How prepared are the UK and US for the next pandemic?

While commonly known as bird flu, H5N1 is increasingly being detected in mammals, including dairy cattle. Although the current risk to humans remains low, emerging evidence suggests that small genetic changes could enable human-to-human transmission.

The study, published in PLOS Global Public Health, outlines key developments in the virus’s history, including the recent spread of a newer strain and rare cases of mammal-to-human transmission. While most cattle-linked human cases have been mild, infections associated with wild birds have led to more severe illness and deaths.

Comparing the UK and US, differences in surveillance, policy and public health capacity are highlighted. The UK’s response remains relatively stable, with coordinated systems and vaccine stockpiles in place, though surveillance still relies on reporting from those in close contact with animals.

In contrast, recent policy changes and reductions in public health capacity in the US risk weakening its ability to detect and respond to outbreaks. Limited transparency and gaps in monitoring - particularly in dairy cattle - could allow the virus to spread undetected.

While the UK is comparatively well-positioned, continued vigilance and investment are essential, with pandemic preparedness remaining a global priority.

Cite as

Read S, Sridhar D (2026) H5N1: How prepared are the US and UK for a pandemic? PLOS Glob Public Health 6(4): e0006068. https://doi.org/10.1371/journal.pgph.0006068

Further information

H5N1: How prepared are the US and UK for a pandemic? | PLOS Global Public Health

Edinburgh Medical School | College of Medicine and Vet Medicine