills as a Senior Infection Prevention and Control Consultant with Bug Control Infection Prevention Advisory Services.
This is through IP&C education, IP&C environmental audits and reports, IP&C policy and procedure review and development and consultancy on infection prevention and control issues. When I’m not working, I spend time with my family and in my garden, where I grow all my own veggies.
With over 35 years of experience as a Registered Nurse, I'm now applying all my experience and skills as a Senior Infection Prevention and Control Consultant with Bug Control Infection Prevention Advisory Services.
In my role, I promote Infection Prevention and Control, to RACF's and disability support services.
This is through IP&C education, IP&C environmental audits and reports, IP&C policy and procedure review and development and consultancy on infection prevention and control issues. When I’m not working, I spend time with my family and in my garden, where I grow all my own veggies.
Caoimhe (Keva) Stewart
Manager of Customer Service
Caoimhe is the Manager of Customer Service at Bug Control | Infection Prevention Services, where she ensures that learners have a seamless and supportive experience. With her previous experience as a Registered Nurse in both the UK and Australia, Caoimhe brings a deep understanding of healthcare to her role. Before joining Bug Control IPS Services, she worked in a variety of nursing settings, including Occupational Health, Palliative Care, and Community Nursing, providing her with the ability to empathise with learners and understand the challenges they face.
Caoimhe is the Manager of Customer Service at Bug Control | Infection Prevention Services, where she ensures that learners have a seamless and supportive experience. With her previous experience as a Registered Nurse in both the UK and Australia, Caoimhe brings a deep understanding of healthcare to her role. Before joining Bug Control IPS Services, she worked in a variety of nursing settings, including Occupational Health, Palliative Care, and Community Nursing, providing her with the ability to empathise with learners and understand the challenges they face.
Her move from nursing to customer service was driven by her passion for helping others, not just in clinical settings but also in ensuring that people have access to the resources and support they need. Now, Caoimhe applies her problem-solving skills, attention to detail, and communication expertise to her role, helping to create a positive and effective learning environment for all students.
Outside of work, Caoimhe enjoys travelling, staying active, and catching up with friends on the weekends. Whether in healthcare or customer service, she’s dedicated to making a meaningful difference and supporting people in their personal and professional growth.