In 1997, a highly pathogenic avian H5N1 influenza virus was transmitted
directly from live commercial poultry to humans in Hong Kong.
Of the 18 people infected, six died. The molecular basis for
the high virulence of this virus in mice was found to involve
an amino acid change in the PB2 protein. To eliminate the
source of the pathogenic virus, all birds in the Hong Kong
markets were slaughtered. In 1999, another avian influenza
virus of H9N2 subtype was transmitted to two children in Hong
Kong. In 20002002, H5N1 avian viruses reappeared in the
poultry markets of Hong Kong, although they have not infected
humans. Continued circulation of H5N1 and other avian viruses
in Hong Kong raises the possibility of future human influenza
outbreaks. Moreover, the acquisition of properties of human
viruses by the avian viruses currently circulating in
southeast China might result in a pandemic.