Strains and stamps

Trouble came from an unexpected direction. The notorious bird flu, which until now had been roaming somewhere in Europe and East Asia, and in Russia had visited only remote regions, suddenly appeared near the very walls of Moscow, and even in the off season. While sanitary services take samples and destroy birds from infected farms, the population is trying to understand, based on conflicting reports, where to run and what to fear.

For specialists, of course, bird flu is not such a new thing. It constantly circulates in populations of wild waterfowl – primarily ours, Russian ones. It does not cause noticeable harm to them, but during wintering in warm countries (most often in China, although something similar may have happened in Western Europe last winter), the virus spreads to local ducks, and from them to other poultry. And then he remembers that he is the causative agent of a dangerous infection. At the end of winter, an epizootic begins in these regions - mass disease and death of poultry.

This disaster occurs almost every year - and each time a certain number of people become infected with bird flu. The disease develops in them as rapidly as in chickens, and in two out of every three cases it ends in death. But large epidemics of bird flu never happen: unlike human flu, it is not a respiratory infection, but an intestinal one. Birds become infected with it through food that contains infected droppings, with water from a reservoir where healthy birds splash around with sick ones, etc. A person can also become infected only through food - by eating undercooked chicken, drinking raw water, or even accidentally swallowing a microscopic a piece of leather or fluff. But this path for the virus is a dead end: people cannot become infected from each other through food, and the cells of the respiratory tract do not have the receptor molecules to which the virus “moored.”

But no one today doubts that it was the bird flu that once gave rise to the human flu - which means that this barrier was somehow overcome. No one can guarantee that this will not happen again. What’s even worse is that in an organism infected simultaneously with avian and human influenza viruses, when new viral particles are assembled, genes can get mixed into them (such “hybrid” viruses are called reassortants). Among others, a reassortant may arise that will inherit from human influenza the ability to penetrate respiratory epithelial cells, and from avian influenza – types of active envelope proteins unfamiliar to our immune system: hemagglutinin (H) and neuraminidase (N). In avian influenza, as many as 15 main types of hemagglutinin and 9 neuraminidase are known (the now familiar code “H5N1”, in fact, means “hemagglutinin of the fifth type, neuraminidase of the first”), while “ours” has three and two, respectively. Virologists are confident that this meager diversity also came to our viruses from avian viruses through reassortants. And the appearance of a fundamentally new model of any of these proteins in human viruses usually means a pandemic—a worldwide epidemic with a large number of victims. More recently, it was proven that this is how the causative agent of the “Spanish flu” appeared - the pandemic of 1918-19, which cost humanity, according to various estimates, from 10 to 40 million lives. The last such novelty – the famous “Hong Kong”, aka H3N2 – entered the “flu market” almost 40 years ago, in 1968, and since then, virologists and epidemiologists have been anxiously awaiting its successor every winter. It is the threat of the emergence of a killer strain that makes us so wary of every outbreak of bird flu and especially of reports of its transmission from person to person.

In this sense, the current outbreak near Moscow does not pose a particular threat. It is easy to see that the deadly strain (and it has already been identified as H5N1) did not reach the unfortunate laying hens from nature. Firstly, there are no mass migrations of waterfowl in central Russia in January-February. Secondly, poultry farms and private farms near Moscow may not be an example of sanitation and hygiene, but for their inhabitants to eat from the same feeders with wild birds or swim in the same pond with them - such practices for our farms, to put it mildly, are extremely uncharacteristic . Finally, the primary source of infection emerged from the very beginning - all the birds from the first wave of the disease were bought a day or two earlier at the new Poultry Market near the Moscow Ring Road.

It is quite obvious that we are talking about importation - the pathogen entered the region not from wild birds, but from infected farms. Moreover, it is unlikely to happen to live birds - the latent period of development of the disease lasts 1-2 days in birds, and its outbreaks have so far occurred no closer to the Caucasus and the Urals. And if you didn’t transport infected chickens on direct flights, there was no way to sell them for healthy ones. Most likely, the virus arrived in feed, on the walls of cages, or on something else that an unknown, zealous owner regretted throwing away and could not properly disinfect (previous outbreaks, like the current one, occurred mainly not in poultry farms, but in rural backyards). And the tactics to counter the threat are, in general, also obvious: to completely destroy poultry in those farms where the disease has already been detected; strictly disinfect equipment and premises, strengthen sanitary control and protective measures in other farms in the region, try to trace the source and routes of infection... For people directly working with poultry - mechanical protection against accidental ingestion of biomaterial (regular gauze bandages) and preventive medications, for everyone else - recommendations to fry chicken legs well and forget about eggnog for a while. This is roughly what professionals are doing now - doctors, veterinarians, Rospotrebnadzor employees.

But besides professionals, we also have bosses in our country. There are a lot of them, and they cannot stay away from an important matter. Moreover, they always know what to do and who is to blame.

In the very first days of the outbreak, even before the official identification of the causative strain, the chief veterinarian of the Moscow region, Valery Sitnikov, publicly suggested that this was a case of biological sabotage: someone, they say, deliberately infected them right at the market. Of course, Mr. Sitnikov did not provide not only evidence of the intentionality of the action, but also no assumptions about who might need such a thing. And why? We ourselves know that the Americans drop the Colorado potato beetle to us from helicopters, and if there is no water in the tap...

However, this gap was filled a few days later by the speaker of the lower house of the federal parliament and the leader of the ruling party, Boris Gryzlov. He stated that “this is a conscious project that was aimed at the production and sale of expensive vaccines, and it was not invented in Russia.” And he further explained that bird flu had been known for a long time, dogs and birds died from it every year, it was just that it used to be called distemper. Our country has not known such bold medical generalizations, perhaps, since the time of the unforgettable Trofim Denisovich Lysenko - one of whose associates, I remember, also “discovered” the transformation of bacteria and viruses into each other. Well, yes, we have a fashion for consolidation - subjects of the Federation, departments, political parties, and now, it seems, diagnoses. It is possible that United Russia will soon delight us with a combination of congenital dementia with logorrhea and hyperactivity syndrome.

If the bosses only talked, it wouldn’t be so bad, but they also take action. Urgent mass vaccinations of poultry with bird flu vaccine have begun in the region. Generally speaking, the effectiveness of the vaccination campaign, launched already during the outbreak of the disease, is fully described by the folk proverbs “to go hunting, feed the dogs” and “it’s too late to drink Borzh when the buds have fallen off.” There is more sense in vaccinating people, but the drug available to Russian doctors was found to be ineffective according to the results of clinical trials (completed last year).

Another favorite Russian preventive measure is shooting. Despite the fact that wild birds were not involved in this outbreak, immediately after the first cases of the disease, teams of hunters were formed in the Odintsovo and Domodedovo regions and enthusiastically began to shoot all birds. (By the way, such shootings only increase the likelihood of human infection, and if it were really a matter of wild birds, it would be necessary to think not about creating Sonderkommandos, but about closing the spring hunt.) The capital’s authorities did not stand aside either: municipal authorities have already instructions were given to take measures to prevent birds from nesting in the attics of houses. Fortunately, in February in our area the only people building nests are crossbills, which have not yet been seen in Moscow attics. Only incurable bosses can believe that in April-May someone else will remember this directive.

However, they are unlikely to evaluate the measures taken in terms of results. Their task is to somehow react and report. Check the box that measures have been taken. “Our job is to crow, but at least it’s not dawn!”

As they say, medicine is powerless against this disease.