Serological analysis in humans in Malaysian Borneo suggests prior exposure to H5 avian influenza near migratory shorebird habitats

Hannah Klim (), Timothy William, Jack Mellors, Caolann Brady, Giri S. Rajahram, Tock H. Chua, Helena Brazal Monzó, Jecelyn Leslie John, Kelly Costa, Mohammad Saffree Jeffree, Nigel J. Temperton, Tom Tipton, Craig P. Thompson, Kamruddin Ahmed, Chris J. Drakeley, Miles W. Carroll and Kimberly M. Fornace ()
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Hannah Klim: University of Oxford
Timothy William: Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit
Jack Mellors: University of Oxford
Caolann Brady: University of Oxford
Giri S. Rajahram: Queen Elizabeth II Hospital
Tock H. Chua: University of Malaysia Sabah
Helena Brazal Monzó: London School of Hygiene and Tropical Medicine
Jecelyn Leslie John: University of Malaysia Sabah
Kelly Costa: Universities of Kent and Medway
Mohammad Saffree Jeffree: University of Malaysia Sabah
Nigel J. Temperton: Universities of Kent and Medway
Tom Tipton: University of Oxford
Craig P. Thompson: University of Warwick
Kamruddin Ahmed: University of Malaysia Sabah
Chris J. Drakeley: London School of Hygiene and Tropical Medicine
Miles W. Carroll: University of Oxford
Kimberly M. Fornace: London School of Hygiene and Tropical Medicine

Nature Communications, 2024, vol. 15, issue 1, 1-13

Abstract: Abstract Cases of H5 highly pathogenic avian influenzas (HPAI) are on the rise. Although mammalian spillover events are rare, H5N1 viruses have an estimated mortality rate in humans of 60%. No human cases of H5 infection have been reported in Malaysian Borneo, but HPAI has circulated in poultry and migratory avian species transiting through the region. Recent deforestation in coastal habitats in Malaysian Borneo may increase the proximity between humans and migratory birds. We hypothesise that higher rates of human-animal contact, caused by this habitat destruction, will increase the likelihood of potential zoonotic spillover events. In 2015, an environmentally stratified cross-sectional survey was conducted collecting geolocated questionnaire data in 10,100 individuals. A serological survey of these individuals reveals evidence of H5 neutralisation that persisted following depletion of seasonal H1/H3 HA binding antibodies from the plasma. The presence of these antibodies suggests that some individuals living near migratory sites may have been exposed to H5 HA. There is a spatial and environmental overlap between individuals displaying high H5 HA binding and the distribution of migratory birds. We have developed a novel surveillance approach including both spatial and serological data to detect potential spillover events, highlighting the urgent need to study cross-species pathogen transmission in migratory zones.

Date: 2024
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DOI: 10.1038/s41467-024-53058-y

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