India can do it!

Against the background of the H5N1 pandemic in birds and an epidemic among cattle in the US, the Government of Victoria, in Australia, published a statement on May 21 that the province had recorded the country’s first human H5N1 case. This doesn’t seem to be much cause (but also not negligible cause) for concern because, according to the statement as well as other experts, this strain of avian influenza hasn’t evolved to spread easily between people. The individual in question who had the infection — “a child”, according to Victoria’s statement — had a severe form of it but has since recovered fully as well.

But this story isn’t testament to Australia’s pathogen surveillance, at least not primarily; it’s testament to India’s ability to do it. In Vivek Agnihotri’s film The Vaccine War — purportedly about the efforts of Bharat Biotech, the ICMR, and the NIV to develop Covaxin during the COVID-19 pandemic — Raima Sen, who plays the science editor of a fictitious publication called The Daily Wire, says about developing the vaccine in a moment of amusing cringe on a TV news show that “India can’t do it”. Agnihotri didn’t make it difficult to see myself in Sen’s character: I was science editor of the very real publication The Wire when Covaxin was being developed. And I’m here to tell you that India, in point of fact, can: according to Victoria’s statement, the child became infected by a strain of the H5N1 virus in India and fell ill in March 2024.

And what is it that India can do? According to Victoria’s statement, spotting the infection required “Victoria’s enhanced surveillance system”. Further, “most strains don’t infect humans”; India was able to serve the child with one of the rare strains that could. “Transmission to humans” is also “very rare”, happening largely among people who “have contact with infected birds or animals, or their secretions, while in affected areas of the world”. Specifically: “Avian influenza is spread by close contact with an infected bird (dead or alive), e.g. handling infected birds, touching droppings or bedding, or killing/preparing infected poultry for cooking. You can’t catch avian influenza through eating fully cooked poultry or eggs, even in areas with an outbreak of avian influenza.”

So let’s learn our lesson: If we give India’s widespread dysregulation of poultry and cattle health, underinvestment in pathogen surveillance, and its national government’s unique blend of optimism and wilful ignorance a chance, the country will give someone somewhere a rare strain of an avian influenza virus that can infect humans. Repeat after me: India can do it!