For those involved in pandemic planning and preparedness, a key uncertainty is whether or not a strain of the currently circulating H5N1 virus will evolve efficient human transmissibility.

For this reason, bio-era keeps special watch for any reported human infections that could signal a chain of inefficient human transmission, or any animal disease outbreaks with high potential to lead to unreported human disease.

In recent weeks, Myanmar (Burma), Azerbaijan and Indonesia have all been struggling to contain H5N1 outbreaks, but with mixed success. Their struggles to contain H5N1 are worth watching, because a number of factors combine in these outbreak areas, such as limited government monitoring and response capacities, weak public health infrastructure, high rates of poverty and slum dwelling, and problematic cultural and agricultural practices, which heighten the risk of human infections arising that go undetected, which could in turn lead to the beginnings of inefficient human-to-human transmission.

This “Signpost Alert” briefly summarizes recent developments in four recent outbreak countries.