Why should you care about bird flu?

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Dr Samira Mubareka wearing a lab coat in a lab.
Dr. Samira Mubareka is a clinician scientist whose work focuses on emerging viruses. (Photo credit: Kevin van Paassen/Sunnybrook Health Sciences Centre)

Last week, the city of Brampton confirmed that two dead waterfowl found in the city had tested positive for highly pathogenic avian influenza (HPAI) virus, or bird flu. This follows earlier reports of cases detected in nearby Halton and Niagara Regions, adding the Greater Toronto Area to the growing list of places affected by the virus.

As its name implies, HPAI typically infects birds but since early 2022, there have been growing reports of mammals getting infected and dying of influenza infection across a large geographic area. These mammals range from small land animals like raccoons and skunks to large carnivores like bears and mountain lions, as well as marine mammals like sea lions and dolphins. The illnesses are caused by the H5N1 strain of bird flu that is currently circulating across multiple continents.

To learn more about the bird flu outbreak and what we can do to prepare, I spoke to Dr. Samira Mubareka, an infectious diseases physician, medical microbiologist and scientist at Sunnybrook Research Institute. She is also an associate professor in the department of laboratory medicine and pathobiology in the Temerty Faculty of Medicine at the University of Toronto. Her research uses a collaborative One Health approach to conduct surveillance in wildlife and look at the biology of emerging viruses and transmission between species, including humans.

BZ: How widespread is bird flu right now?

SM: The level of avian influenza activity we’re seeing at the moment is unprecedented. To step back a bit, the first cases in North America were reported in late 2021 in birds in Newfoundland, and from there, it spread along the eastern seaboard into the United States along Atlantic flyways. Subsequently there were cases reported in the west of Canada and the United States, followed by cases in Central and South America. Beyond affecting wild and farmed birds, we are seeing spillover of HPAI into mammals, many of whom die of severe neurological complications. There has also been renewed focus on HPAI because a reported outbreak among farmed mink in Spain, with mammal-to-mammal transmission, and large die-offs of marine mammals, including sea lions. The virus also appears to be reassorting, or exchanging genetic material among H5N1 lineages. All of these represent red flags that reflect an amount of viral activity that we really haven’t seen before. We’ve also never seen this level of bird depopulation, both from die-offs and as a control measure. This has potential to impact biodiversity, wildlife health and conservation, as well as food costs and security. There have been a significant number of outbreaks, including here in Ontario, and some of them have been fairly close to densely populated areas. Having said all this, it is important to underscore that the risk remains low for humans, and that we have not had any human cases in Canada. Regardless, we need to prepare for that possibility.

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Why should you care about Marburg?

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Dr. Rob Fowler sitting with WHO colleagues outside a training centre in Sierra Leong.
Dr. Rob Fowler (second from right) with World Health Organization colleagues at the Ebola Clinical Training Centre in Freetown, Sierra Leone. (Photo credit: Rob Fowler)

Earlier this year, Equatorial Guinea declared its first outbreak of Marburg virus disease, with 11 confirmed deaths so far. The disease is caused by Marburg virus, which belongs to the same family of viruses as Ebola, and presents with similar symptoms including high fever, diarrhea, abdominal pain and cramping, and occasionally severe bleeding.

Dr. Rob Fowler is a critical care physician at Sunnybrook Health Sciences Centre and a professor in the Department of Medicine at the Temerty Faculty of Medicine at the University of Toronto. He volunteered with the World Health Organization (WHO) on the front lines of the Ebola outbreak in West Africa in 2014 to 2015 and in Congo in 2018, and this past year, co-chaired the WHO guideline development group that published the first guidelines for Ebola virus disease therapeutics.

I was privileged to be able to chat with Dr. Fowler recently to talk about the recent Marburg outbreak, what lessons we can take away from Ebola and how Canadian researchers and clinicians can help.

BZ: How did you react when you first found out that the cluster of people who died of suspected hemorrhagic fever had tested positive for Marburg virus?

RF: Well, anytime there’s a Marburg outbreak, it’s worrisome. Historically, it’s a virus that spreads efficiently from person to person and the mortality has typically been very high. Like Ebola, this virus often shows up in areas that have underdeveloped healthcare systems and a lot of characteristics within society at large that enable person-to-person spread. Tight living quarters is one example. These areas oftentimes don’t have the ability to limit virus spread because of a lack of access to consistent running water. So you know that Marburg or Ebola outbreaks are of course very tough for patients and healthcare teams, but also very difficult for the healthcare system and the population at large to manage. I feel for the folks that are in the thick of it right now because it’s very, very hard.

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Why should you care about tea?

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John Hales holding a spoonful of tea
John Hales is a level five tea master. (Photo credit: John Hales)

Whether it’s tea, chai or chă, there’s no doubt that tea is one of the oldest and most popular drinks in the world. From steaming mugs of hot tea in the winter to iced and bubble teas in the summer, rarely does a day go by that I don’t consume tea in some form. But I’ve never really given much thought to where it comes from or how it’s made, which is why I was so excited to sit down (over a cup of tea, of course) with John Hales. John has been working in the tea industry since he was 19 years old and is currently a level five tea master at Metropolitan Tea.

BZ: Let’s start at the beginning. How did you get started in the tea industry?  

JH: I guess you could say I was born into tea. My dad was a tea buyer and I got my first job was preparing teas for the tea tasters when I was 19 years old. I would weigh the teas by hand, brew them and flick the leaves into the lid for the taster to inspect. Then I became the guy that was tasting, blending and buying the tea. After a few years of doing that, I took on a new role where I was the middleman between the tea growing estates and the tea buyers. That job took me to Mombasa, Kenya, where my eldest daughter Rosie was born. After we moved back to the UK, I started working for a tea broking company, which closed in 2004 after we realized that the internet made it easier for buyers to have direct access to growers. I heard about an opportunity in Canada with a company called Metropolitan Tea and moved my family here in 2005 and that’s where I am today.

BZ: Wow, that’s quite the journey. How has the world of tea changed since you first started out?

JH: It’s really changed a lot, both in terms of the what and the how. When I was working for the specialty tea company as a 19 year old, specialty teas were pretty much jasmine tea, lapsang souchong and Darjeeling. Then Earl Grey was introduced as a flavoured tea, followed by lemon flavoured teas and all of a sudden, people realized that you could flavour all these teas. In the last few years, the doors have just blown off on specialty teas. Now, we can even do pina colada flavoured teas! It speaks to this movement away from traditional tea as I knew it growing up. We still see good sales in black, white, green and yellow teas, but herbal tea is where all the expansion is taking place.

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