Mpox, bird flu, polio – viruses that made headlines in 2024. Experts warn of a new pandemic. How does virologist Alexander Kekulé assess the situation?
Even after the corona pandemic, viruses continue to pose a danger to people. What do we have to prepare for? t-online asked the virologist Alexander Kekulé.
t-online: Mr. Kekulé, Mpox infections recently caused excitement in North Rhine-Westphalia. Should this worry us?
Alexander Kekulé: No not really. Nobody will die from the virus in this country. Severe cases are only observed in people with previous illnesses that weaken the immune system. As a rule, such an infection goes away on its own. If the pustules become infected, you may need to give antibiotics. And you have to know that the disease is easily transmitted through smear infections, especially through sexual contact and among children.
Don’t you see any reason to be alarmed?
No, but we must continue to expect outbreaks from imported infections. That doesn’t mean that every dark-skinned person in this country is a danger. I would therefore like to urgently warn against prejudices. Children with African roots living here are just as harmless as white children. So far, the Mpox virus has only come from people who have recently been to an African outbreak area.
Prof. Dr. Alexander Kekulé is a specialist in virology, microbiology and infection epidemiology and was an advisor to the federal government on disease control. As director of the Institute for Medical Microbiology at the University of Halle, he went into regular retirement on September 30, 2024. During the pandemic, he became known through his talk show appearances and his podcast on MDR.
Does the bird flu virus alarm you? Many people see it as a candidate that could trigger a new pandemic.
I classify the threat somewhat differently than some of my German-speaking colleagues, who have already spoken to the press of a “pandemic in the early stages”. In order to trigger a pandemic, the H5N1 bird flu virus would first have to learn to fly, i.e. become contagious through the respiratory tract. We have been monitoring H5N1 since the 1990s. There have been many outbreaks in animals and also repeated human infections. However, transmission never occurred via the respiratory tract.
The virus is currently spreading to herds of cattle in the USA. You don’t get the impression that enough is being done against the virus, do you?
Americans are doing far too little to contain the spread. The farmers and the dairy industry even refuse to allow the monitoring authorities to take samples, as the division in society due to the Corona measures is still having an impact. Profit obviously takes precedence over safety here. Traces of the H5N1 virus are already regularly found in commercial milk in the USA. The fact that a technologically highly developed country cannot get this under control is unacceptable.
It was recently said that the virus is only two mutations away from jumping to humans.
Yes, but for some reason H5N1 has not evolved in this direction, even though there has been a gigantic wave of infections in the animal kingdom for years. I have doubts as to whether H5N1 can become a pandemic pathogen through gradual mutations – we are talking about “antigen drift” here.
The virus has not only been found in birds, but also in a variety of mammals, from minks to seals and deer. The American failure has already led to a “panzootia,” a global epidemic in the animal kingdom. However, H5N1 does this solely through smear infections; infection via the respiratory tract has never been observed.
But it could happen.
However, in my assessment, which, as I said, differs from that of some prominent colleagues, H5N1 would have to mix its genetic material with another influenza virus that already causes human respiratory infections.
The pandemic pathogen would then be a chimera – in influenza virology we speak of “reassortants” – that combines the properties of H5N1 and one or two other precursors. What is alarming in this context is that in the USA there are apparently already unnoticed H5N1 infections in people who have had no contact with dairy cows.
What makes mixing so dangerous?
If someone like that also catches a seasonal flu virus, a reassortant can develop that triggers a pandemic within a few weeks. Conversely, a mammal infected with H5N1 could also breed a new pandemic virus if it also becomes infected with a human flu virus. This is not uncommon, especially in livestock farming.
If that happens, it would without question be the greatest failure in the history of medicine. Never before have we known in advance where the danger comes from during a pandemic, and never before has humanity had the means to prevent the foreseeable catastrophe.