Should we change the definition of avian influenza for eradication purposes?

Abstract

The current definitions of high-pathogenicity avian influenza (HPAI), formulated over 10 years ago, were aimed at including viruses that were overtly virulent in in vivo tests and those that had the potential to become virulent. At that time the only virus known to have mutated to virulence was the one responsible for the 1983-84 Pennsylvania epizootic. The mechanism involved has not been seen in other viruses, but the definition set a precedent for statutory control of potentially pathogenic as well as overtly virulent viruses. The accumulating evidence is that HPAI viruses arise from low-pathogenicity avian influenza (LPAI) H5 or H7 viruses infecting chickens and turkeys after spread from free-living birds. At present it can only be assumed that all H5 and H7 viruses have this potential and mutation to virulence is a random event. Therefore, the longer the presence and greater the spread in poultry the more likely it is that HPAI virus will emerge. The outbreaks in Pennsylvania, Mexico, and Italy are demonstrations of the consequences of failing to control the spread of LPAI viruses of H5 and H7 subtypes. It therefore seems desirable to control LPAI viruses of H5 and H7 subtype in poultry to limit the probability of a mutation to HPAI occurring. This in turn may require redefining statutory AI. There appear to be three options: 1) retain the current definition with a recommendation that countries impose restrictions to limit the spread of LPAI of H5 and H7 subtypes; 2) define statutory AI as an infection of birds/poultry with any AI virus of H5 or H7 subtype; 3) define statutory AI as any infection with AI virus of H5 or H7 subtype, but modify the control measures imposed for different categories of virus and/or different types of host.