#Influenza at human-animal interface - Summary & #risk #assessment (23 Jan. - 31 March 2026) (WHO, Apr. 29 '26): #H5N1, #H9N2, #H10N3, #H1N1v, #H3N2v cases reported

 

New human cases {2}: 

-- From 23 January to 31 March 2026, based on reporting date, detections of  influenza A(H5N1) in four humans, influenza A(H9N2) in five humans, influenza A(H10N3) in one human, an influenza A(H1N1) variant ((H1N1)v) virus in one human, an influenza A(H1N2)v virus in one human, and influenza A(H3N2)v virus in one human were reported officially. 

Circulation of influenza viruses with zoonotic potential in animals: 

-- High pathogenicity avian influenza (HPAI) events in poultry and non-poultry animal species continue to be reported to the World Organisation for Animal Health (WOAH).{3} 

-- The Food and Agriculture Organization of the United Nations (FAO) also provides a global update on avian influenza viruses with pandemic potential.{4} 

-- Additionally, low pathogenicity avian influenza viruses as well as swine influenza viruses continue to circulate in animal populations. 

Risk assessment {5}: 

-- Sustained human to human transmission has not been reported associated with the above-mentioned human infection events. 

-- Based on information available at the time of this risk assessment update, the overall public health risk from currently known influenza A viruses detected at the human-animal interface has not changed and remains low. 

-- The occurrence of sustained human-to-human transmission of these viruses is currently considered unlikely. 

-- Although human infections with viruses of animal origin are infrequent, they are not unexpected at the human-animal interface.  

Risk management: 

-- Candidate vaccine viruses (CVVs) for zoonotic influenza viruses for pandemic preparedness purposes were reviewed and updated at the February 2026 WHO consultation on influenza vaccine composition for use in the northern hemisphere 2026-2027 influenza season. 

-- A detailed summary of zoonotic influenza viruses characterized since September 2025 is published here and updated CVVs lists are published here.  

IHR compliance {6}: 

-- This includes any influenza A virus that has demonstrated the capacity to infect a human and its haemagglutinin (HA) gene (or protein) is not a mutated form of those, i.e. A(H1) or A(H3), circulating widely in the human population. 

-- Information from these notifications is critical to inform risk assessments for influenza at the human-animal interface.  

Avian influenza viruses in humans -  Current situation:  

-- Since the last risk assessment of 22 January 2026, four laboratory-confirmed human cases of A(H5N1) infection were detected in Bangladesh (one case) and Cambodia (three cases).  

-- A(H5N1), Bangladesh  

- On 9 February 2026, the National International Health Regulations Focal Point of Bangladesh notified WHO of a laboratory-confirmed human case of avian influenza A(H5) infection in a child from Chattogram Division. 

- The patient, with no known comorbidities, developed symptoms on 21 January 2026 and was admitted to hospital on 28 January.  

- A nasopharyngeal swab was collected on 29 January as part of the Hospital-based Influenza Surveillance (HBIS) platform for influenza-like illness (ILI) and severe acute respiratory infection (SARI) sentinel surveillance in Bangladesh. 

- The patient was referred to a specialized private hospital and admitted to intensive care on 31 January. 

- The patient died on 1 February.  

- On 7 February, the Institute of Epidemiology, Disease Control and Research (IEDCR), serving as the National Influenza Centre (NIC), received and tested the sample, confirming influenza A(H5) by realtime reverse transcription polymerase chain reaction (RT-PCR) on the same day. 

- Virus characterization and whole genome sequencing was conducted at International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), which confirmed that the A(H5N1) virus belongs to clade 2.3.2.1a of highly pathogenic avian influenza A(H5N1) virus (Gs/GD lineage), similar to the clade of viruses circulating in local poultry since around 2011. 

- Genetic sequence data are available in GISAID (EPI_ISL_20367262; submission date 19 Feb 2026; Institute of Epidemiology, Disease Control & Research (IEDCR)). 

- The case had exposure to household poultry, with two ducks and one chicken reportedly dying shortly before the case’s illness onset. 

- Animal and environmental samples were collected and tested with RT-PCR and serology by the zoonotic investigation team of icddr,b. 

- Two samples from ducks in the community and two samples from chicken meat in the freezer of household tested positive for influenza A(H5). 

- Samples from symptomatic close human contacts tested negative for influenza.  

- This is the first confirmed human case of avian influenza A(H5) reported in Bangladesh in 2026. 

- In 2025, four human cases of avian influenza A(H5) were reported.  

- According to reports received by WOAH, various influenza A(H5) subtypes continue to be detected in wild and domestic birds in Africa, the Americas, Asia and Europe. 

- Infections in non-human mammals are also reported, including in marine and land mammals.{7} 

- A list of bird and mammalian species affected by HPAI A(H5) viruses is maintained by FAO.{8}   

-- A(H5N1), Cambodia 

- Between 15 February and 31 March 2026, Cambodia notified WHO of three laboratory-confirmed cases of A(H5N1) virus infection. 

(...)

- All cases above had exposure to sick or dead backyard poultry. 

- The first case was detected through SARI surveillance. 

- The other two cases were detected following the detection of A(H5N1) in sick and dead poultry which initiated deployment of rapid response teams from the public health sector and active case finding. 

- The last case was identified as having had exposure to sick and dead poultry, sampled and then developed ILI symptoms. 

- Three human infections with A(H5N1) viruses have been confirmed in Cambodia in 2026 and none have been fatal. 

- Influenza A(H5N1) viruses continue to be detected in domestic birds in Cambodia in 2026, including in areas where human cases have been detected.{9} 

- Where the information is available, the genetic sequence data from the viruses from the human cases closely matches that from recent local animal viruses and are identified as clade 2.3.2.1e viruses. 

- From the information available thus far on these recent human cases, there is no indication of human-to-human transmission of the A(H5N1) viruses.   

-- A(H9N2), China  

- Between 9 February and 20 March 2026, China notified WHO of four laboratory-confirmed cases of A(H9N2) virus infection. 

(...)

-- A(H9N2), Italy, ex-Senegal {10} 

- On 21 March 2026, Italy notified WHO of the detection of A(H9N2) virus in an adult male. 

- The case had travelled to Senegal for more than six months and returned to Italy in mid-March 2026. 

- Upon arrival in Italy, the case sought medical care, presenting with fever and persistent cough that had been present since mid-January. 

- Laboratory investigations conducted on a bronchoalveolar lavage specimen on 16 March showed a positive Mycobacterium tuberculosis result, as well as detection of an un-subtypeable influenza A virus. 

- The case was admitted to an isolation room under airborne precautions in a negative-pressure room and received antitubercular and antiviral treatment. 

- As of 24 March, the patient was clinically stable and improving.  

- On 20 March 2026, the regional reference laboratory confirmed the A(H9) subtype, and on 21 March, influenza A(H9N2) was confirmed by next-generation sequencing. 

- Initial genetic findings suggest the infection was likely acquired from an avian source linked to Senegal. 

- Additional samples have been sent to Italy’s National Influenza Center, where further characterization confirmed virus subtype Influenza A(H9N2), with close genetic similarity to strains previously identified in poultry in Senegal. 

- No direct exposure to animals, wildlife or rural environments was identified. 

- There was also no reported contact with symptomatic or confirmed human cases. 

- Further epidemiological investigations on the source of exposure are ongoing. 

- Contacts identified in Senegal were asymptomatic. 

- All identified and traced contacts in Italy have tested negative for influenza and completed the period of active monitoring for the onset of symptoms and the quarantine required by national guidelines. 

- Human infections with influenza A(H9) viruses have been reported from countries in Africa and Asia, where these viruses are also detected in poultry. 

- This is the first imported human case of avian influenza A(H9N2) reported in the European Region. 

-- Risk Assessment for avian influenza A(H9N2):  

- 1. What is the global public health risk of additional human cases of infection with avian influenza A(H9N2) viruses?  

Most human cases follow exposure to the A(H9N2) virus through contact with infected poultry or contaminated environments. 

Most human infections of A(H9N2) to date have resulted in mild clinical illness. 

Since the virus is endemic in poultry in multiple countries in Africa and Asia, additional human cases associated with exposure to infected poultry or contaminated environments are expected but remain unusual. 

The impact to public health if additional sporadic cases are detected is minimal. 

The overall global public health risk is low.  

- 2. What is the likelihood of sustained human-to-human transmission of avian influenza A(H9N2) viruses related to these events?  

At the present time, no sustained human-to-human transmission has been identified associated with the recently reported human infections with A(H9N2) viruses. 

Current evidence suggests that A(H9N2) viruses from these cases did not acquire the ability of sustained transmission among humans, therefore sustained human-to-human transmission is thus currently considered unlikely.  

- 3. What is the likelihood of international spread of avian influenza A(H9N2) virus by travellers?  

Should infected individuals from affected areas travel internationally, their infection may be detected in another country during travel or after arrival, such as in the case reported by Italy. 

If this were to occur, further community level spread is considered unlikely as current evidence suggests the A(H9N2) virus subtype has not acquired the ability to transmit easily among humans.  

-- A(H10N3), China  

- On 9 February 2026, China notified WHO of one laboratory-confirmed case of human infection with an avian influenza A(H10N3) virus in a 34-year-old man from Guangdong province who developed symptoms on 29 December 2025. 

- On 1 January 2026, he was admitted to hospital and diagnosed with severe pneumonia, severe acute respiratory distress syndrome (ARDS) and sepsis. 

- Oseltamivir treatment was initiated on 3 January. 

- The patient's condition was stable at the time of reporting. 

- On 12 January, the sample was sent to the provincial laboratory for testing. 

- The result was positive for A(H10N3). On 14 January, the National Influenza Center confirmed the positive result.    

- The patient works near two establishments that keep live poultry on the premises and chickens are present at the household. 

- Environmental samples collected from sites related to likely poultry exposure, including the patient's home, the workplace and a nearby poultry market tested negative for A(H10N3) influenza virus. 

- No further cases were detected among contacts of these cases.   

- A total of 98 close contacts of the patient were traced.  

- Since 2021, a total of seven cases of human avian influenza A(H10N3) virus infection have been reported globally and all were from China.   

-- Risk Assessment for avian influenza A(H10N3):   

- 1. What is the global public health risk of additional human cases of infection with avian influenza  A(H10N3) viruses?   

Human infections with avian influenza A(H10) viruses have been detected and reported previously.   

The circulation and epidemiology of these viruses in birds have been previously reported.{12} 

Avian influenza A(H10N3) viruses with different genetic characteristics have been detected previously in wild birds since the 1970s and more recently spilled over to poultry in some countries. 

As long as the virus continues to circulate in birds, further human cases can be expected but remain unusual. 

The impact to public health if additional sporadic cases are detected is minimal. 

The overall global public health risk of additional sporadic human cases is low.    

- 2. What is the likelihood of sustained human-to-human transmission of avian influenza A(H10N3)   viruses?   

No sustained human-to-human transmission has been identified associated with the event described above or past events with human cases of influenza A(H10N3) viruses. 

Current epidemiologic and virologic evidence suggests that contemporary influenza A(H10N3) viruses assessed by the Global Influenza Surveillance and response System (GISRS) have not acquired the ability of sustained transmission among humans, therefore sustained human-to-human transmission is thus currently considered unlikely.    

- 3. What is the likelihood of international spread of avian influenza A(H10N3) virus by travellers?   

Should infected individuals from affected areas travel internationally, their infection may be   detected in another country during travel or after arrival. 

If this were to occur, further community   level spread is considered unlikely based on current limited evidence.  

Swine influenza viruses in humans  

-- Influenza A(H1N1)v, China  

- On 20 March 2026, China notified WHO of a laboratory-confirmed case of A(H1N1)v influenza virus infection in a child from Yunnan province. 

- The patient had onset of illness on 30 January 2026, was hospitalized on 2 February with pneumonia, and recovered in a few days. 

- The patient had reported exposure to domestic pigs prior to illness onset.  

-- Influenza A(H1N2)v, China 

- On 3 February 2026, China notified WHO of a laboratory-confirmed case of A(H1N2)v influenza virus infection in a child from Yunnan province. 

- The patient had onset of mild illness on 20 January 2026, and the infection was laboratory-confirmed on 2 February 2026. 

- The patient had reported exposure to domestic pigs prior to illness onset. This case and the one above are not epidemiologically linked.  

-- Influenza A(H3N2)v, Brazil 

- On 26 January 2026, Brazil notified WHO of a laboratory-confirmed case of A(H3N2)v influenza virus infection. 

- On 1 September 2025, a male child residing in the state of Mato Grosso do Sul presented with ILI symptoms and was taken to a health unit on 2 September. 

- The patient had no reported comorbidities or recent travel history and reported being vaccinated against seasonal influenza in the last campaign. 

- On 9 September, a respiratory sample was collected at the health unit, which is a sentinel unit for ILI. 

- On 12 September, the Central Public Health Laboratory of Mato Grosso do Sul (Lacen/MS) reported that the RT-qPCR test for influenza A virus subtyping amplified the influenza A marker along with the H3 marker, indicating a swine-origin variant of the influenza H3 virus. 

- The sample was sent to the National Influenza Center (NIC) of the Adolfo Lutz Institute, where the A(H3N2)v was confirmed by molecular tests and genomic sequencing. 

- The sequences were entered into GISAID on 1 October. 

- The sample was also shared with the WHO Collaborating Centre at the US Centers for Disease Control and Prevention (CDC), where it was genomically and antigenically characterized. 

- An epidemiological investigation was conducted, which identified the case as a student at an agricultural school where pigs and laying hens are raised, although the institution's coordinators reported that the students had not had direct contact with pigs recently. 

- It was reported that the case had contact with classmates who presented ILI symptoms during this period. 

- All household contacts were vaccinated against seasonal influenza in the 2025 season, except for the patient's mother. 

- To date, no other human cases of infection with the A(H3N2)v virus have been detected in association with this case. 

-- Risk Assessment:   

- 1. What is the public health risk of additional human cases of infection with swine influenza viruses?   

Swine influenza viruses circulate in swine populations in many regions of the world. 

Depending on geographic location, the genetic characteristics of these viruses differ. 

Most human cases are exposed to swine influenza viruses through contact with infected animals or contaminated environments. 

Human infection tends to result in mild clinical illness in most cases. 

Since these viruses continue to be detected in swine populations, further human cases are expected. 

The impact to public health if additional sporadic cases are detected is minimal. 

The overall risk of additional sporadic human cases is low.   

- 2. What is the likelihood of sustained human-to-human transmission of swine influenza viruses?    

No sustained human-to-human transmission was identified associated with the events described above. 

Current evidence suggests that contemporary swine influenza viruses have not acquired the ability of sustained transmission among humans, therefore sustained human-to-human transmission is thus currently considered unlikely.  

- 3. What is the likelihood of international spread of swine influenza viruses by travelers?    

Should infected individuals from affected areas travel internationally, their infection may be detected in another country during travel or after arrival. 

If this were to occur, further community level spread is considered unlikely as current evidence suggests that these viruses have not acquired the ability to transmit easily among humans.  

For more information on zoonotic influenza viruses, see the report from the WHO Consultation on the Composition of Influenza Virus Vaccines for Use in the 2026-2027 Northern Hemisphere Influenza Season that was held on 23-26 February 2026 at this link.  

Overall risk management recommendations: 

Surveillance and investigations 

• Due to the constantly evolving nature of influenza viruses, WHO continues to stress the importance of global strategic surveillance in animals and humans to detect virologic, epidemiologic and clinical changes associated with circulating influenza viruses that may affect human (or animal) health. 

- Continued vigilance is needed within affected and neighbouring areas to detect infections in animals and humans. 

- Close collaboration with the animal health and environment sectors is essential to understand the extent of the risk of human exposure and to prevent and control the spread of animal influenza. 

- WHO has published guidance on surveillance for human infections with avian influenza A(H5) viruses. 

• As the extent of influenza virus circulation in animals is not clear, epidemiologic and virologic surveillance and the follow-up of suspected human cases should continue systematically. 

- Guidance on investigation of non-seasonal influenza and other emerging acute respiratory diseases has been published on the WHO website. 

• Countries should: 

- increase avian influenza surveillance in domestic and wild birds, 

- enhance surveillance for early detection in cattle populations in countries where HPAI is known to be circulating, include HPAI as a differential diagnosis in non-avian species, including cattle and other livestock populations, with high risk of exposure to HPAI viruses; 

- monitor and investigate cases in non-avian species, including livestock, report cases of HPAI in all animal species, including unusual hosts, to WOAH and other international organizations, 

- share genetic sequences of avian influenza viruses in publicly available databases, 

- implement preventive and early response measures to break the HPAI transmission cycle among animals through movement restrictions of infected livestock holdings and strict biosecurity measures in all holdings, 

- employ good production and hygiene practices when handing animal products, and 

- protect persons in contact with suspected/infected animals.{11} 

- More guidance can be found from WOAH and FAO. 

• When there has been human exposure to a known outbreak of an influenza A virus in domestic poultry, wild birds or other animals – or when there has been an identified human case of infection with such a virus – enhanced surveillance in potentially exposed human populations becomes necessary. 

- Enhanced surveillance should consider the health care seeking behaviour of the population, and could include a range of active and passive health care and/or communitybased approaches, including: 

* enhanced surveillance in local influenza-like illness (ILI)/SARI systems, 

* active screening in hospitals and of groups that may be at higher occupational risk of exposure, and 

* inclusion of other sources such as traditional healers, private practitioners and private diagnostic laboratories. 

• Vigilance for the emergence of novel influenza viruses with pandemic potential should be maintained at all times including during a non-influenza emergency. 

- In the context of the cocirculation of SARS-CoV-2 and influenza viruses, WHO has updated and published practical guidance for integrated surveillance. 

Notifying WHO 

• All human infections caused by a new subtype of influenza virus are notifiable under the International Health Regulations (IHR, 2005).{12,13} 

- State Parties to the IHR (2005) are required to immediately notify WHO of any laboratory-confirmed{14} case of a recent human infection caused by an influenza A virus with the potential to cause a pandemic{15}. 

- Evidence of illness is not required for this report. Evidence of illness is not required for this report. 

• WHO published the case definition for human infections with avian influenza A(H5) virus requiring notification under IHR (2005): https://www.who.int/teams/global-influenzaprogramme/avian-influenza/case-definitions. 

Virus sharing and risk assessment 

• It is critical that these influenza viruses from animals or from humans are fully characterized in appropriate animal or human health influenza reference laboratories. 

- Under WHO’s Pandemic Influenza Preparedness (PIP) Framework, Member States are expected to share influenza viruses with pandemic potential on a timely basis16 with a WHO Collaborating Centre for influenza of GISRS. 

- The viruses are used by the public health laboratories to assess the risk of pandemic influenza and to develop candidate vaccine viruses.  

• The Tool for Influenza Pandemic Risk Assessment (TIPRA) provides an in-depth assessment of risk associated with some zoonotic influenza viruses – notably the likelihood of the virus gaining human-to-human transmissibility, and the impact should the virus gain such transmissibility. 

- TIPRA maps relative risk amongst viruses assessed using multiple risk elements. 

- The results of TIPRA complement those of the risk assessment provided here, and those of prior TIPRA risk assessments are published at  http://www.who.int/teams/global-influenza-programme/avianinfluenza/tool-for-influenza-pandemic-risk-assessment-(tipra).  

Risk reduction 

• Given the observed extent and frequency of avian influenza in poultry, wild birds and some wild and domestic mammals, the public should avoid contact with animals that are sick or dead from unknown causes, including wild animals, and should report dead birds and mammals or request their removal by contacting local wildlife or veterinary authorities.  

• Eggs, poultry meat and other poultry food products should be properly cooked and properly handled during food preparation. Due to the potential health risks to consumers, raw milk should be avoided. WHO advises consuming pasteurized milk. If pasteurized milk isn’t available, heating raw milk until it boils makes it safer for consumption. 

• WHO has published practical interim guidance to reduce the risk of infection in people exposed to avian influenza viruses. 

Trade and travellers 

• WHO advises that travellers to countries with known outbreaks of animal influenza should avoid farms, contact with animals in live animal markets, entering areas where animals may be slaughtered, or contact with any surfaces that appear to be contaminated with animal excreta. Travelers should also wash their hands often with soap and water. All individuals should follow good food safety and hygiene practices.  

• WHO does not advise special traveller screening at points of entry or restrictions with regards to the current situation of influenza viruses at the human-animal interface. 

- For recommendations on safe trade in animals and related products from countries affected by these influenza viruses, refer to WOAH guidance.  

Links:  

- WHO Human-Animal Interface web page https://www.who.int/teams/global-influenza-programme/avian-influenza 

- WHO Influenza (Avian and other zoonotic) fact sheet https://www.who.int/news-room/fact-sheets/detail/influenza-(avian-and-other-zoonotic) 

- WHO Protocol to investigate non-seasonal influenza and other emerging acute respiratory diseases https://www.who.int/publications/i/item/WHO-WHE-IHM-GIP-2018.2 

- WHO Public health resource pack for countries experiencing outbreaks of influenza in animals:  https://www.who.int/publications/i/item/9789240076884 

- Cumulative Number of Confirmed Human Cases of Avian Influenza A(H5N1) Reported to WHO  https://www.who.int/teams/global-influenza-programme/avian-influenza/avian-a-h5n1-virus 

- Avian Influenza A(H7N9) Information https://www.who.int/teams/global-influenza-programme/avian-influenza/avian-influenza-a-(h7n9)virus 

- World Organisation of Animal Health (WOAH) web page: Avian Influenza  https://www.woah.org/en/home/ 

- Food and Agriculture Organization of the United Nations (FAO) webpage: Avian Influenza https://www.fao.org/animal-health/avian-flu-qa/en/ 

- WOAH/FAO Network of Expertise on Animal Influenza (OFFLU) http://www.offlu.org/ 

___

{1} This summary and assessment covers information confirmed during this period and may include information received outside of this period. 

{2} For epidemiological and virological features of human infections with animal influenza viruses not reported in this assessment, see the reports on human cases of influenza at the human-animal interface published in the Weekly Epidemiological Record here.  

{3} World Organisation for Animal Health (WOAH). Avian influenza. Global situation. Available at: https://www.woah.org/en/disease/avian-influenza/#ui-id-2. 

{4} Food and Agriculture Organization of the United Nations (FAO). Global Avian Influenza Viruses with Zoonotic Potential situation update. Available at: https://www.fao.org/animal-health/situation-updates/global-aiv-withzoonotic-potential. 

{5} World Health Organization (2012). Rapid risk assessment of acute public health events. World Health Organization. Available at: https://iris.who.int/handle/10665/70810. 

{6} World Health Organization. Case definitions for the four diseases requiring notification in all circumstances under the International Health Regulations (2005). Available at: https://www.who.int/publications/m/item/case-definitions-for-the-four-diseases-requiring-notification-towho-in-all-circumstances-under-the-ihr-(2005).  

{7} World Organisation for Animal Health (WOAH). Avian influenza. Global situation. Available at: https://www.woah.org/en/disease/avian-influenza/#ui-id-2. 

{8} Food and Agriculture Organization of the United Nations. Global Avian Influenza Viruses with Zoonotic Potential situation update. Available at: https://www.fao.org/animal-health/situation-updates/global-aiv-withzoonotic-potential/bird-species-affected-by-h5nx-hpai/en. 

{9} World Organisation for Animal Health. WAHIS. https://wahis.woah.org/#/in-review/7409. 

{10} World Health Organization. World Health Organization (10 April 2026). Disease Outbreak News: Avian Influenza A(H9N2) in Italy (https://www/who.int/emergencies/disease-outbreak-news/item/2026-DON597). 

{11} World Organisation for Animal Health. Statement on High Pathogenicity Avian Influenza in Cattle, 6 December 2024 (https://www.woah.org/en/high-pathogenicity-avian-influenza-hpai-in-cattle/). 

{12} World Health Organization. International Health Regulations (2005), as amended through resolutions WHA67.13 (2014), WHA75.12 (2022), and WHA77.17 (2024) (https://apps.who.int/gb/bd/pdf_files/IHR_20142022-2024-en.pdf). 

{13} World Health Organization. Case definitions for the four diseases requiring notification in all circumstances under the International Health Regulations (2005) (https://www.who.int/publications/m/item/casedefinitions-for-the-four-diseases-requiring-notification-to-who-in-all-circumstances-under-the-ihr-(2005)). 

{14} World Health Organization. Manual for the laboratory diagnosis and virological surveillance of influenza (2011) (https://apps.who.int/iris/handle/10665/44518). 

{15} World Health Organization. Pandemic influenza preparedness framework for the sharing of influenza viruses and access to vaccines and other benefits, 2nd edition (https://iris.who.int/handle/10665/341850). 

{16} World Health Organization. Operational guidance on sharing influenza viruses with human pandemic potential (IVPP) under the Pandemic Influenza Preparedness (PIP) Framework (2017) (https://apps.who.int/iris/handle/10665/259402). 

Source: 

Link: https://www.who.int/publications/m/item/influenza-at-the-human-animal-interface-summary-and-assessment--31-march-2026

_____

#Measles - #Bangladesh (WHO, D.O.N., April 23 '26)

 

Situation at a glance

On 4 April 2026, the National International Health Regulations (IHR) Focal Point for Bangladesh notified WHO of a nationwide increase in measles cases, geographically affecting 58 out of 64 districts across all eight divisions in Bangladesh. 

A total of 19 161 suspected measles cases and 2897 laboratory-confirmed measles cases have been reported between 15 March and 14 April 2026, including 166 measles related deaths (CFR 0.9%). 

The majority (79%) of the reported cases are children aged under 5 years. 

A targeted measles-rubella (MR) vaccination campaign started on 5 April, and various outbreak response measures are ongoing including strengthening nationwide surveillance and epidemiological analysis to enhance case detection and reporting. 

Based on currently available information, WHO assesses the risk at the national level as high due to ongoing transmission across multiple divisions, the large number of susceptible children, documented immunity gaps, and the occurrence of suspected measles-related deaths.

Description of the situation

On 4 April 2026, the National IHR Focal Point of Bangladesh notified WHO of a significant increase in measles cases, driven by sustained domestic transmission. 

Since January 2026, Bangladesh has experienced a marked increase in measles cases. 

Geographically, cases have been reported across all eight divisions, in 58 out of 64 districts (91% of districts), indicating widespread transmission nationally.  

Since 15 March 2026 and as of 14 April, a total of 19 161 suspected measles cases and 2973 laboratory-confirmed measles cases have been reported. 

Moreover, 166 suspected measles-related deaths (CFR 0.9%) and 30 confirmed measles-related deaths (CFR= 1.1%) have been recorded. 

A total of 12 318 hospital admissions and 9772 hospital discharges have also been reported. 

The highest cumulative burden of suspected measles cases since 15 March 2026 has been reported in Dhaka (8263 cases), Rajshahi (3747 cases), Chattogram (2514 cases), and Khulna (1568 cases). 

In Dhaka, cases are concentrated in densely populated informal settlements, including Demra, Jatrabari, Kamrangirchar, Korail, Mirpur, and Tejgaon industrial and slum clusters.  (HEOC, DGHS, 15 April 2026).

Children aged under 5 years account for the majority of reported cases (79%), including children aged under 2 years (66%) and infants aged under 9 months (33%). 

A total of 166 suspected deaths have been reported (CFR 1%), mainly among unvaccinated children aged under 2 years.

Epidemiology

Measles is a highly contagious acute viral disease which affects individuals of all ages and remains one of the leading causes of death among young children globally. The mode of transmission is airborne or via droplets from the nose, mouth, or throat of infected persons.

Initial symptoms, which usually appear 10-14 days (range 7-23 days) after infection, include high fever, usually accompanied by a runny nose, bloodshot eyes, cough and tiny white spots inside the mouth. The rash usually appears 10-14 days after exposure and spreads from the head to the trunk to the lower extremities. A person is infectious from four days before up to four days after the appearance of the rash. There is no specific antiviral treatment for measles, and most people recover within 2-3 weeks.

Measles is usually a mild or moderately severe disease. However, measles can lead to complications such as pneumonia, diarrhoea, secondary ear infection, inflammation of the brain (encephalitis), blindness, and death. Postinfectious encephalitis can occur in about one in every 1000 reported cases. About two or three deaths may occur for every 1000 reported cases.

Vaccination with measles containing vaccine is safe and effective, providing protection against measles and its complications for all eligible populations. WHO recommends two doses of Measles Containing Vaccine (MCV) to be provided through the routine immunization schedule. Strong routine immunization systems are therefore critical foundations for achieving and sustaining high levels of population immunity to vaccine preventable diseases such as measles.

WHO further recommends the conduct of Supplementary Immunization Activities (SIAs) or mass immunization campaigns as an effective strategy for delivering vaccination to children who may have been missed by routine services. In protecting vulnerable populations against measles, mass vaccination campaigns can rapidly improve population immunity by reducing the number of susceptible individuals in the population.

Public health response

A nationwide measles-rubella (MR) vaccination campaign was approved by the National Immunization Technical Advisory Group (NITAG) on 30 March 2026, targeting children aged 6–59 months (with expanded coverage for 6–8 months), and started on 5 April in 30 upazilas (sub-districts) of 18 priority districts. A nationwide campaign commenced on 20 April. 

Vitamin A campaign was held throughout the country on 15 March 2025.  During this outbreak response, Vitamin A supplementation is provided to all suspected and confirmed measles cases as an essential component of standard treatment and case management. 

District Rapid Response Teams (RRTs) have been activated, and vaccine procurement fast-tracked by the Ministry of Health. Other outbreak response actions include strengthening routine immunization to prevent further spread of the outbreak, enhancing hospital preparedness, ensuring availability of vitamin A, strengthening isolation capacity, and reinforcing infection prevention and control measures. 

Strengthening nationwide surveillance and epidemiological analysis, is also ongoing including measures to improve case detection and reporting. Trainings are being conducted at health facilities to improve case detection and reporting, and weekly situation reports produced to support evidence-based decision-making. 

National and divisional guidelines have been issued to guide response activities, including vaccination, clinical management, infection prevention and control, patient care pathways, and procurement. 

WHO risk assessment

Measles is a highly contagious viral disease that affects susceptible individuals of all ages and remains one of the leading causes of death among young children globally. Measles can cause serious illness in at-risk groups, including children under 5 years of age, those who are malnourished especially those with vitamin A deficiency and people with weakened immune systems. Measles complications include hearing loss, diarrhoea, pneumonia and blindness. Severe complications of measles include encephalitis, brain damage, and death. 

The current outbreak in Bangladesh is occurring in the context of suboptimal population immunity. A substantial proportion of cases occurred among children who were either unvaccinated or had received only one dose of measles-containing vaccine. In addition, some children were infected before reaching the age of eligibility for vaccination at 9 months. Most cases (91%) occurred among children aged 1 to 14 years, indicating substantial immunity gaps in this age group. 

Before this outbreak, Bangladesh had made substantial progress towards measles elimination. Reported coverage with the first dose of measles-containing vaccine increased considerably between 2000 (89% - WUENIC) and 2016 (118% - WUENIC), while coverage with the second dose also improved between its nationwide introduction in 2012 (22% - WUENIC) and 2024 (121% - WUENIC). During the same period, confirmed measles incidence declined sharply. However, recent declines in MR1 and MR2 coverage due to nationwide stockout of MR vaccine between 2024-2025, combined with routine immunization gaps and the absence of regular nationwide supplementary measles-rubella campaigns since 2020, have increased the number of susceptible children and contributed to the current outbreak. 

The risk at the national level is assessed as high due to ongoing transmission across multiple divisions, the large number of susceptible children, documented immunity gaps, and the occurrence of suspected measles-related deaths. The concentration of cases among unvaccinated and under-vaccinated children including infants too young to be vaccinated, raises concern for continued uninterrupted transmission and severe disease outcomes. 

Overall, the outbreak suggests a reversal from Bangladesh’s previous progress towards measles elimination and highlights increasing vulnerability to sustained transmission. Continued spread is likely unless urgent measures are implemented to strengthen surveillance, rapidly detect and respond to cases, and close immunity gaps through high-quality vaccination activities. 

There are considerable risks of cross-border spread, facilitated by cross-border population movement, with major urban centres such as Dhaka, Chattogram, Sylhet, and Cox’s Bazar being important international travel and transit hubs increasing the likelihood of national and international spread, particularly among unvaccinated or inadequately vaccinated travelers. 

Measles is endemic across the South-East Asia region. The risk is assessed as high at regional level.

Bangladesh shares extensive land borders with India and Myanmar, and population mobility across these borders may facilitate continued transmission. In Myanmar there is a considerable number of unvaccinated/zero dose children. With ongoing conflict and humanitarian crisis, surveillance and response capacities are limited. India, despite achieving high vaccination coverage, has reported a rise in case count over the past six months. Cities with high incidence such as Jashore and Chapainawabganj (an identified hotspot) share busy land crossings with India, thereby increasing the risk of introduction across the border. Despite Bangladesh’s progress towards measles elimination the current outbreak highlights the vulnerability of the population and underscores the fragility of immunization gains.

The risk at the global level is assessed as moderate due to high levels of population mobility, combined with ongoing widespread measles transmission and immunity gaps.

WHO advice

WHO recommends maintaining sustained homogeneous coverage of at least 95% with the first and second doses of the MCV vaccine in all municipalities and strengthening integrated epidemiological surveillance of measles and rubella to achieve timely detection of all suspected cases in public, private, and social security healthcare facilities.  

WHO recommends strengthening epidemiological surveillance in high-traffic border areas to rapidly detect and respond to highly suspected measles cases. Providing a rapid response to imported measles cases to avoid the re-establishment of endemic transmission through the activation of rapid response teams trained for this purpose and by implementing national rapid response protocols when there are imported cases. Once a rapid response team has been activated, continued coordination between the national, sub-national, and local levels must be ensured, with permanent and fluid communication channels between all levels. During outbreaks, it is recommended to establish adequate hospital case management to avoid nosocomial transmission, with appropriate referral of patients to isolation rooms (for any level of care) and avoiding contact with other patients in waiting rooms and/or other hospital rooms.  

WHO recommends vaccination of at-risk populations (without proof of vaccination or immunity against measles and rubella), such as healthcare workers, persons working in tourism and transportation (hotels, airports, border crossings, mass transportation, and others), and international travelers. Implementing a plan to immunize migrant populations in high-traffic border areas, prioritizing those considered at-risk, including both migrants and residents, in these municipalities increases vaccination coverage to increase population immunity.  

In all settings, consideration should be given to providing susceptible contacts with post-exposure prophylaxis (PEP), including a dose of MCV or normal human immunoglobulin (NHIG) (if available) for those at risk and in whom the vaccine is contraindicated. In well-resourced settings, MCV should be provided to susceptible contacts within 3 days. For contacts for whom vaccination is contraindicated or is not possible within 3 days post-exposure, consideration can be given to providing NHIG up to 6 days post-exposure. Infants, pregnant women, and the immunocompromised should be prioritized.  

WHO recommends maintaining a stock of the MR and/or measles, mumps, rubella (MMR) vaccine, and syringes/supplies for control actions of imported cases. Facilitating access to vaccination services according to the national scheme to those from other countries or people from the same country who perform temporary activities in countries with ongoing outbreaks; displaced populations; indigenous populations, or other vulnerable populations.  

WHO does not recommend any restriction on travel and trade based on the information available on the current outbreak.  

Further information

-- World Health Organization. Measles [Internet]. Geneva: World Health Organization; [cited 2026 Apr 6]. Available from: https://www.who.int/health-topics/measles 

-- World Health Organization. Measles fact sheet [Internet]. Geneva: World Health Organization; 2025 Nov 28 [cited 2026 Apr 6]. Available from: https://www.who.int/news-room/fact-sheets/detail/measles  

-- World Health Organization. Immunization dashboard [Internet]. Geneva: World Health Organization; [cited 2026 Apr 6]. Available from: https://immunizationdata.who.int/  

-- World Health Organization. Measles outbreak guide [Internet]. Geneva: World Health Organization; 2022 Aug 31 [cited 2026 Apr 6]. Available from: https://www.who.int/publications/i/item/9789240052079  

-- Directorate General of Health Services (Bangladesh). Press releases [Internet]. Dhaka; [cited 2026 Apr 6]. Available from: https://dghs.gov.bd/pages/press-releases/  

-- Measles vaccines: WHO position paper – April 2017; https://www.who.int/publications/i/item/who-wer9217-205-227

-- Measles: Vaccine Preventable Diseases Surveillance Standards; https://www.who.int/publications/m/item/vaccine-preventable-diseases-surveillance-standards-measles

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Citable reference: World Health Organization (23 April 2026). Disease Outbreak News: Measles in Bangladesh. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON598

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON598

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Avian #Influenza #H9N2 - #Italy (#WHO, D.O.N., April 10 2026)

 

Situation at a glance

-- On 21 March 2026, the National International Health Regulations (IHR) Focal Point for Italy notified the World Health Organization (WHO) of the identification of a human case of avian influenza A(H9) in an adult male returning from Senegal. 

- Next generation sequencing confirmed Influenza A(H9N2). 

- According to epidemiological investigations, the patient had no known history of exposure to poultry or any person with similar symptoms prior to the onset of symptoms. 

- Authorities in Italy have implemented a series of measures aimed at monitoring, preventing and controlling the situation. 

- According to the IHR (2005), a human infection caused by a novel influenza A virus subtype is an event that has the potential for high public health impact and must be notified to the WHO. 

- This is the first imported human case of avian Influenza A(H9N2) reported in the European Region. 

- Based on currently available information, WHO assesses the current risk to the general population posed by A(H9N2) viruses as low but continues to monitor these viruses and the situation globally.

Description of the situation

-- On 21 March 2026, the National IHR Focal Point for Italy notified WHO of the identification of a human case of avian influenza A(H9) in an adult male.

-- The patient had been in Senegal for more than six months and traveled to Italy in mid-March. Upon arrival, he visited the emergency department with a fever and a persistent cough.

-- On 16 March, a bronchoalveolar lavage specimen was collected, which showed a positive Mycobacterium tuberculosis result, as well as detection of un-subtypeable influenza A virus. The patient was placed in a negative-pressure isolation room with airborne precautions. He was treated with antitubercular medication and antiviral oseltamivir. By 9 April, his condition was stable and improving.

-- On 20 March, a regional reference laboratory identified the A(H9) subtype, and on 21 March, next-generation sequencing confirmed influenza A(H9N2). Initial genetic findings suggest the infection was likely acquired from an avian source linked to Senegal. Additional samples have been sent to Italy’s National Influenza Center, where further characterization confirmed virus subtype Influenza A(H9N2), with close genetic similarity to strains previously identified in poultry in Senegal.

-- No direct exposure to animals, wildlife or rural environments was identified. There was also no reported contact with symptomatic or confirmed human cases. Further epidemiological investigations on the source of exposure are ongoing.

-- Contacts identified in Senegal were asymptomatic. All identified and traced contacts in Italy have tested negative for influenza and completed the period of active monitoring for the onset of symptoms and the quarantine required by national guidelines. They also received oseltamivir as a preventive measure. 

Epidemiology

-- Animal influenza viruses normally circulate in animals but can also infect people. Infections in humans have primarily been acquired through direct contact with infected animals or through indirect contact with contaminated environments. Depending on the original host, influenza A viruses can be classified as avian influenza, swine influenza, or other types of animal influenza viruses.

-- Avian influenza virus infections in humans may cause diseases ranging from mild upper respiratory tract infection to more severe diseases and can be fatal. Conjunctivitis, gastrointestinal symptoms, encephalitis and encephalopathy have also been reported.

-- Laboratory tests are required to diagnose human infection with influenza. WHO periodically updates technical guidance protocols for the detection of zoonotic influenza using molecular methods. 

-- Human infections with influenza A(H9) viruses have been reported from countries in Africa and Asia, where these viruses are also detected in poultry. The majority of cases of human avian influenza A(H9N2) infection have been reported from China. This is the first imported human case of avian Influenza A(H9N2) virus infection reported in the European Region. 

Public health response

-- Contact tracing procedures have been initiated, and relevant authorities in Italy, as well as internationally (National IHR Focal Point for Senegal, WHO, and European Centre for Disease Prevention and Control (ECDC)) have been informed through IHR channels. Once avian influenza was suspected, the response moved quickly from hospital-level management to regional laboratory confirmation and national coordination. Additionally, the regional surveillance system was notified, integrated within the One Health avian influenza reporting framework.

WHO risk assessment

-- Most reported human cases of A(H9N2) virus infection have been linked to exposure to infected poultry or contaminated environments, with the majority of cases experiencing mild clinical illness. Sporadic human cases following exposure to infected birds or contaminated environments can be expected since the virus remains enzootic in poultry populations. Avian influenza A(H9N2) viruses have been detected in poultry and environmental samples collected at live bird markets in Senegal and authorities in the country reported a human case of infection with an A(H9N2) virus in 2020.

-- Current epidemiological and virological evidence indicates that none of the characterized influenza A(H9N2) viruses thus far have acquired the ability for sustained transmission among humans. Thus, the likelihood of sustained human-to-human spread is low at this time. Infected individuals traveling internationally from affected areas may be identified in another country during or after arrival. However, if this were to occur, further community-level spread is considered unlikely. The risk assessment would be revisited if and when further epidemiological and virological information becomes available.

WHO advice

-- This case does not change the current WHO recommendations on public health measures and surveillance of influenza.

-- The public should avoid contact with high-risk environments such as live animal markets/farms or surfaces that might be contaminated by poultry feces. Respiratory protection is highly recommended for those handling live or dead (including slaughtering) poultry in occupational or backyard-farming settings. Good hand hygiene, i.e. frequent washing of hands or the use of alcohol-based hand sanitizer is recommended. WHO does not recommend any specific additional measures for travelers.

-- Under Article 6 of the IHR, all human infections caused by a new subtype of influenza virus are notifiable. The case definition for notification of human influenza infection caused by a new subtype under the IHR is provided here. State Parties to the IHR are required to immediately notify WHO of any laboratory-confirmed case of a human infection caused by such an influenza A virus.

-- WHO advises against the application of any travel or trade restrictions based on the current information available on this event. 

Further information

-- WHO fact sheet on Influenza (avian and other zoonotic): https://www.who.int/news-room/fact-sheets/detail/influenza-(avian-and-other-zoonotic)

-- WHO Global influenza programme, human-animal interface: https://www.who.int/teams/global-influenza-programme/avian-influenza

-- WHO Monthly Risk Assessment Summary: Influenza at the human-animal interface: https://www.who.int/teams/global-influenza-programme/avian-influenza/monthly-risk-assessment-summary

-- Protocol to investigate non-seasonal influenza and other emerging acute respiratory diseases: https://www.who.int/publications-detail-redirect/WHO-WHE-IHM-GIP-2018.2

-- World Health Organization. Public health resource pack for countries experiencing outbreaks of influenza in animals: revised guidance: https://www.who.int/publications/i/item/9789240076884

-- Implementing the integrated sentinel surveillance of influenza and other respiratory viruses of epidemic and pandemic potential by the Global Influenza Surveillance and Response System: https://www.who.int/publications/i/item/9789240101432

-- Case definitions for the four diseases requiring notification in all circumstances under the International Health Regulations (2005): https://www.who.int/publications/m/item/case-definitions-for-the-four-diseases-requiring-notification-to-who-in-all-circumstances-under-the-ihr-(2005)

-- Mosaic Respiratory Surveillance Framework: https://www.who.int/initiatives/mosaic-respiratory-surveillance-framework/

-- Practical interim guidance to reduce the risk of infection in people exposed to avian influenza viruses: https://www.who.int/publications/i/item/B09116

-- Antigenic and molecular characterization of low pathogenic avian influenza A(H9N2) viruses in sub-Saharan Africa from 2017 through 2019: https://hal.inrae.fr/hal-03213105v1

-- Genetic and Molecular Characterization of Avian Influenza A(H9N2) Viruses from Live Bird Markets (LBM) in Senegal: https://doi.org/10.3390/v17010073

-- Genetic characterization of the first detected human case of low pathogenic avian influenza A/H9N2 in sub-Saharan Africa, Senegal: https://doi.org/10.1080/22221751.2020.1763858

-- ECDC. First human case of influenza A(H9N2) infection imported in the EU: https://www.ecdc.europa.eu/en/news-events/first-human-case-influenza-ah9n2-infection-imported-eu

-- Ministry of Health, Italy. Influenza A (H9N2) virus case identified in Lombardy. Routine surveillance and prevention procedures activated: https://www.salute.gov.it/new/it/comunicato-stampa/virus-influenzale-h9n2-identificato-caso-lombardia-attivate-le-ordinarie/

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Citable reference: World Health Organization (10 April 2026). Disease Outbreak News: Avian Influenza A(H9N2) in Italy. Available at: https://www/who.int/emergencies/disease-outbreak-news/item/2026-DON597

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON597

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#Mpox - cMulti-country external #situation #report no. 64, published 26 March 2026 (#WHO, summary)

 

{Excerpt}

Highlights

• Transmission of mpox continues mostly within sexual networks, affecting both women and men, followed by household transmission, and in some historically endemic areas, affecting all age groups. 

- All clades of monkeypox virus (MPXV) continue to circulate. 

- Unless mpox outbreaks are rapidly contained and human-to-human transmission is interrupted, there is a risk of sustained community transmission in all settings. 

• In February 2026, 46 countries across all WHO regions reported a total of 1184 confirmed mpox cases, including four deaths (case fatality ratio [CFR] 0.3%). 

- Of these cases, 58.6% were reported in the WHO African Region. 

• Four WHO regions – the Region of the Americas and the African, South-East Asian and Western Pacific regions – reported a decline in confirmed cases in February, compared to January 2026, while the European Region reported an increase in confirmed cases. 

- The Eastern Mediterranean Region reported the same monthly case count in January and February 2026.

• Seventeen countries in Africa reported active transmission of mpox in the last six weeks (1 February – 15 March 2026), with 907 confirmed cases, including seven deaths (CFR 0.8%). 

- Countries reporting the highest number of cases in this period are Madagascar, the Democratic Republic of the Congo, Kenya, Burundi, and Liberia. 

• Three countries, Argentina, Austria, and the Central African Republic, have reported mpox due to clade Ib MPXV for the first time. 

• Outside Africa, community transmission of clade Ib MPXV continues in the WHO European Region, with Austria, Belgium, Portugal, Spain, and the United Kingdom of Great Britain and Northern Ireland reporting community transmission, including in sexual networks of men who have sex with men.  

• This report provides an update on mpox outbreak transmission dynamics across different clades and settings. 

• On 7 April 2026, World Health Day, WHO will join a One Health summit convened by the Government of France. 

- The Summit will foster international and interdisciplinary dialogue to highlight the interdependence of human, animal, plant and ecosystem health, and the need for coordinated, science-based approaches to address shared health threats, including for emergency response. 

(...)

Source: 

Link: https://www.who.int/publications/m/item/multi-country-outbreak-of-mpox--external-situation-report--64---26-march-2026

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Rapid #risk #assessment, acute event of potential public health concern: #Diphtheria, #Africa Region (#WHO, March 20 '26)

{Summary)

Risk statement

-- This WHO Rapid Risk Assessment (RRA, v2) aims to assess the risk of diphtheria at the regional level, considering the public health impact, the risk of geographical spread and the risk of insufficient control capacities with available resources. 

-- Diphtheria is a major public health problem in the WHO African Region (AFR) despite significant efforts on immunization in the past decades (e.g. introduction of DTP vaccine in the Expanded Program on Immunisation in 1974). 

-- Between 2000 and 2024, 75 789 diphtheria suspected cases were reported across the Region with an average 3 500 cases per year.    

-- Between the beginning of 2025 and as of 1 March 2026, over 29 000 suspected diphtheria cases with 1 420 deaths (CFR 4.9%) have been reported across these eight countries: Algeria, Chad, Guinea, Mali, Mauritania, Niger, Nigeria and South. 

-- This represents a 67% increase in the number of suspected cases (11 749 additional cases) and a 59.4% increase in the number of deaths (529 additional deaths) reported since the last WHO RRA (v1) conducted in October 2025, Nigeria continues to account for the majority of suspected cases (62.6%) and deaths (66%) in the Region. 

-- Of the 18 130 total confirmed cases (clinically compatible, laboratory-confirmed and epidemiologically linked) across the eight affected countries, 752 (4%) cases were recorded as laboratory-confirmed: Algeria (8), Chad (1), Guinea (48), Mali (66), Mauritania (12), Niger (313), Nigeria (211) and South Africa (93).     

-- Case data trends from 2026 have been difficult to interpret, with extremely delayed case reporting from countries (both to the national and regional levels), and instances of under-reporting also being notified, particularly from humanitarian settings. 

-- However, a lower number of cases are being consistently reported than earlier in the outbreak and thus it appears that new cases continue to decline or plateau, as seen in half of the affected countries (Chad, Mali, Mauritania, and Nigeria).    

-- Since the first WHO RRA (v1) conducted in October 2025, the regional CFR remains around 5%. 

-- While Guinea continues to report among the highest CFRs in the region at 19%, South Africa’s CFR has increased since the last WHO RRA (v1) to 19%.  

-- Children aged 5–14 yrs (57%) and females (63%) are the most affected; where information is available on the vaccination status of cases, most cases are unvaccinated, under-vaccinated, or with unknown vaccination status.   

-- While the overall risk was previously assessed as “HIGH” at the regional level in October 2025, it is now considered “MODERATE” due to:  

• Overall declining trend in number of weekly cases regionally, with country-specific trends also declining in half of the affected countries (Chad, Mali, Mauritania and Nigeria), and only sporadic cases reported from South Africa. 

• Strengthened coordination of public health response through the activation of an Incident Management System (IMS) in most of the affected countries. A joint Regional Office for Africa (AFRO) and WHO headquarters (HQ) IMS structure was activated to support the regional coordination of the response, with high-level ministerial commitment to controlling the outbreaks in the affected countries.  

• Implementation of immunization activities as part of the outbreak response in most of the affected countries. 

• Strengthening of surveillance, case management, community sensitization, through capacity building activities, and the provision of diphtheria antitoxin (DAT), antibiotics, laboratory supplies, etc.  

-- Nonetheless, some challenges continue to prevent the effective containment of these outbreaks:  

• The complex humanitarian situation in many of the affected countries continues to contribute to poor access to immunization and healthcare services for internally displaced persons (IDPs), nomads, miners, and migrants. Unsanitary living conditions (in displacement camps) are also favouring the transmission of diphtheria. These increase the exposure risk of vulnerable groups (particularly women and children) to diseases.   

• Limited laboratory confirmation due to lack of reagents, sample transportation challenges and limited available of laboratory capacity.  

• In most of the affected countries, the annual coverage for routine diphtheria vaccination remains below the national targets thereby contributing to the resurgence of cases and outbreaks.  

• Global scarcity of DAT for the treatment of affected persons. 

• High internal and cross-border movements of susceptible individuals (unvaccinated or not fully vaccinated). 

• Persistent funding challenges across most affected countries exacerbated by the current challenging international funding landscape.  

-- The overall risk at the global level remains ‘’LOW’’ due to: 

- The global risk of diphtheria outbreaks from the ongoing multi-country diphtheria outbreak in the African region is assessed as low, given the existence of routine immunization programs in most countries. 

- Nonetheless, the risk posed by international travel of susceptible populations from the WHO African Region cannot be overlooked, highlighting the need to strengthen risk communication, demand generation and reactive immunisation, as well as the need for enhanced data sharing and surveillance globally. 

(...)

Source: 

Link: https://www.who.int/publications/m/item/who-rapid-risk-assessment---diphtheria--african-region-v.2

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