Bird flu: first death from H3N8 strain recorded in China, avian influenza symptoms - as UK restrictions lifted

The WHO has stressed ‘the importance of global surveillance’ to detect changes in circulating influenza viruses

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Just a day after the UK government announced that an order requiring all bird owners to keep their animals indoors in order to stop the spread of avian influenza will be lifted, the World Health Organisation (WHO) has reported the first documented human death from the H3N8 virus, which killed a woman in China.

With memories of the Covid-19 pandemic still fresh in the mind, the news of the first human death from bird flu could come as a worry for many people. But how worried should we be, and is there really a chance of another global pandemic? Here is everything we know.

What is H3N8?

H3N8 is a subtype of the influenza A virus that can infect birds, horses, dogs, and other mammals. H3N8 has been known to be circulating since 2002, when it first appeared in North American waterfowl. It is one of the most prevalent strains in birds, but is not well-adapted to infect humans.

In recent years, H3N8 has also been responsible for outbreaks of respiratory illness in dogs, which are believed to have originated from equine influenza viruses. This strain of influenza virus can be highly contagious and cause severe symptoms, including coughing, fever and pneumonia in infected animals.

The virus had not been observed in humans until recently, when in April and May of 2022, two non-fatal cases appeared, both in China. Of the two cases, one became critically ill, and the other only experienced a slight illness.

According to the WHO, both cases most likely contracted the virus through direct or indirect contact with infected animals.

A woman walks past a row of caged chickens at a Beijing market in 2004 (Photo: FREDERIC J. BROWN/AFP via Getty Images)A woman walks past a row of caged chickens at a Beijing market in 2004 (Photo: FREDERIC J. BROWN/AFP via Getty Images)
A woman walks past a row of caged chickens at a Beijing market in 2004 (Photo: FREDERIC J. BROWN/AFP via Getty Images)

The third case, which resulted in the first recorded death from the virus, claimed the life of a 56-year-old woman from southeast China’s Guangdong province. The WHO said that she became ill on 22 February, was hospitalised on 3 March for severe pneumonia, and passed away on 16 March 2023.

“The patient had multiple underlying conditions. She had a history of exposure to live poultry before the onset of the disease, and a history of wild bird presence around her home,” the UN health agency said in a statement on Tuesday (11 April).

“No close contacts of the case developed an infection or symptoms of illness at the time of reporting,” it added.

How worried should we be?

The WHO - which is calling for additional research on the effects of the virus in both animals and people - said that the virus still does not have “the ability to spread easily from person to person”, meaning “the risk of it spreading among humans at the national, regional and international levels is considered to be low.”

The organisation stated that exposure to a live poultry market may have been the source of the fatal infection, but “it is still unclear what the exact source of this infection is and how this virus is related to other avian influenza A(H3N8) viruses that are circulating in animals.”

In China, where avian flu viruses are continuously spread across vast populations of domestic poultry and wild birds, sporadic infections from other strains in people are common. But the WHO was not made aware of the third official H3N8 diagnosis until a month after Chinese health officials became aware of the infection.

The nation’s health officials have previously come under fire for withholding crucial information on the spread of Covid in the country; it has been accused of concealing early cases and refusing to cooperate in the search for the virus’s source.

The capacity of avian influenza viruses to develop and cause a pandemic makes the monitoring of these viruses crucial, said the WHO, which stressed “the importance of global surveillance to detect virological, epidemiological and clinical changes associated with circulating influenza viruses which may affect human (or animal) health.”

What are the symptoms of bird flu?

Though only three instances of human H3N8 infection have been officially recorded, a number of cases involving other strains of avian flu have been observed around the world.

Since the present outbreak of bird flu - the biggest in history, affecting more than 200 million domestic birds worldwide and countless wild birds - began in 2021, there has only been one instance of an individual from the UK contracting the H5N1 virus.

Early in 2022, Alan Gosling, a retired engineer from Devon, contracted the virus after some of his house-dwelling ducks contracted the disease.

According to the WHO, animal influenza infections can cause illnesses ranging from conjunctivitis or minor flu-like symptoms to severe acute respiratory illness or even death. There have been reports of neurological or gastrointestinal issues, although these are uncommon, it was emphasised.