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I've taken an intensive molecule virology class focusing on H5N1, and the probability of a recombination event that would allow human to human transmission in a more virulent form than its current form is remote. This is what we may be disagreeing over. Now, a recombination event that would allow h2h but with a reduced virulent is higher in probability than the former, but is still remote. Most of the clinical and genetic research of H5N1 suggest that it has not undergone a recombination event that allows insertion into cells with alpha 2-6 S.A. linkage and higher virulence and mortality.
Wild fowl is the natural reservoir of all influenza viruses, and they are 2-3 SA linkage. Pigs have both, hence they are "mixing vessels" for recombination. This is where 2-6 linkage is often originated and usually has reduced virility.
Now, H1N1, the 1918 pandemic, seemed to jumped directly to humans with no intermediate recombination. Based on the length of time that H5N1 has been exposed to the human population, it seems improbable that mutation has occurred resulting in a highly virulent H5N1 (which would mean it does has 2-6 linkage).
There is no doubt that there will probably be h2h transmission of at least a form of H5N1, but probably with not as high a virulence as the current form that we see spreading in birds. My professor said that the human deaths that have resulted are probably due to epithelial cell infection because those cells do have some 2-6 SA receptors. This contact requires very, very close contact with infected fowl, though, and usually does not provide much of a chance for recombination.
So that's it in a nutshell. I do not think there will be a pandemic, though there may at some point in the next few years be a bad flu season.
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