MASSACHUSETTS NURSE NEWSLETTER :: July/August 2005

Transmission of viruses between animals and people

According to the Centers for Disease Control and Prevention, influenza A viruses are found in many different animals, including ducks, chickens, pigs, whales, horses, and seals. However, certain subtypes of influenza A virus are specific to certain species, except for birds which are hosts to all subtypes of influenza A.

Avian influenza viruses may be transmitted to humans in two main ways:

• Directly from birds or from avian virus-contaminated environments to people.
• Through an intermediate host, such as a pig.

Influenza viruses have eight separate gene segments. The segmented genome allows viruses from different species to mix and create a new influenza A virus if viruses from two different species infect the same person or animal. For example, if a pig were infected with a human influenza virus and an avian influenza virus at the same time, the viruses could reassort and produce a new virus that had most of the genes from the human virus, but a hemagglutinin and/or neuraminidase from the avian virus. The resulting new virus might then be able to infect humans and spread from person to person, but it would have surface proteins (hemagglutinin and/or neuraminidase) not previously seen in influenza viruses that infect humans.

It also is possible that the process of reassortment could occur in a human. Theoretically, influenza A viruses with a hemagglutinin against which humans have little or no immunity that have reassorted with a human influenza virus are more likely to result in sustained humanto- human transmission and pandemic influenza. Thus, careful evaluation of influenza viruses recovered from humans who are infected with avian influenza is very important to identify reassortment if it occurs.

While it is unusual for people to get influenza infections directly from animals, sporadic human infections and outbreaks caused by certain avian influenza A viruses and pig influenza viruses have been reported. These sporadic human infections and outbreaks, however, rarely result in sustained transmission among humans.