Showing posts with label a/h3n2. Show all posts
Showing posts with label a/h3n2. Show all posts

Thursday, April 30, 2026

Prior #immunity to seasonal #influenza #H3N2 virus confers varying levels of cross - #protection against challenge with clade 2.3.4.4b #H5N1, #H7N9, or #H9N2 virus in a #ferret model

 


ABSTRACT

Evaluating how prior immunity to seasonal influenza viruses influences subsequent zoonotic influenza A virus (IAV) infection in animal models is critical for pandemic preparedness. In this study, we investigated the cross-protective effect of pre-existing A(H3N2) immunity in ferrets challenged with three distinct subtypes of zoonotic IAVs: low pathogenic A(H7N9) and A(H9N2) viruses, and highly pathogenic clade 2.3.4.4b A(H5N1) virus. Our results show that A(H3N2) preimmunity conferred some protection against A(H5N1) and A(H9N2) virus infection, as evidenced by more rapid viral clearance in the upper respiratory tract, reduced virus shedding in the nasal wash on select days post-inoculation, and a lowered frequency of viral detection in specific tissues compared with naive animals. In contrast, A(H3N2) preimmunity provided minimal cross-protection against A(H7N9) infection, as weight loss and viral dissemination in tissues were not significantly reduced in A(H3N2) preimmune ferrets relative to naive animals. These findings highlight the variable breadth and magnitude of cross-protection elicited by prior seasonal IAV immunity against zoonotic influenza virus challenges in the ferret model. Seasonal influenza A(H3N2) preimmunity provided differing levels of cross-protection against zoonotic influenza A virus infections in ferrets.

Source: 


Link: https://journals.asm.org/doi/10.1128/spectrum.03974-25

____

Wednesday, April 29, 2026

#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

_____

Tuesday, April 14, 2026

#Vaccine-Elicited #Antibody Responses to #Influenza #H3N2 Subclade K

 


{Summary}

Influenza A(H3N2) subclade K (J.2.4.1) is a genetic branch of H3N2 with 11 mutations in hemagglutinin compared with the A/H3N2/Croatia/10136RV/2023 (H3N2 CR/23) vaccine strain, of which 8 mutations are on the hemagglutinin head surface (...) (...). As of February 2026, influenza A viruses currently represent approximately 96.3% of circulating influenza strains in the US, with H3N2 accounting for 88.4% of influenza isolates and subclade K comprising 91.5% of H3N2 isolates. The rapid expansion of H3N2 subclade K represents a major public health concern. This study reports antibody responses to H3N2 subclade K and other influenza strains before and after influenza vaccination.

(...)

Source: 


Link: https://jamanetwork.com/journals/jama/article-abstract/2846268

____

Saturday, April 11, 2026

Predicting the #antigenic #evolution of seasonal #influenza viruses using phylogenetic #convergence

 


Abstract

The antigenic evolution of human seasonal influenza viruses is primarily driven by single amino acid substitutions immediately adjacent to the receptor binding site in the hemagglutinin (HA) protein. The ability to predict these substitutions would allow vaccine strains to be selected with an understanding of likely future antigenic variation. Here, we estimate the effect of HA substitutions on viral fitness using measurements of convergent evolution in a large phylogeny. We show that the substitutions which have historically caused major antigenic changes in H3N2 influenza viruses were nearly always one of few substitutions near the HA receptor binding site estimated to be under positive selection in sequences collected before the antigenic transition, based on convergent acquisition of the substitution in multiple independent lineages. Furthermore, this signal predates the establishment of the major clade containing the antigenic substitution by more than one year, so is highly informative for prospective prediction.


Competing Interest Statement

The authors have declared no competing interest.


Funder Information Declared

National Institute of Allergy and Infectious Diseases, https://ror.org/043z4tv69, 75N93021C00014

National Institutes of Health, https://ror.org/01cwqze88, R01AI165818

Medical Research Council, https://ror.org/03x94j517, MR/Y004337/1

Source: 


Link: https://www.biorxiv.org/content/10.64898/2026.04.10.717627v1

____

Friday, April 10, 2026

#USA, Weekly #US #Influenza #Surveillance #Report: Key Updates for Week 13, ending April 4, 2026 (#CDC, summary)

 


(...)

Key Points

-- Seasonal influenza activity continues to decrease in most areas of the country. 

- Influenza A activity is low across all HHS regions while the amount of and trends in influenza B activity vary by region.

-- Influenza A(H3N2) viruses are the most frequently reported influenza viruses overall this season.

-- Among 2,166 influenza A(H3N2) viruses collected since September 28, 2025, that underwent additional genetic characterization at CDC, 92.8% belonged to subclade K.

-- The cumulative influenza-associated hospitalization rate overall in FluSurv-NET is the third highest since the 2010-2011 season

- Children younger than 18 years have the second highest cumulative hospitalization rate for that age group since the 2010-2011 season.

-- Twelve influenza-associated pediatric deaths occurring during the 2025-2026 season were reported to CDC this week, bringing the season total to 139 reported influenza-associated pediatric deaths.

-- Among children who were eligible for influenza vaccination and with known vaccination status, approximately 85% of reported pediatric deaths this season have occurred in children who were not fully vaccinated against influenza.

-- CDC's in-season severity assessment framework classified the season as moderate across all ages. 

- CDC also assesses severity by three age groups: pediatric (0-17 years), adult (18-64 years), and older adults (≥65 years). 

- At this point in the season, the pediatric age group is classified as having high severity, while both the adult and older adult age groups are classified as having moderate severity. 

- These assessments are conducted each week during the season, and the season's severity assessment can change if activity should increase again.

-- CDC estimates that there have been at least 31 million illnesses, 370,000 hospitalizations, and 23,000 deaths from flu so far this season.

-- Influenza (flu) vaccination has been shown to reduce the risk of flu and its potentially serious complications. 

- There is still time to get vaccinated against flu this season. 

- Approximately 135 million doses of influenza vaccine have been distributed in the United States this season.

-- There are prescription flu antiviral drugs that can treat flu illness; those should be started as early as possible and are especially important for patients at higher risk for flu-related complications.1

-- Influenza viruses are among several viruses contributing to respiratory disease activity. CDC provides updated, integrated information about COVID-19, flu, and respiratory syncytial virus (RSV) activity on a weekly basis.

-- No new avian influenza A(H5) infections were reported to CDC this week. To date, person-to-person transmission of influenza A(H5) viruses has not been identified in the United States.

(...)

Source: 


Link: https://www.cdc.gov/fluview/surveillance/2026-week-13.html

____

Thursday, April 9, 2026

#Birth #imprinting effects on the #antibody responses of #H7N9 patients from 2013-2018 in #China

 


Abstract

Background

There is an urgent need to understand the immune correlates of protection against avian influenza viruses (AIV), where pre-existing immunity may be limited.

Methods

Here, we characterized the antibody response in 12 severely ill A(H7N9) patients and examined its association with early-life imprinting and clinical outcome.

Results

We find that A(H7N9) patients imprinted with A(H2N2) during early life show minimal H7-IgM and a rapid IgG response across diverse hemagglutinin subtypes. They also have more high avidity H7-antibodies compared to older or younger patients. Early antibody titers against seasonal H1, H3, and conserved stalk domains trend negatively with clinical severity in A(H7N9) infection, while an inverse pattern is observed following severe A(H1N1) infection, potentially suggesting a different mechanism of immune regulation between seasonal and avian influenza virus infections.

Conclusions

These data provide direct serological evidence that birth imprinting profoundly shapes the humoral immune landscape during zoonotic influenza infection and may influence subsequent disease outcome.

Source: 


Link: https://www.nature.com/articles/s43856-026-01554-1

____

Wednesday, April 1, 2026

Broad #protection against #Influenza A Viruses via an adjuvant-free #mucosal microparticle #vaccine with conserved CD8/CD4 bispecific peptides

 


Abstract

Influenza A viruses (IAVs) cause substantial global morbidity and mortality and are responsible for most known viral pandemics. Their rapid antigenic evolution enables escape from natural and vaccine-induced immunity, requiring annual vaccine reformulation, which offers limited breadth and variable effectiveness. Although a universal influenza vaccine remains a critical objective, most strategies have focused on conserved viral glycoproteins to elicit broadly neutralizing antibodies, with comparatively fewer efforts targeting conserved T cell antigens to achieve cross-subtype protection. Current T cell-based approaches often rely on individual CD8+ epitopes, which are limited by peptide instability, delivery constraints, and dependence on adjuvants. Here, we demonstrate a T cell-focused vaccine strategy that uses evolutionary consensus of IAV M1 and NP from the H1N1 and H3N2 subtypes to predict, map, and screen conserved regions enriched with multiple CD8+ and CD4+ epitopes. We selected the top-performing peptides from immunogenicity screening. We encapsulated them in polylactic-co-glycolic acid microparticles (PLGA-MPs) engineered for selective uptake by APCs and pH-dependent sustained release. Intranasal delivery of this vaccine formulation targeted the primary site of infection and induced robust mucosal immunity without the need for conventional adjuvants. Both human and murine influenza-experienced T cells mounted potent recall responses to the vaccine. In mice, immunization elicited strong CD8+ and CD4+ T cell responses and conferred broad protection against homologous H1N1 and H3N2 as well as heterologous H5N1 IAV subtypes. These findings collectively establish a mucosal, T cell-based vaccine platform that is adjuvant-free and capable of providing broad protection against IAV and other viruses with pandemic potential.


Competing Interest Statement

The authors have declared no competing interest.


Funder Information Declared

DBT-ENDFLU, BT/IN/EU-INF/15/RV/19-20

Source: 


Link: https://www.biorxiv.org/content/10.64898/2026.03.29.715080v1

____

Friday, March 20, 2026

14th Meeting of #WHO #Expert Working Group of the Global #Influenza #Surveillance and Response System (GISRS) for Surveillance of #Antiviral Susceptibility (March 20 '26)



Weekly epidemiological record 

20 MARCH 2026, 101th YEAR, No 12, 2026, 101, 53–56

http://www.who.int/wer 


Executive Summary 

The WHO Expert Working Group on Surveillance of Influenza Antiviral Susceptibility (AVWG) supports the WHO GISRS by providing practical guidance for monitoring antiviral susceptibility of seasonal and emerging influenza viruses through global surveillance efforts

The 14th WHO-AVWG meeting was held in virtual format on 10-12 June 2025


Update on susceptibility of seasonal influenza viruses to approved antiviral agents 

From approximately May 2024 to May 2025, five WHO Collaborating Centres (CCs) and two National Influenza Centres (NICs) reported co-circulation of influenza A(H1N1) pdm09, A(H3N2), and B/Victoria viruses. 

A(H1N1)pdm09 dominated in Eastern Asia{1}. Elevated frequency of influenza neuraminidase (NA) inhibitor (NAI) reduced inhibition/ highly reduced inhibition (RI/HRI) was identified among A(H1N1)pdm09 viruses, largely conferred by the NA-H275Y substitution

Reporting frequency was 3.8% in China, lower (≤1%) in other reporting regions, but still measurable and were in some cases a result of prior antiviral use or specific local outbreaks (e.g., a hospital in Iceland with a NA-H275Y+S247N cluster, a primary school classroom outbreak in Japan{2}. The NA-S247N substitution (≤3.3%) was also noted by three centres, but these viruses exhibited normal inhibition (NI) by NAIs when available isolates were tested

Incidence of RI/HRI or NA-associated markers were less frequently reported for A(H3N2) and B/Victoria viruses than A(H1N1)pdm09 viruses. 

Markers and incidence of reduced susceptibility to baloxavir was detected at low frequencies of 0.07 to 2.2%, where the latter value represented a small sample set of only 2 of 89 viruses in Japan

Reduced susceptibility or amino acid markers indicative of reduced susceptibility were observed only in influenza A viruses and not influenza B


Update on susceptibility of zoonotic and animal influenza viruses  to approved antiviral agents 

From approximately May 2024 to May 2025, global surveillance data from WHO CCs, NICs, and associated partners including WHO Essential Regulatory Laboratories and the OFFLU (WOAH/FAO Network of Expertise on Animal Influenza) network reported that most zoonotic and avian influenza viruses, particularly circulating A(H5N1/x) HA clade 2.3.4.4b and 2.3.2.1a/e viruses, were broadly susceptible to NAIs and baloxavir

A(H5N1) 2.3.4.4b virus oseltamivir inhibitory concentrations remain elevated vs. seasonal N1 viruses. 

Small and isolated incidence of NAI associated RI/HRI or markers included: NA-D199G mediated oseltamivir/zanamivir RI detected in A(H5N1) 2.3.4.4b poultry in the Russian Federation (February 2024, reported June 2025), NA-N295S in poultry in India A(H5N1) 2.3.2.1a isolates, and 8 poultry farms in British Columbia, Canada exhibiting A(H5N1) 2.3.4.4b with NA-H275Y

Only two viruses with reduced baloxavir susceptibility were identified, 1 human virus with PA-I38M (California, USA) and 1 environmental virus isolate with PA-V100I (China, Hong Kong Special Administrative Region). 

Beyond A(H5N1/x), nearly 30 avian influenza subtypes including A(H9N2), A(H7N2), A(H7N7), and A(H7N9), and A(H10N7) were analysed across surveillance sites in the Bangladesh, Egypt, the Netherlands and the United States of America (USA). 

They generally lacked NA or PA genotypic markers of reduced drug susceptibility and when available for phenotypic testing, were susceptible to both NAIs and baloxavir. 

A(H7N2) and A(H7N7) viruses from the Netherlands displayed oseltamivir RI compared to human seasonal references, but this may be due to foldchange comparison to a mismatched NA subtype. 

Swine-origin variant viruses (A(H1N1)v, A(H1N2)v, A(H3N2)v) tested across the USA and Europe were largely free of genotypic or phenotypic indicators of reduced susceptibility/inhibition to NAIs or baloxavir. 

Some viruses (the  Netherlands) showed slightly higher NAI median inhibitory concentrations to historical or human seasonal baselines, but all remained below NAI RI thresholds. 


Update of protocols and guidance for GISRS laboratories 

Both genotypic and phenotypic assays may be used as tools to monitor susceptibility of influenza viruses to NAIs and baloxavir

The WHO-AVWG routinely reviews and updates influenza NA and PA amino acid substitutions associated with reduced susceptibility to NAIs and baloxavir; updated tables for the previous reporting period were included on the WHO website{3–5}. 

The US CDC continues to update and ship reference virus panels that can be used for NAI and baloxavir susceptibility testing, available via the International Reagent Resource{6} 

Further guidance on baloxavir and other PA inhibitor testing included the Influenza Replication Inhibition Neuraminidase-based Assay (IRINA), published by the Centers for Disease Control and Prevention, USA{7} and included on the WHO website{8}. 

The WHO AVWG continues to develop algorithms for NICs to aid in influenza response planning (zoonotic, pandemic, and antiviral resistance-specific events), guidance to aid in decisions making for testing strategies (genotypic vs. phenotypic), and guidance for consideration of baloxavir and PA inhibitor specific amino acid substitutions associated with reduced drug susceptibility{9}. 

Additionally, the WHO-AVWG has worked with GISAID to continue to refine and implement modifications to existing tools to facilitate identification of NA and PA substitutions upon sequence submission. 


Outbreak and pandemic preparedness with clinicians’ perspectives 

Two physicians, Profs. Prof. David Hui and Bin Cao, were invited to present recently updated WHO guidance on clinical practice guidelines for influenza{10}. 

Significant updates and discussion surrounded inclusion of baloxavir, which was conditionally recommended for non-severe disease high-risk patients and post-virus exposure prophylaxis (PEP) including influenza viruses associated with high mortality. 

Conditional recommendation against any NAI or baloxavir intervention remains for non-severe disease low-risk patients or seasonal virus PEP. 

Data was presented on multiple PA inhibitors rapidly moving through late-stage clinical trials in China which may have implications on expanded usage of this newer class of influenza drugs. 


Review of External Quality Assessment Programme (EQAP) panels 

EQAP was initiated in 2007 to monitor the quality of GISRS, NICs, other national influenza reference laboratories’ capacity for influenza diagnosis and detection. 

An optional antiviral phenotypic NAI panel was introduced in 2013, and genotypic baloxavir susceptibility was introduced in 2020. 

Results for the 2024 Global EQAP panel were reported during the 14th WHO-AVWG meeting. 

Of the 194 participating laboratories, 26.3% participated in NAI susceptibility testing. 

Results and subsequent discussion from this year’s panel were used by members of WHO-AVWG to assess the training needs of NICs. 


Way forward 

The 2020–2023 Annual Global Update on the Susceptibility of Influenza Viruses (Global AVS) manuscript was published{11} and drafting of a 2023–2025 publication is underway. The next WHO-AVWG meeting will be held in June 2026.

___

{1} World Health Organization. Influenza Transmission Zones. 2026. https://cdn.who.int/media/docs/ default-source/influenza/influenzaupdates/2025_09_24_influenza-transmission-zones. pdf?sfvrsn=22361408_3&download=true

{2} Takashita E, Shimizu K, Usuku S, Senda R, Okubo I, Morita H, et al. An outbreak of influenza A(H1N1) pdm09 antigenic variants exhibiting cross-resistance to oseltamivir and peramivir in an elementary school in Japan, September 2024. Euro Surveill. 2024;29(50).

{3} World Health Organization. Summary of neuraminidase (NA) amino acid substitutions assessed for their effects on inhibition by neuraminidase inhibitors (NAIs). 2025. https://cdn.who.int/media/docs/default-source/ influenza/laboratory---network/quality-assurance/human-nai-marker-table_ for-publication_final_20240918.pdf

{4} World Health Organization. Summary of neuraminidase (NA) amino acid substitutions assessed for their effects on inhibition by NA inhibitors (NAIs) among avian influenza viruses of Group 1 (N1, N4, N5, N8 subtypes) and Group 2 (N2, N3, N6, N7, N9 subtypes) NAs. 2025. https://cdn.who.int/media/ docs/default-source/influenza/avwg/avian-nai-marker-whotable__10-10-2025.pdf?sfvrsn=bc0d1e9a_10 

{5} World Health Organization. Summary of polymerase acidic protein (PA) amino acid substitutions assessed for their effects on PA inhibitor (PAI) baloxavir susceptibility. 2025. https://cdn.who.int/media/docs/default-source/influenza/ laboratory---network/quality-assurance/antiviral-susceptibility-influenza/ pa-marker-who-table_28-11-2025_updated.pdf?sfvrsn=5307d6fe_4

{6} International Reagent Resource. 2026. https://www. internationalreagentresource.org/

{7} Patel MC, Flanigan D, Feng C, Chesnokov A, Nguyen HT, Elal AA, et al. An optimized cell-based assay to assess influenza virus replication by measuring neuraminidase activity and its applications for virological surveillance. Antiviral Res. 2022;208:105457. 

{8} World Health Organization. Baloxavir Susceptibility Assessment using Influenza Replication Inhibition Neuraminidase-based Assay (IRINA). https:// cdn.who.int/media/docs/default-source/influenza/avwg/cdc-phenotypic-lp492rev01d---baloxavir-susceptibility-assessment-using-irina.pdf? 

{9} Patel MC, Nguyen HT, Mishin VP, Pascua PNQ, Champion C, Lopez-Esteva M, et al. Antiviral susceptibility monitoring: testing algorithm, methods, and f indings for influenza season, 2023-2024. Antiviral Res. 2025;244:106299. 

{10} World Health Organization. Clinical practice guidelines for influenza 2024. https://www.who.int/publications/i/item/9789240097759.

{11} Hussain S, Meijer A, Govorkova EA, Dapat C, Gubareva LV, Barr I, et al. Global update on the susceptibilities of influenza viruses to neuraminidase inhibitors and the cap-dependent endonuclease inhibitor baloxavir, 2020-2023. Antiviral Res. 2025:106217.

___

Source: 


Link: https://iris.who.int/server/api/core/bitstreams/1ea408da-cd90-438b-b80c-b00aaf4e7315/content

____

Friday, March 13, 2026

Structural #insights into #antibody responses against #influenza A virus in its natural reservoir

 


Abstract

While influenza A virus undergoes rapid antigenic drift in humans, at least some subtypes, such as H3, have relatively stable antigenicity in natural waterfowl reservoirs, despite the presence of immune pressure. However, the underlying mechanisms remain poorly understood. This study identified and characterized 187 antibodies to H3 hemagglutinin from experimentally infected mallard ducks, 18 of which were further analyzed by cryo-EM. Compared with human H3 antibodies, duck H3 antibodies exhibited higher glycan-binding propensity, more balanced immunodominance hierarchy, and targeted distinct epitopes. Other unique features of duck H3 antibodies included a convergent CDR H3-independent heavy chain-only binding mode and an N-glycosylated CDR H3 as decoy receptor. By annotating duck immunoglobulin germline genes, we also demonstrated the importance of gene conversion in duck H3 antibodies. Overall, our findings provide insights into how millennia of coevolution have shaped the interplay between influenza A virus antigenic drift and antibody responses in the natural reservoir.


Competing Interest Statement

N.C.W. consults for HeliXon. The authors declare no other competing interests.


Funder Information Declared

National Institutes of Health, https://ror.org/01cwqze88, R01 AI165692

Carl R. Woese Institute for Genomic Biology, Carl R. Woese Institute for Genomic Biology Postdoctoral Fellowship

Vallee Foundation, https://ror.org/05nmp3276, Vallee Scholars Program

Foundation for Partnership Initiatives in the Niger Delta, https://ror.org/041nz5a71, Searle Scholars Program

Howard Hughes Medical Institute, https://ror.org/006w34k90, Emerging Pathogens Initiative


Source: BioRxIV, https://www.biorxiv.org/

Link: https://www.biorxiv.org/content/10.64898/2026.03.11.711171v1

____



Thursday, March 12, 2026

Interim Estimates of 2025–26 Seasonal #Influenza #Vaccine #Effectiveness — #USA, September 2025–February 2026 (CDC MMWR)

 


Abstract

In the United States, annual influenza vaccination has been recommended for all persons aged ≥6 months, including during the 2025–26 season. Interim influenza vaccine effectiveness (VE) estimates were calculated for patients with acute respiratory illness–associated outpatient visits and hospitalizations from three U.S. respiratory virus VE networks during the 2025–26 influenza season, using a test-negative case-control design. Among children and adolescents aged <18 years, VE was 38%–41% against influenza outpatient visits and 41% against influenza-associated hospitalization. Among adults aged ≥18 years, VE was 22%–34% against influenza outpatient visits and 30% against influenza-associated hospitalization. Among children and adolescents, VE against influenza A ranged from 37% (against outpatient visits) to 42% (against hospitalization) across settings; among adults, VE against influenza A ranged from 30% (against hospitalization) to 34% (against outpatient visits) across settings. Among children and adolescents, VE against influenza A(H3N2)–associated outpatient visits was 35% and against influenza A(H3N2)–associated hospitalization was 38%. VE against influenza B outpatient visits ranged from 45%–71% among children and adolescents and was 63% among adults. Other estimates of VE were not statistically significant or were not reportable. Although interim influenza VE is lower during the 2025–26 influenza season than it was during recent influenza seasons, these findings demonstrate that influenza vaccination still provides protection against influenza. CDC recommends influenza vaccination; U.S. influenza vaccines remain available for persons aged ≥6 months.

Source: 


Link: http://dx.doi.org/10.15585/mmwr.mm7509a2

____

Wednesday, March 11, 2026

Defining the transmissible dose 50% for two #pandemic #influenza viruses in #ferrets

 


ABSTRACT

Ferrets are widely used to model airborne transmission of influenza viruses in humans. Airborne transmission is evaluated by infecting donor ferrets with a high virus dose and monitoring transmission to contact animals sharing the same airspace. Humans can be infected with a broad range of influenza virus doses. Therefore, we evaluated the relationship between inoculation dose and transmission for two pandemic influenza viruses in ferrets. Donor ferrets were inoculated with 100 to 106 tissue culture infectious dose 50 (TCID50) of the 2009 pandemic H1N1 or 1968 pandemic H3N2 virus and were then paired with respiratory contacts. Using the proportion of donors that became infected across virus doses, we calculated the infectious dose 50 (ID50). Subsequently, by comparing the proportion of contacts that became infected, we calculated the transmissible dose 50% (TD50): the donor inoculation dose that resulted in transmission to 50% of contacts. For the 2009 pandemic H1N1 virus, the ID50 and TD50 were equivalent at <1 TCID50. However, for the 1968 pandemic H3N2 virus, the ID50 and TD50 were 100.5 and 104.08 TCID50 (95% CI: 102.34–105.82), respectively. The increased TD50 for the H3N2 virus was associated with significant reductions in peak viral titers and viral shedding in donors over decreasing virus inoculation doses. Collectively, these studies define a new measure of transmission that permits comparisons of transmissibility between viral strains and subtypes in ferrets. We show that the 1968 pandemic H3N2 virus has a higher TD50 and reduced transmissibility in ferrets relative to the 2009 pandemic H1N1 virus.

Source: 


Link: https://journals.asm.org/doi/full/10.1128/jvi.01635-25?af=R

____

My New Space

Most Popular Posts