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‘Increíblemente preocupante’: el brote de gripe aviar en una granja de visones española desencadena temores de pandemia

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Cuando los visones de una gran granja en Galicia, una región del noroeste de España, comenzaron a morir en octubre de 2022, los veterinarios inicialmente pensaron que el culpable podría ser el SARS-CoV-2, que ha afectado a las granjas de visones en varios otros países. Pero las pruebas de laboratorio pronto revelaron algo más aterrador: un virus de influenza aviar mortal llamado H5N1. Las autoridades colocaron inmediatamente a los trabajadores en la granja bajo restricciones de cuarentena. Los más de 50.000 visones de la instalación fueron asesinados y sus cadáveres destruidos.

Ninguno de los trabajadores agrícolas se infectó. Pero el episodio, descrito en un artículo en Eurosurveillance la semana pasada, ha reavivado los temores latentes de que el H5N1 podría desencadenar una pandemia humana . No se sabe que el virus se propague bien entre los mamíferos; las personas casi siempre lo contraen de las aves infectadas, no entre sí. Pero ahora, el H5N1 parece haberse propagado a través de una población de mamíferos densamente agrupada y obtuvo al menos una mutación que favorece la propagación de mamífero a mamífero. Los virólogos advierten que el H5N1, que ahora arrasa con las aves de todo el mundo, podría invadir otras granjas de visones y volverse aún más transmisible.

“Esto es increíblemente preocupante”, dice Tom Peacock, virólogo del Imperial College London. “Este es un mecanismo claro para que comience una pandemia H5”. Isabella Monne, investigadora veterinaria del Laboratorio de Referencia para la Gripe Aviar de la Unión Europea en Italia, donde se secuenciaron las muestras de España, llama al hallazgo «una campana de advertencia».

El H5N1 se detectó por primera vez en una granja de gansos en China en 1996. Un gran brote avícola en Hong Kong en 1997 provocó las primeras muertes humanas documentadas y provocó los primeros temores pandémicos. Alrededor de 2005, el virus se extendió a las aves migratorias, que desde entonces lo han propagado por todo el mundo en varias oleadas grandes. Una nueva variante llamada 2.3.4.4b que surgió en 2020 se ha extendido más rápido y más lejos que cualquier predecesor, asestando grandes golpes a la industria avícola en Europa y América del Norte antes de llegar a América Central y del Sur en el otoño de 2022 . “Parece que este virus está más adaptado a todas las aves que cualquier otro”, dice Richard Webby, investigador de influenza en el Hospital de Investigación Infantil St. Jude.

Debido a que los receptores a los que se une el virus en las vías respiratorias superiores de las aves son menos comunes en las vías respiratorias superiores de los mamíferos, el H5N1 no afecta en gran medida a los mamíferos. Pero esta vez, muchas especies de mamíferos se han infectado, incluidos zorros, gatos, hurones, focas y delfines, presumiblemente a través del contacto con aves infectadas. El 17 de enero, las autoridades de Montana dijeron que tres osos grizzly jóvenes sacrificados en el otoño después de enfermarse gravemente también estaban infectados con H5N1. La gente también se ha contagiado. Hasta ahora ha habido seis infecciones humanas confirmadas en la ola global actual, incluida una muerte.

Hay algunas señales de que 2.3.4.4b es menos patógena en humanos que las versiones anteriores, que mataron a aproximadamente la mitad de los infectados, dice Thomas Mettenleiter, director del Instituto Friedrich Loeffler. “Por supuesto, eso también puede ser una mala noticia, porque podría facilitar que el virus comience a propagarse por debajo del radar, dándole más oportunidades de evolucionar”, dice. Cuanto más a menudo el virus infecta a los mamíferos, mayor es el riesgo, dice Webby. “Es un juego de números”.

Ha habido algunos informes anteriores de brotes de influenza aviar en granjas de visones en China, pero no hay evidencia clara de que el virus se propague entre los animales. En el brote español, parece haber pocas dudas de que lo hizo. En teoría, todos los animales enfermos podrían haber adquirido el virus de su alimento, que incluía subproductos avícolas, pero no se han informado brotes de H5N1 en la región donde se encuentran las granjas avícolas y los mataderos que suministran el alimento. Y el virus se propagó de un corral a otro como se esperaba si se transmitiera entre visones. La cadena de infecciones podría haber comenzado después de que un animal atrapó a un pájaro enfermo y lo metió en su jaula, dice Thijs Kuiken, patólogo veterinario del Centro Médico de la Universidad Erasmus.

Se desconoce con qué facilidad el virus encontrado en España podría infectar a los humanos o propagarse entre ellos. Las muestras de virus secuenciadas de cuatro visones muestran varios cambios en comparación con el virus de las aves, incluido el T271A, una mutación en el gen de una enzima, la polimerasa. Se sabe que el cambio, también observado en muestras virales de otros mamíferos infectados, ayuda a que el H5N1 se replique mejor en los tejidos de los mamíferos. Sin embargo, E627K, otra mutación preocupante en el gen de la polimerasa, no ha surgido y el gen de la hemaglutinina, una proteína en la superficie viral que se adhiere al receptor del huésped, no ha cambiado, dice Peacock. «Es posible que todavía hayamos tenido suerte con este».

Monne dice que su equipo y otros ahora están estudiando las propiedades del virus del visón y los efectos de las mutaciones que ha acumulado. Entre otras cosas, quieren estudiar qué tan bien se transmite el virus a través del contacto cercano entre animales. “Estamos planeando hacer también estudios de transmisión de aerosoles”, dice ella.

El brote vuelve a poner de relieve los riesgos de la cría de visones. El SARS-CoV-2, introducido en las granjas por humanos, se propagó como un reguero de pólvora entre los animales, pero también se transmitió a sus cuidadores, y los investigadores temían que la industria de los visones pudiera convertirse en una fuente permanente de infecciones y un caldo de cultivo para variantes genéticas. Los Países Bajos, que ya habían decidido eliminar gradualmente la cría de visones para 2024 por razones éticas, cerraron todas las granjas restantes en 2021. Dinamarca sacrificó todos los visones del país en 2020, pero la prohibición de criar visones expiró a principios de este año.

Las granjas representan una amenaza igual de grande cuando se trata de H5N1, dice Kuiken. La mayoría de las especies de mamíferos infectadas con el virus hasta ahora son depredadores salvajes y carroñeros que se alimentan de aves infectadas: “animales solitarios o animales que viven en familias pequeñas”, dice. Es poco probable que propaguen el virus lejos o infecten a los humanos. En las granjas de visones, miles de estos carnívoros solitarios se ven obligados a vivir juntos, creando las condiciones ideales para que el virus aviar se adapte a los mamíferos. “Es una construcción humana”, dice Kuiken.

Como mínimo, se deben endurecer las medidas de bioseguridad en las granjas de visones, dice Monne. Los trabajadores agrícolas deben usar máscaras y tomar otras medidas para prevenir la infección, y las granjas deben reducir el riesgo de introducciones accidentales de H5N1. “Deberían mantener a los animales con mucho cuidado lejos de las aves silvestres”. El pavo real dice que tal vez es hora de acabar con la cría de visones. “Que esto esté sucediendo en Europa hoy en día, y después de COVID-19, me está afectando la cabeza”, dice. “Es un poco una amenaza existencial”.

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