Vogelgrippe: Was bedeutet der erste Todesfall durch H5N1 in den USA?

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Der Beginn einer Pandemie ist das nicht. Doch der Fall ist Grund zur Sorge.", "image": [{"@type": "ImageObject", "url": "https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild1/wide__1280x720", "width": 1280, "height": 720, "copyrightHolder": {"@type": "Organization", "name": "\u00a9\u00a0epa CDC HO/\u200bdpa"}}, {"@type": "ImageObject", "url": "https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild1/standard__1120x840", "width": 1120, "height": 840, "copyrightHolder": {"@type": "Organization", "name": "\u00a9\u00a0epa CDC HO/\u200bdpa"}}, {"@type": "ImageObject", "url": "https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild1/square__960x960", "width": 960, "height": 960, "copyrightHolder": {"@type": "Organization", "name": "\u00a9\u00a0epa CDC HO/\u200bdpa"}}], "keywords": "Vogelgrippe, Infektion, USA, Louisiana, Gesundheitswesen, Pandemie", "isAccessibleForFree": "True", "hasPart": { "@type": "WebPageElement", "isAccessibleForFree": "True", "cssSelector": "main .article-page" }, "publisher": { "@id": "https://www.zeit.de/index#publisher" } , "articleBody": "Nun ist es also passiert: In den USA ist erstmals ein Mensch an einer Infektion mit dem Vogelgrippevirus H5N1 gestorben. Die Person aus dem Bundesstaat Louisiana hatte sich bei infiziertem Geflügel einer sogenannten Hinterhofhaltung sowie Wildvögeln angesteckt, wie die Gesundheitsbehörden mitteilten . Schon im Dezember war sie so schwer erkrankt, dass sie in eine Klinik eingewiesen wurde. Dort starb sie nun. Die Behörden teilten mit, dass es sich bei dem Patienten oder der Patientin um einen über 65 Jahre alten Menschen mit Vorerkrankungen handelte, Genaueres ist nicht bekannt. Vor einem Jahr infizierte das Virus erstmals Kühe in den USA, immer wieder steckten sich auch Menschen an. Doch bisher starb keiner von ihnen. Entsprechend schnell verbreitete sich nun die Meldung über diesen ersten Todesfall, und mit ihr die Frage, was er bedeutet. Verändert er die Einschätzung von Experten darüber, wie gefährlich das Vogelgrippevirus H5N1 in seiner aktuellen Form für den Menschen ist? Oder gar die Wahrscheinlichkeit, dass der Erreger eine Pandemie auslösen könnte? In einer Mitteilung schreibt die US-Seuchenschutzbehörde CDC: "Ein Todesfall durch die H5N1-Vogelgrippe in den Vereinigten Staaten ist zwar tragisch, aber nicht unerwartet." Das Risiko für die Bevölkerung schätzt die Behörde derzeit als niedrig ein. Das liegt vor allem daran, dass es weiterhin glücklicherweise keinen Anhaltspunkt für eine Übertragung von Mensch zu Mensch gibt. Doch auch wenn der Fall an sich das Risiko einer Pandemie nicht erhöht, macht er – und die Entwicklung des Virus – Fachleuten Sorgen. Seit 2020 geht ein neuer Stamm um die Welt Tatsächlich besorgt das Vogelgrippevirus H5N1 Expertinnen und Experten schon, seit es 1997 in Hongkong zu einem ersten Ausbruch bei Menschen kam. Damals infizierten sich 18 Menschen an infiziertem Geflügel, sechs davon starben. Seit 2003 wurden der Weltgesundheitsorganisation WHO mehr als 950 Infektionsfälle gemeldet (PDF), von denen etwa die Hälfte starb, die meisten Fälle traten in Asien auf. Seit 2020 verbreitet sich ein neuer Stamm des Vogelgrippevirus, genannt Klade 2.3.4.4b, auf der ganzen Welt. Er hat Millionen Wildvögel und Geflügel infiziert und immer wieder auch Ausbrüche unter Säugetieren verursacht. Vor etwa einem Jahr sprang das Virus auf Milchkühe in den USA über und hat dort bislang mehr als 900 Herden in 16 Bundesstaaten infiziert. Auch Menschen haben sich in den USA seitdem immer wieder mit der neuen Virusvariante angesteckt. Bei den meisten der insgesamt 66 Fällen verlief die Infektion mild, sie hatten etwa eine Bindehautentzündung. Fachleute rätseln schon länger, " warum die meisten dieser Fälle bisher so mild verliefen ". Denn von den " elf menschlichen Infektionen " mit Klade 2.3.4.4b, die seit 2022 in fünf Ländern auftraten, erkrankten immerhin vier Menschen schwer, einer davon in China starb. Manche vermuten, es habe unter anderem damit zu tun, dass in den USA meist junge, gesunde Farmarbeiter betroffen sind. Womöglich könnte sich das Virus anders verhalten, wenn es ältere Menschen mit Vorerkrankungen infiziert. So wie die Person aus Louisiana, die nun gestorben ist. "Für mich ist das die wichtigste Erkenntnis aus dem Fall: Diese Viren sind in der Lage, schwere Krankheiten zu verursachen", sagte die kanadische Virologin Angela Rasmussen Stat News . "Vielleicht nicht mit der gleichen Häufigkeit, wie wir sie bisher bei H5N1 angenommen haben, aber sie sind definitiv dazu in der Lage." Auch andere Experten erwarten, dass das nicht der letzte Todesfall durch H5N1 gewesen sein dürfte, wenn das Virus weiter in Kühen und Vögeln zirkuliert. Doch solange es bei einzelnen Übertragungen von Tier zu Mensch bleibt, ist das Risiko einer Pandemie gering. Die Frage ist nur: Wie lange bleibt das so? Eine Jugendliche musste auf Intensivstation behandelt werden Hier kommt ein Detail des Falls in Louisiana ins Spiel. Zwar handelte es sich bei dem Virus, das den Menschen letztlich tötete, um H5N1, genauer: Klade 2.3.4.4b. Genaue Genanalysen ergaben jedoch, " dass es sich um den Genotyp D1.1 handelt ". Diese Version des Virus unterscheidet sich von den H5N1-Viren, die derzeit in Kühen zirkulieren und von dort immer wieder auf Menschen überspringen und für die vielen milden Krankheitsverläufe verantwortlich waren. Die Version des Virus ist enger mit jenen Viren verwandt, die Vögel in den USA infizieren und kürzlich eine 13-jährige Jugendliche in Kanada so krank machten, dass sie wochenlang auf einer Intensivstation behandelt werden musste. Einem aktuellen Bericht im New England Journal of Medicine zufolge schlossen die behandelnden Ärzte sie wegen ihrer schweren Erkrankung sogar an eine Extrakorporale Membranoxygenierung (ECMO) an, bei der das Blut außerhalb des Körpers mit Sauerstoff angereichert wird. Inzwischen erholt sie sich von der Infektion. In beiden Fällen, bei der Teenagerin in British Columbia und der verstorbenen Person in Louisiana, fanden sich Mutationen im Viruserbgut, " die es dem Virus leichter machen könnten, sich an den menschlichen oberen Atemtrakt anzuheften ". Fachleute gehen davon aus, dass sich diese Veränderungen gebildet haben, während sich das Virus im Körper der Erkrankten vermehrte. So waren sie im Fall des Verstorbenen in Louisiana bei Proben der Vögel, an denen er sich infizierte, nicht gefunden worden. Das CDC schreibt, es sei zwar besorgniserregend und eine Erinnerung, dass sich Viren während einer Infektion im Körper verändern können. Noch besorgniserregender wäre es aber, wenn sich diese Änderungen bereits bei den Vögeln fänden oder sie sich in der Frühphase einer menschlichen Infektion bilden würden. Das könnte das Risiko einer Mensch-zu-Mensch-Übertragung steigern. Die wichtige Nachricht: Offenbar steckten die beiden Infizierten niemanden in ihrem Umfeld mit dem Virus an. Ein Vogel, infiziert mit zwei Viren gleichzeitig Und doch machen sich manche Fachleute – wenn es um die Frage einer möglichen Pandemie geht – vor allem Sorgen über eben jenen D1.1-Genotyp des Virus. Dieser hat sich durch sogenannte Reassortierung neu gebildet, wahrscheinlich indem ein Vogel gleichzeitig mit zwei verschiedenen Influenzaviren infiziert war, deren Erbgut sich dann neu gemischt hat. Heraus kam eine Virusvariante mit einer neuen Neuraminidase, dem N in H5N1. Dieses Protein ermöglicht, dass neu gebildete Viruspartikel die Wirtszelle verlassen und sich weiter im Körper ausbreiten können. Manche Experten befürchten, dass sich diese neue Variante von H5N1 " leichter zu einem pandemischen Virus entwickeln könnte " als die Variante, die in Kuhherden zirkuliert. "Die Rindervariante scheint ziemlich stabil zu sein und könnte noch eine Weile so weiterlaufen", sagte der Experte für Infektionskrankheiten, Michael Osterholm, Science . "D1.1 macht mir Sorgen." Um es deutlich zu sagen: Ob wir vor einer H5N1-Pandemie stehen und wie schwer diese dann ausfallen würde, ist unklar. Niemand kann das Risiko genau beziffern, auch weil Grippeviren " als unberechenbar gelten ". Klar ist nur: Je stärker das Virus in Tieren zirkuliert und je öfter es auf Menschen überspringt, desto wahrscheinlicher wird es, dass es sich besser an den Menschen anpasst. Das wird besonders relevant vor dem Hintergrund der saisonalen Grippewelle, die die USA gerade erfasst. Wenn sich jemand gleichzeitig mit dem Vogelgrippevirus und der saisonalen Grippe infiziert, könnte das dem H5N1-Virus theoretisch die Gelegenheit bieten, Erbgut mit saisonalen Grippeviren auszutauschen und so Mutationen zu erwerben, die es braucht, um sich effizient unter Menschen zu verbreiten. Nach langer Untätigkeit haben die Verantwortlichen in den USA das Risiko, das von H5N1 ausgeht, offenbar erkannt. So sollen Mitarbeiter in betroffenen Milchviehbetrieben und Rohmilch verstärkt getestet werden. Anfang Januar teilte die Biden-Administration zudem mit, 306 Millionen US-Dollar zu investieren, um Bereitschafts- und Überwachungsprogramme sowie die medizinische Forschung gegen das H5N1-Virus zu stärken. 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class="header-fullwidth__media-item" src="https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild1/super__767x511" alt="" /> </picture> <script type="application/ld+json"> { "@context": "https://schema.org", "@type": "ImageObject", "url": "https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild1/super__480x320", "width": 480, "height": 320, "copyrightHolder": { "@type": "Organization", "name": "\u00a9\u00a0epa CDC HO/\u200bdpa" } } </script> <div class="figure__caption"> <span class="figure__copyright">© epa CDC HO/dpa</span> </div> </div> <div class="header-fullwidth__crossfade-item"> <picture class="header-fullwidth__media-container header-fullwidth__media-container--desktop-super header-fullwidth__media-container--mobile-portrait"> <source media="(max-width: 360px)" srcset="https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/portrait__360x480__mobile, 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<source media="(max-width: 660px)" srcset="https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/portrait__660x880__mobile, https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/portrait__660x880__mobile__scale_2 2x" /> <source media="(max-width: 767px)" srcset="https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/portrait__767x1022__mobile, https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/portrait__767x1022__mobile__scale_2 2x" /> <source media="(max-width: 820px)" srcset="https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/super__820x546__desktop, https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/super__820x546__desktop__scale_2 2x" /> <source media="(max-width: 900px)" srcset="https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/super__900x600__desktop, https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/super__900x600__desktop__scale_2 2x" /> <source media="(min-width: 900px)" srcset="https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/super__1000x666__desktop, https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/super__1000x666__desktop__scale_2 2x" /> <img class="header-fullwidth__media-item" src="https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/super__767x511" alt="" /> </picture> <script type="application/ld+json"> { "@context": "https://schema.org", "@type": "ImageObject", "url": "https://img.zeit.de/wissen/2025-01/vogelgrippe-virus-h5n1-usa-todesfall-infektion-bild2/super__480x320", "width": 480, "height": 320, "copyrightHolder": { "@type": "Organization", "name": "\u00a9\u00a0Loic Venance/\u200bAFP/\u200bGetty Images" } } </script> <div class="figure__caption"> <span class="figure__copyright">© Loic Venance/AFP/Getty Images</span> </div> </div> </div> </div> <div class="header-fullwidth__context"> <div class="article__item"> <h1 class="article-heading" > <span class="article-heading__kicker">Vogelgrippe</span><span class="visually-hidden">: </span><span class="article-heading__title">Was bedeutet der erste Todesfall durch H5N1 in den USA?</span> </h1 > </div></div> </div> <div class="article__item"> <div class="summary">Erstmals ist in den USA ein Mensch an einer Infektion mit dem Vogelgrippevirus H5N1 gestorben. Der Beginn einer Pandemie ist das nicht. Doch der Fall ist Grund zur Sorge.</div> <div class="byline" data-ct-row="author"> Von <span itemscope itemtype="http://schema.org/Person"> <a href="https://www.zeit.de/autoren/S/Florian_Schumann/index" rel="author" itemprop="url" data-ct-column="1_of_1" data-ct-subcolumn="false"> <span itemprop="name"><span class="visually-hidden">Dr.</span> Florian Schumann</span></a></span></div> <div class="metadata"> <time datetime="2025-01-07T16:56:49+01:00" class="metadata__date">7. Januar 2025, 16:56 Uhr</time> </div> </div> <div class="article-actions article__item" > <div class="audio-player js-audio-player" data-ct-row="article-player" data-ct-column="false" > <audio class="audio-player__audio " src="https://zon-speechbert-production.s3.eu-central-1.amazonaws.com/articles/b4c5c1b6-ee2e-46b0-a2fa-6b431ac97ed6/full_25878bd8ab35e6ad4bfbc12ed225762994d41e8da437c17fae3ef30ab404e90c981e5886851ae916effe5b9d2026a403.mp3" controls preload="none"> Ihr Browser unterstützt die Wiedergabe von Audio Dateien nicht. 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Wir entwickeln dieses Angebot stetig weiter und freuen uns über <a href="mailto:audiofeedback@zeit.de?subject=Feedback%20TTS">Ihr Feedback</a>. </div> </div> </div> </div> </div> </header> <div class="article-body article-body--article"> <div class="iqdcontainer" data-placement="pos_1" data-device="desktop"></div><div class="iqdcontainer" data-placement="pos_1" data-device="mobile"></div> <div class="article-page" data-page-number="1"> <p class="paragraph article__item">Nun ist es also passiert: In den USA ist erstmals ein Mensch an einer Infektion mit dem <span class="rtr-schema-org" itemscope="" itemtype="http://schema.org/Thing"><a class="rtr-entity" href="https://www.zeit.de/thema/vogelgrippe">Vogelgrippevirus</a></span> H5N1 gestorben. Die Person aus dem Bundesstaat Louisiana hatte sich bei infiziertem Geflügel einer sogenannten Hinterhofhaltung sowie Wildvögeln angesteckt, <a href="https://ldh.la.gov/news/H5N1-death" target="_blank">wie die Gesundheitsbehörden mitteilten</a>. Schon im Dezember war sie so schwer erkrankt, dass sie in eine Klinik eingewiesen wurde. Dort starb sie nun. </p> <div class="iqdcontainer" data-placement="pos_marg_right_1" data-device="desktop"></div> <div class="iqdcontainer" data-placement="pos_2" data-device="mobile"></div> <p class="paragraph article__item">Die Behörden teilten mit, dass es sich bei dem Patienten oder der Patientin um einen über 65 Jahre alten Menschen mit Vorerkrankungen handelte, Genaueres ist nicht bekannt. </p> <p class="paragraph article__item">Vor einem Jahr infizierte das Virus erstmals Kühe in den <span class="rtr-schema-org" itemscope="" itemtype="http://schema.org/Place"><a class="rtr-entity" href="https://www.zeit.de/thema/usa">USA</a></span>, immer wieder steckten sich auch Menschen an. Doch bisher starb keiner von ihnen. Entsprechend schnell verbreitete sich nun die Meldung über diesen ersten Todesfall, und mit ihr die Frage, was er bedeutet. Verändert er die Einschätzung von Experten darüber, wie gefährlich das Vogelgrippevirus H5N1 in seiner aktuellen Form für den Menschen ist? Oder gar die Wahrscheinlichkeit, dass der Erreger eine Pandemie auslösen könnte? <br> </p> <p class="paragraph article__item"><a href="https://www.cdc.gov/media/releases/2025/m0106-h5-birdflu-death.html" target="_blank">In einer Mitteilung</a> schreibt die US-Seuchenschutzbehörde CDC: "Ein Todesfall durch die H5N1-Vogelgrippe in den Vereinigten Staaten ist zwar tragisch, aber nicht unerwartet." Das Risiko für die Bevölkerung schätzt die Behörde derzeit als niedrig ein. Das liegt vor allem daran, dass es weiterhin glücklicherweise keinen Anhaltspunkt für eine Übertragung von Mensch zu Mensch gibt. </p> <p class="paragraph article__item">Doch auch wenn der Fall an sich das Risiko einer <span class="rtr-schema-org" itemscope="" itemtype="http://schema.org/Thing"><a class="rtr-entity" href="https://www.zeit.de/thema/pandemie">Pandemie</a></span> nicht erhöht, macht er – und die Entwicklung des Virus – Fachleuten Sorgen. </p> <h2 class="article__subheading article__item ">Seit 2020 geht ein neuer Stamm um die Welt</h2> <p class="paragraph article__item">Tatsächlich besorgt das Vogelgrippevirus H5N1 Expertinnen und Experten schon, seit es 1997 in Hongkong zu einem ersten Ausbruch bei Menschen kam. Damals infizierten sich 18 Menschen an infiziertem Geflügel, sechs davon starben. 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Wir haben Ihnen eine E-Mail geschickt.</h2> <div class="newsletter-signup__text">Prüfen Sie Ihr Postfach und bestätigen Sie das Newsletter-Abonnement.</div> </div> <form aria-label="Melden Sie sich an, um den Newsletter zu abonnieren" action="https://meine.zeit.de/anmelden" method="POST" data-registration-forward hidden> <h2 class="newsletter-signup__headline">Diese E-Mail-Adresse ist bereits registriert.</h2> <div class="newsletter-signup__text"> Bitte geben Sie auf der folgenden Seite Ihr Passwort ein.<br>Falls Sie nicht weitergeleitet werden, <button type="submit" class="newsletter-signup__button-link">klicken Sie bitte hier</button>. </div> <input type="hidden" name="email" value=""> <input type="hidden" name="error_header" value="register/header_alreadyin"> <input type="hidden" name="entry_service" value="newsletter-signup-was-jetzt"> <input type="hidden" name="return_url"> <input type="hidden" name="product_id" value="sonstige"> <input type="hidden" name="forwarded" value="www.zeit.de"> <input type="hidden" name="wt_zmc" value="fix.int.zonaudev.zeitde.nl_signup.was-jetzt.nl_signup.link.sonstige"> <input type="hidden" name="utm_medium" value="fix"> <input type="hidden" name="utm_source" value="zeitde_zonaudev_int"> <input type="hidden" name="utm_campaign" value="nl_signup"> <input type="hidden" name="utm_content" value="was-jetzt_nl_signup_link_sonstige"> </form> </div> </div> </aside> <p class="paragraph article__item">Seit 2020 verbreitet sich ein neuer Stamm des Vogelgrippevirus, genannt Klade 2.3.4.4b, auf der ganzen Welt. Er hat Millionen Wildvögel und Geflügel infiziert und immer wieder auch Ausbrüche unter Säugetieren verursacht. Vor etwa einem Jahr sprang das Virus auf Milchkühe in den USA über und hat dort bislang <a href="https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/hpai-confirmed-cases-livestock" target="_blank">mehr als 900 Herden</a> in 16 Bundesstaaten infiziert. Auch Menschen haben sich in den USA seitdem immer wieder mit der neuen Virusvariante angesteckt. Bei den meisten der insgesamt 66 Fällen verlief die <span class="rtr-schema-org" itemscope="" itemtype="http://schema.org/Thing"><a class="rtr-entity" href="https://www.zeit.de/thema/infektion">Infektion</a></span> mild, sie hatten etwa eine Bindehautentzündung. </p> <div class="iqdcontainer" data-placement="pos_2" data-device="desktop"></div> <div class="iqdcontainer" data-placement="pos_3" data-device="mobile"></div> <aside class="topicbox article__item" aria-label='Zum Thema: Vogelgrippe'> <h2 class="topicbox__heading"> <span class="topicbox__title">Vogelgrippe</span> </h2> <div class="topicbox__byline">Zum Thema</div> <article class="topicbox-item"> <a href="https://www.zeit.de/gesundheit/2024-11/vogelgrippevirus-h5n1-usa-kanada-kuehe-entwicklung-pandemie" data-ct-label="Vogelgrippevirus H5N1 : Das Virus tut, was viele befürchtet haben"> <h3 class="topicbox-item__heading"> <span class="topicbox-item__kicker"> <svg class="svg-symbol zplus-logo" width="22" height="18" role="img" aria-label="Z+ (abopflichtiger Inhalt);"> <title>Z+ (abopflichtiger Inhalt);</title> <use xlink:href="#svg-zplus" /> </svg>Vogelgrippevirus H5N1 </span><span class="visually-hidden">:</span> <span class="topicbox-item__title">Das Virus tut, was viele befürchtet haben</span> </h3> </a> </article> </aside> <p class="paragraph article__item">Fachleute rätseln schon länger, "<a href="https://www.statnews.com/2024/12/02/bird-flu-h5n1-mild-cases-mystery/" target="_blank">warum die meisten dieser Fälle bisher so mild verliefen</a>". Denn von den "<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2414610" target="_blank">elf menschlichen Infektionen</a>" mit Klade 2.3.4.4b, die seit 2022 in fünf Ländern auftraten, erkrankten immerhin vier Menschen schwer, einer davon in China starb. </p> <p class="paragraph article__item">Manche vermuten, es habe unter anderem damit zu tun, dass in den USA meist junge, gesunde Farmarbeiter betroffen sind. Womöglich könnte sich das Virus anders verhalten, wenn es ältere Menschen mit Vorerkrankungen infiziert. So wie die Person aus <span class="rtr-schema-org" itemscope="" itemtype="http://schema.org/Place"><a class="rtr-entity" href="https://www.zeit.de/thema/louisiana">Louisiana</a></span>, die nun gestorben ist. <br> </p> <p class="paragraph article__item">"Für mich ist das die wichtigste Erkenntnis aus dem Fall: Diese Viren sind in der Lage, schwere Krankheiten zu verursachen", <a href="https://www.statnews.com/2025/01/06/bird-flu-louisiana-fatal-case/" target="_blank">sagte die kanadische Virologin Angela Rasmussen</a> <em>Stat News</em>. "Vielleicht nicht mit der gleichen Häufigkeit, wie wir sie bisher bei H5N1 angenommen haben, aber sie sind definitiv dazu in der Lage." </p> <p class="paragraph article__item">Auch andere Experten erwarten, dass das nicht der letzte Todesfall durch H5N1 gewesen sein dürfte, wenn das Virus weiter in Kühen und Vögeln zirkuliert. Doch solange es bei einzelnen Übertragungen von Tier zu Mensch bleibt, ist das Risiko einer Pandemie gering. Die Frage ist nur: Wie lange bleibt das so? </p> <div class="iqdcontainer" data-placement="pos_3" data-device="desktop"></div> <div class="iqdcontainer" data-placement="pos_4" data-device="mobile"></div> <h2 class="article__subheading article__item ">Eine Jugendliche musste auf Intensivstation behandelt werden</h2> <p class="paragraph article__item">Hier kommt ein Detail des Falls in Louisiana ins Spiel. Zwar handelte es sich bei dem Virus, das den Menschen letztlich tötete, um H5N1, genauer: Klade 2.3.4.4b. Genaue Genanalysen ergaben jedoch, "<a href="https://www.cdc.gov/bird-flu/spotlights/h5n1-response-12232024.html" target="_blank">dass es sich um den Genotyp D1.1 handelt</a>". </p> <p class="paragraph article__item">Diese Version des Virus unterscheidet sich von den H5N1-Viren, die derzeit in Kühen zirkulieren und von dort immer wieder auf Menschen überspringen und für die vielen milden Krankheitsverläufe verantwortlich waren. Die Version des Virus ist enger mit jenen Viren verwandt, die Vögel in den USA infizieren und kürzlich eine 13-jährige Jugendliche in Kanada so krank machten, dass sie wochenlang auf einer Intensivstation behandelt werden musste. Einem <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2415890" target="_blank">aktuellen Bericht</a> im <em>New England Journal of Medicine</em> zufolge schlossen die behandelnden Ärzte sie wegen ihrer schweren Erkrankung sogar an eine Extrakorporale Membranoxygenierung (ECMO) an, bei der das Blut außerhalb des Körpers mit Sauerstoff angereichert wird. Inzwischen erholt sie sich von der Infektion. </p> <p class="paragraph article__item">In beiden Fällen, bei der Teenagerin in British Columbia und der verstorbenen Person in Louisiana, fanden sich Mutationen im Viruserbgut, "<a href="https://www.cdc.gov/bird-flu/spotlights/h5n1-response-12232024.html#:~:text=as%20these%20changes%20may%20result%20in%20increased%20virus%20binding%20to%20%CE%B12%2D6%20cell%20receptors%20found%20in%20the%20upper%20respiratory%20tract%20of%20humans" target="_blank">die es dem Virus leichter machen könnten, sich an den menschlichen oberen Atemtrakt anzuheften</a>". Fachleute gehen davon aus, dass sich diese Veränderungen gebildet haben, während sich das Virus im Körper der Erkrankten vermehrte. So waren sie im Fall des Verstorbenen in Louisiana bei Proben der Vögel, an denen er sich infizierte, nicht gefunden worden. </p> <div class="iqdcontainer" data-placement="pos_4" data-device="desktop"></div> <div class="iqdcontainer" data-placement="pos_5" data-device="mobile"></div> <p class="paragraph article__item">Das CDC schreibt, es sei zwar besorgniserregend und eine Erinnerung, dass sich Viren während einer Infektion im Körper verändern können. Noch besorgniserregender wäre es aber, wenn sich diese Änderungen bereits bei den Vögeln fänden oder sie sich in der Frühphase einer menschlichen Infektion bilden würden. Das könnte das Risiko einer Mensch-zu-Mensch-Übertragung steigern. Die wichtige Nachricht: Offenbar steckten die beiden Infizierten niemanden in ihrem Umfeld mit dem Virus an. </p> <h2 class="article__subheading article__item ">Ein Vogel, infiziert mit zwei Viren gleichzeitig</h2> <p class="paragraph article__item">Und doch machen sich manche Fachleute – wenn es um die Frage einer möglichen Pandemie geht – vor allem Sorgen über eben jenen D1.1-Genotyp des Virus. Dieser hat sich durch sogenannte Reassortierung neu gebildet, wahrscheinlich indem ein Vogel gleichzeitig mit zwei verschiedenen Influenzaviren infiziert war, deren Erbgut sich dann neu gemischt hat. </p> <p class="paragraph article__item">Heraus kam eine Virusvariante mit einer neuen Neuraminidase, dem N in H5N1. Dieses Protein ermöglicht, dass neu gebildete Viruspartikel die Wirtszelle verlassen und sich weiter im Körper ausbreiten können. Manche Experten befürchten, dass sich diese neue Variante von H5N1 "<a href="https://www.science.org/content/article/why-hasn-t-bird-flu-pandemic-started" target="_blank">leichter zu einem pandemischen Virus entwickeln könnte</a>" als die Variante, die in Kuhherden zirkuliert. "Die Rindervariante scheint ziemlich stabil zu sein und könnte noch eine Weile so weiterlaufen", sagte der Experte für Infektionskrankheiten, Michael Osterholm, <em>Science</em>. "D1.1 macht mir Sorgen." </p> <div class="iqdcontainer" data-placement="pos_5" data-device="desktop"></div> <div class="iqdcontainer" data-placement="pos_6" data-device="mobile"></div> <p class="paragraph article__item">Um es deutlich zu sagen: Ob wir vor einer H5N1-Pandemie stehen und wie schwer diese dann ausfallen würde, ist unklar. Niemand kann das Risiko genau beziffern, auch weil Grippeviren "<a href="https://www.statnews.com/2024/10/16/bird-flu-pandemic-overall-risk-low-continued-h5n1-outbreak-dairy-cattle-worrisome/" target="_blank">als unberechenbar gelten</a>". Klar ist nur: Je stärker das Virus in Tieren zirkuliert und je öfter es auf Menschen überspringt, desto wahrscheinlicher wird es, dass es sich besser an den Menschen anpasst. </p> <p class="paragraph article__item">Das wird besonders relevant vor dem Hintergrund der saisonalen Grippewelle, die die USA gerade erfasst. Wenn sich jemand gleichzeitig mit dem Vogelgrippevirus und der saisonalen Grippe infiziert, könnte das dem H5N1-Virus theoretisch die Gelegenheit bieten, Erbgut mit saisonalen Grippeviren auszutauschen und so Mutationen zu erwerben, die es braucht, um sich effizient unter Menschen zu verbreiten. </p> <p class="paragraph article__item">Nach langer Untätigkeit haben die Verantwortlichen in den USA das Risiko, das von H5N1 ausgeht, offenbar erkannt. So sollen Mitarbeiter in betroffenen Milchviehbetrieben und Rohmilch verstärkt getestet werden. Anfang Januar teilte die Biden-Administration zudem mit, 306 Millionen US-Dollar zu investieren, um Bereitschafts- und Überwachungsprogramme sowie die medizinische Forschung gegen das H5N1-Virus zu stärken. 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