NEJM Interviews NEJM Outbreaks Update — H5N1
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Mar 4, 2025 
Yoshihiro Kawaoka, a renowned veterinarian and virologist, joins editors Eric Rubin and Lindsey Baden to discuss the critical issue of avian influenza. They explore how H5N1 spreads between chickens, cows, and even cats, raising concerns about potential human transmission. Kawaoka highlights the virus's mutations that may facilitate infections in humans and the economic impact of recent outbreaks, particularly on food supply and dairy production. The conversation underscores the urgent need for robust safety measures to mitigate these risks.
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H5N1 Influenza Explained
- H5N1 influenza is a subtype of influenza A virus, primarily infecting birds.
- It's named for its surface glycoproteins, hemagglutinin (H) and neuraminidase (N).
HPAI Definition
- HPAI (highly pathogenic avian influenza) kills poultry like chickens and turkeys at a 100% rate experimentally.
- Other avian influenza viruses infect poultry but do not cause death.
Avian Flu Impact on Poultry
- The current avian flu is impacting US poultry due to its spread from wild waterfowl to domestic birds.
- This transmission leads to die-offs in chickens and turkeys and egg shortages.