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University of Nebraska Medical Center

Mortality Due to H5N1 Human Infections Could Decrease by Switching Receptor

Precision Vaccinations Avian influenza mortality might be due to a H5N1 virus pneumonia. The Lancet Infectious Disease recently published a Correspondence offering insights regarding the current influenza A(H5N1) outbreak in dairy cattle and poultry, raising concerns about increased risk for sustained human-to-human transmission.

On July 24, 2024, these researchers wrote that avian influenza viruses’ increasing host range and ability to spread between mammals and humans raise concerns about a potential pandemic risk. This pandemic risk is a concern as mortality was 52% of the 876 influenza A(H5N1) cases reported in Europe since 2002.

Our experience from the 2009 H1N1 pandemic was that admissions to intensive care were due to H1N1 pneumonia.

They argue that the high mortality might be due to an H5N1 virus pneumonia, and should the H5N1 switch to the upper airway receptor for human influenza (H1, H2, and H3), α2,6-sialic acid (SA α2,6), we hypothesize that the mortality would be lower because most infections would be restricted to the upper respiratory tract infections and only in rare cases pneumonia.

The influenza virus hemagglutinin protein binds to sialic acid receptors on the host cells, which can be either SA α2,3 or SA α2,6. SA α2,3 is found on specific human tissues, especially lung alveoli, and conjunctiva, while SA α2,6 is predominantly found in the upper respiratory tract of humans.

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