H5N1 on the move: what the avian flu resurgence means for diagnostics

Although transmission of avian influenza from animals to humans remains very rare, recent cases are raising concern among health officials. Since early last year, 67 human infections have been confirmed in the US, primarily among individuals working on poultry or dairy farms. Most infections have been mild with low public risk; however, this month marked the first reported fatality in Louisiana. Additionally, China reported 10 cases and Vietnam one since last September. These developments have prompted enhanced surveillance efforts to swiftly identify potential zoonotic spread. Given that many infections may present mildly or without symptoms, rigorous testing and monitoring are essential to promptly detect any shifts in the virus or its patterns of transmission.

The virus has shown an unprecedented ability to infect a growing range of mammals, including wild animals (foxes, seals, otters), farmed mink, US dairy cattle, and recently even a sheep in Yorkshire, England. This spread in mammals increases the virus's opportunities to adapt to mammalian hosts, potentially making it easier to infect humans. The virus crossing species barriers necessitates broader and more vigilant surveillance in humans exposed to potentially infected animals. Diagnostic testing is the foundation of this surveillance. Differentiating H5N1 from seasonal influenza strains is crucial for appropriate public health response and patient management, requiring specific subtyping capabilities in diagnostic tests. The current surveillance focuses on livestock and agriculture, not rapid clinical diagnosis in humans. However, the World Health Organisation (WHO) has begun urging countries to maintain and strengthen pandemic preparedness plans, including diagnostic capacity.

As we reflect on lessons learnt from the recent COVID-19 pandemic, testing bottlenecks were a key vulnerability in fast detection roll-out and it’s vital these mistakes are not made again. We see the lack of readily available, rapid H5N1-specific diagnostics as a significant gap in global pandemic preparedness. Widespread testing capacity would be essential if sustained human-to-human transmission were to occur.

We know that rapid diagnostic testing capable of delivering reliable results in a matter of minutes for H5N1 avian flu could dramatically enhance response efforts during the current resurgence. That’s why our technology could support surveillance and clinical triage in a future outbreak.

How could Pictura Bio technology help future outbreaks? Rapid on-site testing of exposed individuals like farmworkers, veterinarians, or anyone exposed to potentially infected animals could enable immediate preventative measures, significantly reducing potential transmission. We know diseases mutate - our patented PIC-ID fluorescent labelling and machine learning-enabled detection technology provide real-time identification without needing target-specific reagents because the software makes the test strain-specific. Training it to detect a new mutation is straightforward, and new tests can be distributed to already deployed systems by software update. This enables clinicians and public health workers to work with actionable results in under a minute, potentially stopping transmission early.

Testing in under a minute would shift avian influenza management from reactive (based on slow lab results) to near real-time intervention. This speed could significantly enhance the ability to contain clusters, protect workers, manage livestock outbreaks, and mitigate the public health and economic consequences of the H5N1 resurgence, both here in the UK and globally.

Achieving such speed while maintaining high accuracy (sensitivity and specificity) remains a significant technological challenge, but the potential benefits for controlling rapidly evolving outbreaks like H5N1 are immense. Funding, investment and allocation of resources for the research and development of rapid, specific, and field-deployable H5N1 diagnostic tests is vital for humans to enable faster detection and response, potentially stopping a future influenza pandemic.