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Epidemiol Health System J. 2025;12(4): 243-247.
doi: 10.34172/ehsj.26493
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  PDF Download: 1

Mini-Review

H5N1 at the Pandemic Threshold: Military-Grade Preparedness for an Avian Influenza Crisis

Gian Marco Ludovici 1,2* ORCID logo, Paola Amelia Tassi 2 ORCID logo, Alba Iannotti 2,3 ORCID logo, Colomba Russo 2,3 ORCID logo, Riccardo Quaranta 2,4 ORCID logo, Andrea Malizia 1,2 ORCID logo

1 Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
2 International Master Courses in Protection Against CBRNe Events, Department of Industrial Engineering and School of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
3 Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy
4 National Institute for Nuclear Physics-National Laboratory of Frascati INFN-LNF, Frascati, Italy
*Corresponding Author: Gian Marco Ludovici, Email: gianmarco.ludovici@alumni.uniroma2.eu

Abstract

Background and aims: The rapid evolution of highly pathogenic avian influenza H5N1, with recent spillover to mammals and sporadic human cases, may pose a serious pandemic risk. This study focused on examining how integrating CBRNe principles can address critical gaps in traditional preparedness frameworks.

Methods: This narrative review comprehensively synthesized evidence from virological research (2003-2025), WHO outbreak reports, and military-civilian biosecurity collaborations.

Results: H5N1’s pandemic potential is escalating through key mutations, such as HA-T160A and PB2-E627K, which enhance mammalian airway replication. Current surveillance systems remain inadequate, particularly at animal-human interfaces. Crucially, CBRNe adaptations demonstrated superior containment in simulations. NATO’s 2023 Global BioLock exercise achieved a 63% reduction in cross-border transmission through spectral biosensor checkpoints and coordinated alert protocols. Moreover, military-civilian partnerships proved effective in the rapid deployment of field hospitals, as observed in Spain’s establishment of a 72-hour biocontainment unit.

Conclusion: In general, the convergence of H5N1’s virological risk factors and CBRNe’s operational capabilities suggests the necessity of a paradigm shift. Thus, it is proposed that an international task force be established to standardize CBRNe protocols for avian influenza, prioritizing environmental biosurveillance and dual-use training for health workers. This strategic integration offers a tangible solution to mitigate the most probable pandemic threat, as the WHO considers it to be.


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Submitted: 23 May 2025
Revision: 12 Dec 2025
Accepted: 13 Dec 2025
ePublished: 30 Dec 2025
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