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A Bird-Flu Pandemic in People? Here’s What It Might Look Like.

There is no guarantee that a person-to-person virus would be benign, scientists say, and vaccines and treatments at hand may not be sufficient.

A pair of workers clad in white protective suits, black boots, white masks and white gloves carry a large black garbage sack. A pelican sits on the ground near them with its wings outstretched.
Workers in Lima, Peru, collected dead pelicans from a beach in 2022. The H5N1 virus has been rapidly gaining new hosts.Credit...Guadalupe Pardo/Associated Press

Apoorva Mandavilli has followed the H5N1 virus for more than 20 years.

The bird flu outbreak in dairy cattle has so far spilled over to just three farmworkers in the United States, as far as public health authorities know. All of them have had mostly mild symptoms.

But that does not guarantee that the virus, called H5N1, will remain benign if it begins to spread among people. Accumulating evidence from the animal world and data from other parts of the globe, in fact, suggest the opposite.

Some dairy cows never recovered from H5N1, and died or were slaughtered because of it. Infected terns seemed disoriented and unable to fly. Elephant seal pups had trouble breathing and developed tremors after catching the virus. Infected cats went blind, walking in circles; two-thirds of them died.

“I definitely don’t think there is room for complacency here,” said Anice Lowen, a virologist at Emory University.

“H5N1 is a highly pathogenic type of influenza virus, and we need to have a high degree of concern around it if it’s spilling over into humans,” she said.

In ferrets experimentally inoculated with the virus through their eyes — the presumed route of infection in the U.S. farmworkers — the virus rapidly spread to their airways, lungs, stomach and brain, according to a report published on Wednesday.


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