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Chapter 1: What recent bird flu cases have been confirmed in Australia?
We're doing a bonus episode of the Health Report this week because you've likely seen in your newsfeed bird flu or avian influenza. So at the time of recording, and this is a rapidly evolving story with changing numbers, but right now as we record, there are two confirmed cases of H5N1 in birds in Western Australia.
And these are, of course, the first cases of this particular virus strain on the mainland. And breaking news at the time of recording is that Ingham's Chicken, which is one of the nation's biggest poultry producers, has just announced that it's going to lock down its Western Australian operations in response to the potential threat of bird flu.
So to be very clear, there are no confirmed cases of H5N1 in poultry. This is just managing the hypothetical risk. So I'm joined by Belinda Smith, who is the co-host of The Health Report, because Norman is gallivanting. Thank you. He is gallivanting, like a migratory bird. Yes, correct. So thank you for joining me. Thanks for having me.
I think we need to start very clearly with what we are talking about here. Yes. We are talking about, everyone's familiar, particularly at the moment, with influenza. Absolutely. We're talking about a strain of influenza, specifically H5N1. Mm-hmm. 2344B lineage.
It's a really catchy name, isn't it? But we'll just call it H5N1, just for the purposes of this bonus episode. So, yeah, like you said, this is a strain of influenza. It infects more than just birds. It infects mammals, including, in some cases, humans.
What you've likely seen in your news feed this weekend is that we've had the first confirmed case of H5N1 in a brown skua seabird... This has happened at Cape LeGrand National Park near Esperance in Western Australia.
Since this first confirmation, apparently dozens of people have rung up reporting sick or unwell birds. So this may just be an uptick in people being, I guess, aware that avian influenza has reached our shores, so they're more likely to call in. But, you know, maybe it's more than that. Perhaps it's a little bit more widespread than we first thought.
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Chapter 2: What precautions are being taken by poultry producers in response to H5N1?
I think it's very important that we say up the top that at this stage, there is no evidence of human cases of H5N1 in Australia. There's not been human cases of this particular lineage in Australia before. There was a case in 2024 of bird flu in a returned traveller in Australia, but it was a different subtype of the virus. Okay.
So at this stage, this is potentially very problematic for wildlife, agricultural experts are saying. There's no evidence that this has jumped because it's a zoonotic virus. It's in animals. As the hosts, we know that COVID, hantavirus, you and I spoke about that and that was a breaking story. These zoonotic viruses can jump from an animal to a human. That's right.
So as you can imagine, the vets who have found this sick bird and the other sick bird have been approached by a lot of media. And we did reach out for comment to see what their health journey had been and if they were undergoing any quarantine. And understandably, they were not available. You know, government bodies have been aware of the potential for H5N1 to come to Australian shores.
It's very likely that there were already protocols in place in terms of quarantine and monitoring for symptoms.
Yes, I think that's fair to say. Right now, the health risk is not really to humans. It's really to wildlife. This disease has been absolutely catastrophic to birds around the world, mammals as well in other cases. So when we're talking about mortality, the risk is way higher for birds and chickens and things like that than for people.
And we have covered on the health report previously when we talked about the detection of H5N1 on Heard Island and Macdonald Island, which is about 4,000 kilometres southwest of mainland Australia. Norman and I covered that a while ago. And this particular virus has wiped out nearly 13,000 baby seals.
Wow.
So huge wildlife implications. But at this stage, again, there is no evidence of spread to humans. But it is possible, but it's a low risk.
That's right. Exactly right. Yes.
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Chapter 3: What is the risk of human transmission of H5N1 in Australia?
So how does it spread to humans, I guess? Because that's the natural question that people ask. Yeah.
So what do we know about this? I guess most of the information we have comes from the U.S., where we saw a spread from dairy cows to workers that worked at these dairy farms. And it seems like it's spread by aerosol and infected milk, because there's lots of the virus in the milk that's produced by these cows. I'll be very clear, there's been no human-to-human transmission that we know of.
Yes, and I think if we go back to the United States last year, where bird flu was a big problem in poultry, in cattle, and there was evidence of that animal to human transmission. There's a paper that we're going to link in the show notes that was published in July last year in Nature Medicine, which actually looked at human infections with H5N1 from March 2024 to May 2025.
So they had a total of 70 human cases and 41 of those were exposed to dairy cows, 24 were exposed to commercial poultry, two to backyard poultry and three had no identified source of infection.
Hmm.
I guess the next question is, well, how does it present? What does it look like if it does go from animal to human? And in this study of 70 human cases, 62% reported eye redness. So conjunctivitis is a very big part of the story. Yeah, right. Okay. Yes.
And if we suspect that it could be bird flu, if you come to me and I suspect it's bird flu, we do the normal swabs, but we also swab the eye because it's often a big part. Wow. Okay. So the virus gets into the eye? I think it's just the way the virus manifests. Yes.
So 89% of these people had eye redness, 46% had fever, 41% had respiratory symptoms and one person out of this 70 died tragically from the virus. And if you go to the CDC in the US, there are two reported deaths from bird flu. Right. So I think that gives us a little bit of a snapshot of what can occur.
And even in this study, there was no evidence with these 70 human cases of human-to-human transmission.
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Chapter 4: How does H5N1 spread from animals to humans?
So there's been roughly 1,000 reported cases of human H5N1 infection from around 2003 to earlier this year. So not a whole lot, but of those, about 480 were fatal. So what happens if someone has H5N1 influenza? Is it treated any differently to your standard seasonal flu?
Yeah.
So I guess the good point here is that we have antivirals, which we are currently using for patients who are infected with influenza. And those same antivirals, so things like oseltamivir, which people might have heard of before, will be effective, it is thought, against these H5N1 strains. So we do have, unlike COVID, Belle, which I think everyone's brain at the moment goes... Oh, 100%. Yeah.
I remember zoonotic viruses, but potentially is the theory or some form of animal host to human and then human to human transmission. We're in a different time and space entirely. We know this virus. We know how it potentially behaves. We know that antivirals are effective against it. And as we said, there are potential vaccines that have been developed. So it is a different...
story or picture to COVID, just to reassure people.
Absolutely. I mean, epidemiologists, experts in public health, they've been preparing for an influenza pandemic. When COVID hit, it sort of almost came as a surprise to a lot of people because it's a coronavirus and not an influenza virus, which is what everyone was like, you know, ready for. So we've been ready for a flu pandemic for quite a while.
Something that really struck me about this H5N1 virus is it's been around for quite a long time. So it seemed to turn really nasty about 30 years ago and started causing mass mortality in chickens. Chickens basically have a 100% mortality rate. But the first human case of H5N1 happened soon after it sort of emerged as this really pathogenic bird flu.
It was in May 1997 when a three-year-old boy was admitted to hospital in Hong Kong with sort of fluish-like symptoms. He unfortunately died six days later, but it's thought that he caught it from infected chickens. So this virus has been infecting people for a long time, almost as long as it's been a highly pathogenic influenza.
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Chapter 5: What symptoms are associated with H5N1 infection in humans?
So the fact that it hasn't yet mutated to the point where it can do human to human transmission is quite interesting in itself. Because this is what experts are really scared of, right? Jumping from mammals to humans is one thing. But once it starts being between humans, that's when you've got a pandemic on your hands.
And the issue here is when a normal human flu virus, like the seasonal flu, for instance, is in a person and that same person gets infected then with H5N1, when two viruses meet in the same vessel, being a human body or animal or whatever... they can swap genetic material.
So even though H5N1 doesn't have the ability to jump from human to human, it might acquire that ability if it can swap that genetic material with a flu virus that can do that. So that's why we want to keep human infections down as much as possible to stop that sort of cross-pollination of the genetic material.
And, you know, viruses do mutate. I say this to patients all the time. Viruses are quite clever. They mutate, they change their receptors to then be able to infect humans. That is why with any infection, good control, surveillance, management of the cases, including in wildlife, is so critical.
And so in the US over the past year or so, the CDC has been gutted. What does this mean for disease surveillance?
Well, it's not good and it's all bad news. So, you know, and that was a big criticism of the 2025 outbreak in the US, that the CDC had lost a lot of staff. People will recall a lot of the people who left the CDC or who were removed, funding was cut, which has implications for disease surveillance. It means that you're not contact tracing as well.
So there were lots of fears in 2025 that there was a lot more potentially bubbling away. than what the CDC were aware of. So I think that had huge implications in 2025. In Australia, though, it appears that there is a very clear response from the press conferences we have seen.
There's very clear advice on if you see unwell birds or dead birds, not to touch them, to keep your animals like your dogs on a leash so that they don't have contact with a potentially infected bird. And we're going to link in the show notes the phone number you can contact if you see an unwell bird, but the advice is to photograph it and not to touch it.
Don't let anything near it. So if H5N1 does become a human pandemic... What do we have in place then to protect us? I mean, right now, like I said, the health risk is really at wildlife. Here in Australia, our native wildlife are naive to this kind of virus.
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Chapter 6: What treatments are available for H5N1 infection?
It's not been here. So there are fears that it can be actually quite devastating to our native populations, black swans in particular. The fact that it's been found in Western Australia could be bad news for the old black swans. For poultry farmers, obviously, this is a really, really big concern.
Victorian farms had to cull millions and millions of chickens really recently because of a different strain of bird flu.
Yes.
There are vaccines for chickens that can help protect them from, you know, let's repeat the refrain, it won't stop you from getting the disease, but it will help curb severe disease and death. In terms of human vaccinations, there is potential to really quickly ramp up a vaccine against H5N1 should it become a pandemic.
So recently I went to CSL Securus, which is a really big manufacturer of seasonal flu vaccines, but they also have the manufacturing facilities to switch to a pandemic flu vaccine if they need to. So they actually have a few of these H5N1 viruses stored away in a virus library, ready to go, ready to pull the trigger once the World Health Organisation says that there is a pandemic.
That's their signal to switch from making seasonal flu vaccines to pandemic flu vaccines.
Some would argue, why not now in preparedness? But I guess they expire. There's implications if they're not being used.
The cold chain, that kind of thing. And we haven't seen this human-to-human spread yet. So CSL Securus say that they can manufacture 150 million doses of pandemic vaccine within around four to six months. So they can really get things cranking really quickly. And before... They used to make the flu vaccine in eggs, chicken eggs.
But what if there's an avian flu outbreak and there are no eggs to manufacture vaccines in?
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Chapter 7: How prepared is Australia for a potential H5N1 pandemic?
So again, we're going to link this paper in the show notes. This is from the Lancet Respiratory Medicine, which gives you an idea of what currently exists on the market when it comes to vaccination for humans against H5N1. And as of September 2024, there were at least 20 H5 influenza vaccines licensed and available. Hmm.
And by varying companies, including the one you mentioned, AstraZeneca, Sinovac Biotech in China. So there are vaccines around. And this particular paper, which was published in the Lancet Respiratory Medicine at that time of publishing, which I believe was 2025... They said that only one country in the world, Finland, had implemented a vaccination program for at-risk groups.
Now, I don't know if that's, you know, this is a slightly older paper from last year, but at the time it was only one country. Wow. Well, we can learn from the Finns, I reckon. Yeah, absolutely. So I think the reassuring thing here is that there are vaccines available. There's clearly the ability to upscale production if required.
At this stage, there is no evidence of animal to human transmission. In Australia? In Australia, yes. And even in the outbreak in the United States last year, there was no evidence of human to human transmission, even with, you know, 70 or so cases.
Mm-hmm.
So it doesn't mean that this is, you know, no risk. Is anything no risk? I'm not sure. But I think that we are quite prepared for this. They have been expecting H5N1 to come to the Australian mainland. And I remember Norman Bell saying to me, Birds migrate. Yeah, 100%. It's a matter of time. So there are things in place here to monitor, to do really careful surveillance.
And if you're listening and you're feeling nervous, we've given you the advice, which is to not touch any unwell or sick birds.
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Chapter 8: What should the public do if they encounter sick birds?
Poultry farmers, if you've got chickens in your backyard.
Yeah, just keep an eye out if they're looking unwell or not laying. That's another sign of bird flu in poultry.
But it's don't panic, it's watch this space. And if you want to read some more reliable information, everything is linked in the show notes. But at this stage, this is low risk to the human population, but a potentially significant risk to Australian wildlife. That's right.
And Australia has spent years preparing for this and they've committed $95 million in biosecurity, environmental and public health funding last October. And they've actually committed more money to this, and that was before this case was actually confirmed. So we've already invested in the preparedness element.
This is obviously a developing story, and we will cover it again on the health report this week, which you are kindly going to co-host with me again, Belle. Yes, I'll see you in a couple of days. So if you want to hear more and what else is happening as this story develops, you can tune in this week.
But remember, there's links in the show notes for some reliable information so you know what to do. We'll catch you later in the week.
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