The global H5N1 influenza panzootic in mammals

Thomas P. Peacock, Louise Moncla, Gytis Dudas, David VanInsberghe, Ksenia Sukhova, James O. Lloyd-Smith, Michael Worobey, Anice C. Lowen and Martha I. Nelson ()
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Thomas P. Peacock: Pirbright
Louise Moncla: University of Pennsylvania
Gytis Dudas: Vilnius University
David VanInsberghe: Emory University School of Medicine
Ksenia Sukhova: Imperial College London
James O. Lloyd-Smith: University of California Los Angeles
Michael Worobey: University of Arizona
Anice C. Lowen: Emory University School of Medicine
Martha I. Nelson: National Institutes of Health (NIH)

Nature, 2025, vol. 637, issue 8045, 304-313

Abstract: Abstract Influenza A viruses have caused more documented global pandemics in human history than any other pathogen1,2. High pathogenicity avian influenza viruses belonging to the H5N1 subtype are a leading pandemic risk. Two decades after H5N1 ‘bird flu’ became established in poultry in Southeast Asia, its descendants have resurged3, setting off a H5N1 panzootic in wild birds that is fuelled by: (1) rapid intercontinental spread, reaching South America and Antarctica for the first time4,5; (2) fast evolution via genomic reassortment6; and (3) frequent spillover into terrestrial7,8 and marine mammals9. The virus has sustained mammal-to-mammal transmission in multiple settings, including European fur farms10,11, South American marine mammals12–15 and US dairy cattle16–19, raising questions about whether humans are next. Historically, swine are considered optimal intermediary hosts that help avian influenza viruses adapt to mammals before jumping to humans20. However, the altered ecology of H5N1 has opened the door to new evolutionary pathways. Dairy cattle, farmed mink or South American sea lions may have the potential to serve as new mammalian gateways for transmission of avian influenza viruses to humans. In this Perspective, we explore the molecular and ecological factors driving the sudden expansion in H5N1 host range and assess the likelihood of different zoonotic pathways leading to an H5N1 pandemic.

Date: 2025
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DOI: 10.1038/s41586-024-08054-z

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