Unusual cat deaths in Poland: why is there concern and what does WHO say?

A very particular situation has arisen in Poland in recent weeks. Authorities have had to euthanize 14 cats and eleven others have died. The last one, says in a brief report the World Health Organization (WHO) died on June 30

The situation was notified to the entity by the Polish authorities, who had to analyze 47 cat samples to better understand what was happening. Twenty-nine (62%) were positive for influenza A (H5N1).

The WHO explains that while sporadic infection of cats with A(H5N1) has been reported previously, this represents the first report of a high number of infected cats over a wide geographic area within a country.

Although the situation has begun to worry, the good news is that none of the humans who have had contact with these cats have shown any symptoms. For this reason, the WHO states that they nationally assess the risk of human infections as low for the general population and low to moderate for cat owners and individuals occupationally exposed to infected cats (such as vets) who do not use proper personal protective equipment with H5N1.

After analyzing the samples, the 19 viruses they sequenced showed that they all belonged to the H5 2.3.4.4b clade and were highly related to each other. These are viruses "similar to the influenza A (H5N1) 2.3.4.4b clade viruses that have been circulating in wild birds and caused outbreaks in poultry in Poland recently." These viruses have become dominant in Asia, Europe, the Americas, and Africa.

At the moment, the WHO is monitoring the situation and working hand in hand with other health entities such as the Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (WOAH) and different Polish agencies.

Avian flu spreads, cats affected

Dr. Justine Shotton, a senior vice president at the BVA, expressed concern over the reported cases of feline infectious peritonitis (FIP) in Cyprus. Although FIP is also observable in cats in the UK, ongoing tests are actively determining if this represents a new strain of the virus. Given this situation, veterinarians advise cat owners to get in touch if they have any concerns about their pet's health or welfare and to discuss possible preventative healthcare options.

In another incident, Polish authorities are currently investigating an outbreak of highly pathogenic H5N1 bird flu in domestic cats. As of 11 July, 29 cats from 13 regions of the country have tested positive for H5N1 influenza. The affected cats showed symptoms such as breathing difficulties, bloody diarrhea, and neurological issues. Tragically, eleven cats died, and authorities had to euthanize an additional fourteen. They are closely monitoring the situation to prevent further spread of the disease.

Dr. Gregorio Torres, the head of science at the World Organisation for Animal Health, has highlighted a recent paradigm change in the ecology and epidemiology of avian influenza. This shift has raised global concerns due to the disease spreading to new geographical regions, leading to unusual wild bird die-offs, and a worrisome increase in mammalian cases.

The investigation into the source of the cat infections is still ongoing, with possibilities including direct or indirect contact with infected birds or their environments, and consumption of infected birds or contaminated food. The available information shows that two cats lived outdoors, 18 cats had indoor access to a balcony, terrace, or garden, and five cats were completely kept indoors. Seven of the cats had reportedly come into contact with wild birds.

What symptoms did the cats develop?

As reported by the WHO, some cats developed severe symptoms, including difficulty breathing, bloody diarrhea, and neurological signs, with rapid deterioration and, in some cases, death.

To be precise, "20 cats had neurological signs, 19 had respiratory signs, and 17 had both neurological and respiratory signs."

However, at the moment it is unknown what was the source of exposure of the cats to the virus, but one of the hypotheses suggests that they may have had direct or indirect contact with infected birds. They may even have eaten them and may have ingested contaminated food.

“Of the 25 cats for which information was available, two were outdoor cats, 18 were indoor cats with access to a balcony, deck, or backyard, and five were indoor cats with no access to the outside environment. It is reported that seven cats had the opportunity to come into contact with wild birds ”, explains the WHO.

Are humans at risk?

According to WHO estimates, only 12 human cases with avian influenza A (H5N1) clade 2.3.4.4b virus have been reported so far. Of these, four were severe and eight were mild or asymptomatic.

But there is still a big question to be resolved. "It is not clear whether the detection of the virus in these mild or asymptomatic cases was due to infection or temporary contamination of the nasal passages," as most cases had direct or indirect contact with infected live or dead poultry.

Polish authorities gave health self-assessment questionnaires to all owners of infected cats and instructed them to self-monitor for influenza-like illness (ILI) or acute respiratory illness (ARI) for 10 days from their last contact with the infected cat.

As of July 12, 70 individuals who had contact with confirmed cats completed self-monitoring, and none reported symptoms. This indicates that humans did not detect any cases of infection after contact with an infected cat.

The WHO recalls that detections of the avian influenza A (H5N1) virus in humans remain rare, and they have not documented sustained person-to-person transmission.

WOHA also recommends that countries “strengthen influenza surveillance in animals and humans. To facilitate an early response, authorities should enhance risk-based surveillance in animals before and during high-risk periods. Prompt reporting of avian influenza cases in animals to WOAH is essential.

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