The episodic resurgence of highly pathogenic avian influenza H5 virus

Ruopeng Xie, Kimberly M. Edwards, Michelle Wille, Xiaoman Wei, Sook-San Wong, Mark Zanin, Rabeh El-Shesheny, Mariette Ducatez, Leo L. M. Poon, Ghazi Kayali, Richard J. Webby and Vijaykrishna Dhanasekaran ()
Additional contact information
Ruopeng Xie: The University of Hong Kong
Kimberly M. Edwards: The University of Hong Kong
Michelle Wille: The University of Sydney
Xiaoman Wei: The University of Hong Kong
Sook-San Wong: The University of Hong Kong
Mark Zanin: The University of Hong Kong
Rabeh El-Shesheny: National Research Centre
Mariette Ducatez: Université de Toulouse, Institut national de recherche pour l’agriculture, l’alimentation et l’environnement, Ecole Nationale Vétérinaire de Toulouse
Leo L. M. Poon: The University of Hong Kong
Ghazi Kayali: Human Link, DMCC
Richard J. Webby: St Jude Children’s Research Hospital
Vijaykrishna Dhanasekaran: The University of Hong Kong

Nature, 2023, vol. 622, issue 7984, 810-817

Abstract: Abstract Highly pathogenic avian influenza (HPAI) H5N1 activity has intensified globally since 2021, increasingly causing mass mortality in wild birds and poultry and incidental infections in mammals1–3. However, the ecological and virological properties that underscore future mitigation strategies still remain unclear. Using epidemiological, spatial and genomic approaches, we demonstrate changes in the origins of resurgent HPAI H5 and reveal significant shifts in virus ecology and evolution. Outbreak data show key resurgent events in 2016–2017 and 2020–2021, contributing to the emergence and panzootic spread of H5N1 in 2021–2022. Genomic analysis reveals that the 2016–2017 epizootics originated in Asia, where HPAI H5 reservoirs are endemic. In 2020–2021, 2.3.4.4b H5N8 viruses emerged in African poultry, featuring mutations altering HA structure and receptor binding. In 2021–2022, a new H5N1 virus evolved through reassortment in wild birds in Europe, undergoing further reassortment with low-pathogenic avian influenza in wild and domestic birds during global dissemination. These results highlight a shift in the HPAI H5 epicentre beyond Asia and indicate that increasing persistence of HPAI H5 in wild birds is facilitating geographic and host range expansion, accelerating dispersion velocity and increasing reassortment potential. As earlier outbreaks of H5N1 and H5N8 were caused by more stable genomic constellations, these recent changes reflect adaptation across the domestic-bird–wild-bird interface. Elimination strategies in domestic birds therefore remain a high priority to limit future epizootics.

Date: 2023
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DOI: 10.1038/s41586-023-06631-2

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