Passeriformes, Poultry, Pastures, People, and Preparedness (5Ps): Tackling Avian Influenza A (H5Nx) Challenges at the Agriculture Interface

The SARS-CoV-2 pandemic has laid bare both the strengths and the inadequacies of pandemic preparedness in Canada. Agricultural systems have complex relationships with human health and many infectious diseases have agricultural roots. Pandemic preparedness and response activities have traditionally focused on modelling scenarios related to population-wide interventions (e.g. vaccine prioritization) once sustained community transmission occurs. This leaves a significant and time-sensitive gap in our understanding of early, upstream pathogen dynamics when spillover from animals to humans is first observed. The urgency of this gap has become critical due to the recent and unexpected occurrence of highly pathogenic influenza A (HPAI) H5N1 in North American dairy cattle. We will address this gap in our understanding of early, upstream dynamics by developing an influenza A (H5Nx) quantitative modelling framework, rooted in a One Health approach. Our approach will use mathematical models to quantify and inform risk analysis, intervention assessment, and policy development with a specific focus on 1) occupational risk of spillover in the Canadian agricultural workforce, and 2) the downstream impacts of sector-specific interventions to reduce the risk of spillover and prevent sustained person to person transmission. Infections in humans with animal contact due to occupational exposures, represent an upstream, early public health intervention point. Early interventions could reduce chains of transmission and the possibility that influenza A viruses accumulate mutations that increase pandemic potential. Understanding how to minimize the risk of spillover (and spillback) within and between agricultural commodity groups, agricultural workers and Canadian communities is an important step for early pandemic preparedness and risk assessment to reduce the broader risk posed by influenza A (H5Nx) as a virus with pandemic potential.