The role of mammals in Avian Influenza: A review

Avian influenza (AI) is an infectious viral disease of birds, including domestic poultry, which has been causing outbreaks worldwide, leading to several millions of dead wild birds and culled poultry. AI is mainly found in birds, but recently, there was an increase in reported infections in mammals, ranging from no symptoms to mass mortality events and some human cases. Epidemiologically of great concern, evidence of mammalian adaptations have been found, but the transmission routes and pathogenesis in mammals are still to be defined. Hence, it is paramount to address all facets of AI viruses epidemiology, including investigating taxa not customarily thought to be involved in the transmission and/or trafficking of AI, such as wild mammals. The scope of this report was to assess the role of mammals in AI epidemiology, virology and pathology, i.e. AI maintenance, reservoir role, immunity, role of mammals in a potential pandemic. To do so, we performed an all-encompassing review of the literature on the topic with a two-fold approach: a systematic review of the published AI cases in wild mammals and a narrative approach to provide an expert opinion on the role of mammals in AI spread. The final number of peer-reviewed papers included in the systematic literature review was 76, resulting in 120 unique infection records with AI in wild mammal species. The most represented taxa were included in the order Carnivora. The risk of infection was identified mainly as predation (or feeding) upon infected birds or contact with avian species. Evidence of mammal-to-mammal transmission in the wild is only circumstantial and yet to be confirmed. Cases of AI from the systematic review of experimental findings were discussed concerning epidemiology, pathology and virology. Knowledge gaps and potential pandemic drivers were identified. In summary, although a greater number of infections in wild mammals have been reported, there is no hard evidence for sustained mammal-to-mammal transmission in the wild. The factors contributing to the increased number of infections found in wild carnivores are not clear yet, but the unprecedented global spread of highly pathogenic avian influenza (HPAI) viruses creates ample opportunities for intense, mostly alimentary, contact between infected wild birds and carnivores. Close surveillance of circulating strains and continued assessment of new epidemiological situations are crucial to quickly identify strains with enhanced mammalian fitness.