Avian Influenza in Iraq between Fact and Illusion

Professor Dr. Salah Mahdi Hassan / Poultry Health and Production Consultant and Expert

Iraq is one of the countries in which the presence of the avian influenza virus under the H5N1 and H5N8 types has been diagnosed, and it has infected poultry flocks, both broilers and layers, and has led to significant economic losses. It is also one of the countries in which the presence and continuous movement of the low-pathogenic avian influenza virus under the H9N2 type has been diagnosed since the late nineties of the last century until now.

One of the facts that must be mentioned is that the influenza virus under the H9N2 type appears to have been present in the Iraqi field since the nineties of the last century in the fields of the Kurdistan region, and then spread to the rest of the fields in various areas of Iraq (undocumented observations and statements), noting that the vaccine was used unofficially in those fields. However, in 2010, researcher Awat Arif Al-Naqshbandi / PhD thesis in poultry diseases – University of Duhok indicated that in 2008, the H9N2 virus was isolated and its genetic sequence was determined from several poultry farms in Erbil and Sulaymaniyah that were suffering from severe respiratory symptoms accompanied by high mortality rates at a rate of (41.9%) of the number of farms included in the study, noting that the viral isolation and genetic sequencing were conducted in the reference laboratory in Weyberg / United Kingdom on 7/15/2008.

Accordingly, it seems that the field reality of Iraqi poultry farms in recent years, especially after the official use of the H5N1 vaccine was allowed in 2021 (although it was used unofficially before 2021), indicates the presence of avian influenza viruses of several subtypes, including H5N1, H5N8, and H9N2 (according to data from the Veterinary Department – Iraqi Ministry of Agriculture), and the situation may have become endemic, in addition to the presence of viruses of another subtype that have not been identified due to the lack of interest of the official veterinary authorities in this regard. However, the permanent presence of H9N2 and H5N1 viruses is the most common in spreading in Iraq (undocumented data), in addition to the availability and widespread use of vaccines containing these two viruses. The presence of these two subtypes (H9N2 and H5N1) in commercial poultry in Iraq increases the possibility of reassortment with other subtypes of avian influenza virus, which increases the risk of the emergence of a dangerous pandemic virus, which will naturally pose a major threat to the poultry industry and public health together. In 1994, scientific reports stated that H9N2 had evolved into more than 102 genotypes, and when its proteins were reassorted with H5N1, it produced more than 13 genotypes of new modified viruses. Therefore, it seems that this phenomenon may be normal in terms of the presence of the same subtypes in the same places in Iraq. Scientific reports indicated that the reassortment of these viruses may be direct or indirect, which plays a dangerous role in the entry of strong pandemic viruses, which exposes Iraqi people to health risks.

Of the 102 genotypes of the H9N2 virus, scientific research has confirmed that the S genotype, also known as “genotype 57,” may play a dangerous role in chickens. Reports from China indicate that this S genotype is ready to donate its internal genes for reorganization in other influenza viruses, which has led to the production of new mutated viruses of the highly pathogenic avian influenza virus HPAI, such as: H5N2, H7N7, H7N9, and H10N8. Donating genetic segments from H9N2 to the H7N9 and H10N8 viruses may enable the viruses to survive and spread continuously among poultry before adapting to human infection.

As for the H5N1 virus, it has been reported to have been present in Iraq since 2005 in domestic poultry in the Sarkabkan area of ​​Sulaymaniyah Governorate, accompanied by a fatal case of a 14-year-old village girl, which reactivated in 2015-2016 with highly virulent infections that left more than 2,823,035 million birds. As I mentioned earlier, “some Iraqi fields were using unlicensed H5N1 bird flu vaccines,” and “these fields also recorded severe H5N1 bird flu infections.” On 6/19/2021, the Iraqi Ministry of Agriculture issued a statement announcing official approval to import the H5N1 bird flu vaccine and use it in Iraqi fields without referring to the scientific mechanism and research conducted to determine the types of poultry allowed to use the vaccine, meaning (broilers, broiler mothers, layers, layer mothers, or domestic poultry), and what is the country of origin of the vaccine and what is the strain The vaccine used in the imported vaccine and what is its genetic sequence? What is the initial period specified for use, followed by serological follow-ups, viral isolation and molecular biology tests (PCR)? As a result, an exit plan must be developed from the vaccination process and the vaccine must be stopped. Unfortunately, all of these procedures were not addressed or discussed by the Veterinary Department, which announced a meeting that included poultry disease experts in Iraq. I do not know what the experts did in this meeting? Noting that after I suddenly learned about the import issue and because the Veterinary Department, represented by its former Director General, banned me because I did not follow what he wanted in terms of deception and concealing facts from officials, and the situation continued even after he left office, unfortunately, I say that I worked on writing a detailed report and a roadmap for how to introduce the influenza vaccine and deal with it, under the full supervision of the Veterinary Department, and submitted it to the Advisory Board in the General Secretariat of the Council of Ministers, and in the hands of Dr. Hussein Al-Wasiti, Advisor to the Prime Minister for Agricultural Affairs and a member of the Advisory Board, and I have a complete official copy and the official papers of the Advisory Board that prove what I have mentioned now. However, the matter, unfortunately, was left to the private sector without supervision, which worked to introduce H5N1 bird flu vaccines from many sources, some of which do not follow calibration systems or research and development (R&D), and the biggest disaster is that there are vaccine mixtures containing the two viruses H5N1 and H9N2??? It is worth noting that the last government report for the Veterinary Department was dated 5/14/ 2024 indicated the diagnosis of the presence of H5N1 virus in pathological samples from large numbers of seagull deaths in the Dokan Dam area / Sulaymaniyah Governorate.

The last twenty years have witnessed that the genetic gene of the HA protein of the H5N1 subtype has evolved to the point of genetic mutation, leading to the production of a number of different genetic and antigenic Clades and subclades, and today the H5N1 virus has evolved into ten basic clades (0-9 clades) and other dual, triple, quadruple and quintuple subclades depending on the diversity of HA genes. It is worth noting that in recent years, the most widespread chains in the world included chains 2.3.2 and 2.3.4, as well as chain 7.2, which achieved an environmental presence and continued to exist through the development into new chain branches, represented by the mutant of chain 2.3.4.4, which was previously known as chain 2.3.4.6.

On the other hand, H5N1 viruses can re-organize with H9N2 viruses prevalent in the Iraqi field and perhaps other avian influenza viruses such as H5N8, which caused severe infections in laying hens flocks in Diyala (12/17/2017) / Jadidat al-Shatt, and in Babylon (1/11/2018) / Al-Faihaa Abu Ghraq poultry, which led to the culling of more than 200,000 laying hens, producing more than 47 genotypes. Therefore, the current highly virulent H5N1 viruses are a mutated mixture of various influenza viruses, in addition to the fact that this current virus has developed a new mechanism to generate highly virulent H5 subtype viruses with different types of NA protein, which represents and poses a “serious” threat to public health in Iraq, where the poultry sector is witnessing a wave of high mortality, and the anatomical field image indicates the possibility of infection with the H5N1 virus, which was indicated by some private veterinary laboratories (data not officially approved), and we expect that the situation in Iraq will be similar to what happened in China recently, and through what research and scientific reports have shown of the reorganization of the H5N1 epidemic viruses from the genetic series 2.3.2.1 and the series 2.3.4.4 and the series 7.2, which represented the viruses H5N2, H5N6 and H5N8, and therefore the matter is very worrying because these new mutations that form the genetic backbone For the 2.3.4.4 series of the H5N1 mutant virus, it has worked on reorganization events of the circulating viruses such as: H3, H5, H6, H7, H9 and H11, which are the resulting new viruses and are found in abundance in birds.

The H9N2 virus can be transmitted through airborne droplets in chickens, which is attributed to its rapid spread in poultry farms. Researchers Zhang et al. (2013) reported that most of the H9N2 viruses isolated before 2000 were not characterized by transmission through the atmosphere in which the chicks were raised, but it was noted that a number of viruses isolated since 2001 and after, despite being produced by division and complete reproduction in infected chickens, have widespread spread through the air. Scientific research and reports indicate that some of the natural isolates of the H9N2 virus have acquired the ability to be transmitted efficiently in fur animals (mink) by respiratory droplet, and in mice by contact and nasal droplet. It was also indicated that some viruses can be transmitted through cats, guinea pigs, and fur animals by contact.

Therefore, the concern for public health in the community is due to the high prevalence of the H9N2 virus among animal species, and thus the increased virulence of the virus and its ability to transfer internal genes from other influenza viruses to generate a new influenza virus that is highly transmissible between mammals.

In recent years, the problem of the H5N1 virus, which was previously limited to Asia and poultry, has emerged due to its global spread to new species of mammals, which leads to endangering wildlife, agricultural production and human health. The problem began in 2020, when a new genotype of H5N1 viruses belonging to the 2.3.4.4b branch appeared and spread rapidly in wild birds from Europe to Africa, North America, South America and Antarctica.

In the beginning, the arrival of H5N1 viruses to North America seemed to be easy. Back in 2014, when the first H5 virus spread from Asia to North America, U.S. poultry farmers worked to limit the virus’s spread through biological surveillance and the culling of more than 50 million chickens and turkeys, ending the largest transboundary animal disease outbreak in U.S. history. Today, despite the culling of more than 90 million wild birds in the United States since 2022, deadly outbreaks continue to occur as a result of infection from wild birds. Wild birds have also introduced H5N1 to cattle and marine mammals. The images of decomposing seal carcasses on the Argentine beaches, as well as the yellowish curd-like appearance of milk produced by dairy cows infected with the H5N1 virus, give a true picture of the current outbreaks of the H5N1 clade: 2.3.4.4b virus, which differ from previous outbreaks, and therefore the strategies used previously to control the disease appear to be currently unsuccessful. We will have a detailed article soon to explain the status of the H5N1 virus in infecting mammals, with the overwhelming facts of its ability to be transmitted between mammals and the mechanism of the epidemic, God forbid, in humans.

What is the situation in Iraq now, and what preventive measures are required from the veterinary and health authorities?

First: Veterinary Department / Representative of the Iraqi Veterinary Authority:

1- Stopping the circulation of all types of bird flu vaccines and working on isolating and investigating the presence of influenza viruses in all poultry and wild bird rings and along the map of Iraq, in addition to accurate serological examination and seeking the assistance of international reference laboratories for this purpose.

2- Conducting serological examinations on all farm animals (cows, sheep and goats) for initial investigation of the presence of antibodies specific to bird flu, especially H5N1.

3- Given the field news of highly fatal disease outbreaks, the diagnosis of which ranges between influenza, IB disease and Newcastle disease (all of which are not scientifically proven diagnoses, but rather according to the examiner’s diagnosis), it is necessary to work on emphasizing the application of strict biosecurity procedures in the fields by holding seminars and symposia and using visual and written media to implement this order.

4- Preventing all private veterinary laboratories from dealing with disease samples, especially those related to the bird flu virus, and limiting the decision on such an order to the central veterinary laboratory in Baghdad exclusively and the veterinary laboratories in the governorates that are responsible for transferring disease samples with the known preventive measures to the central laboratory.

5- Announcing the presence of the H5N1 virus shall be exclusively through the Veterinary Department, the body legally responsible for animal health in Iraq.

6- The process of approving the use of influenza vaccine in poultry has its own methods and mechanisms for monitoring it in vaccinated poultry. It must be discussed by experts and specialists in virology, immunology, epidemiology and poultry diseases from the Ministry of Agriculture, the Ministry of Health and the Ministry of Higher Education, in addition to experts and consultants in the Iraqi field. One of the most important advantages of these experts is that they do not own private offices or clinics to marginalize the commercial factor and activate the scientific factor exclusively. Since it is included within the strategic activities of the poultry industry exclusively and through it to community health in general, it must be under the umbrella of the Council of Ministers. Therefore, it is necessary to link this issue with the National Safety and Security Committee due to the seriousness of the issue. Let the current French experience in vaccinating commercial ducks with H5 influenza vaccines, which has proven a dazzling initial success that made the United States the first country to rethink the use of the vaccine in cows, be a vital example that must be emulated. We also have an article about the French experience in using the influenza vaccine in ducks, which we will present soon, God willing.

Secondly: Public Health Department / Iraqi Ministry of Health:

Given the news of human infections with the H5N1 bird flu virus in several countries, including the United States, China and the Philippines, which so far appear to be a case of transmission from animals to humans, there is a fear as a result of what was mentioned about the virus previously in this article, there may be a pandemic, and since the Public Health Department in the Iraqi Ministry of Health is the body responsible for community health, precautionary measures must be taken, including:

1- Conduct a serological examination for all workers in Iraqi poultry fields to determine the presence of antibodies to the H5N1 virus.

2- Conduct a serological examination for all animal breeders and butchers, due to the current epidemic virus H5N1 causing infections in cows, pigs and other wild and marine mammals, and also to investigate the presence of these antibodies.