Updated joint FAO/WHO/WOAH public health #assessment of recent #influenza #H5 virus #events in #animals and #people, based on data as of 1 March '26 (18 May 2026)

Key points 

    -- Based on currently available information, Food and Agriculture Organization of the United Nations (FAO)/World Health Organization (WHO) / World Organisation for Animal Health (WOAH) assess the global public health risk posed by Gs/Gd-like high pathogenicity avian influenza (HPAI) A(H5) viruses as low. 

    -- The risk of infection for occupationally or frequently exposed persons (e.g., with backyard poultry) is assessed as low to moderate depending on local epidemiologic conditions and the risk mitigation and hygiene measures in place. 

    -- Transmission among animals continues and sporadic human infections at the human-animal-environment interface continue to be reported. 

    -- While additional human infections associated with exposure to infected animals or contaminated environments are expected, the overall global public health impact of such infections is currently considered minor. 

    -- The assessment may change rapidly as new epidemiological or virological information becomes available. 

    -- This joint FAO/WHO/WOAH risk assessment updates the transmission risk using new global information available since the previous assessment of 28 July 2025. 

    -- Given the potential risk to human health and the wide-ranging impacts on wild birds and mammals, poultry, livestock and other animal populations, timely notification to global authorities and the application of a One Health approach remain essential to monitor and characterize virus circulation, limit transmission within species and between species, reduce spread among animals, and prevent human infections. 

Infections in animals  

    -- To date, HPAI A(H5) viruses have been detected in birds and/or mammals across all continents except Oceania. 

    -- The predominant H5 virus clades currently circulating worldwide derive from clades 2.3.2.1 and 2.3.4.4. 

    -- Between 1 July 2025 and 1 March 2026, an additional 185 A(H5N1) events{i} in animals (including birds and bovines) have been reported to WOAH. 

    -- Of these, 1204 outbreaks occurred in poultry (of any farming system), 6326 outbreaks in wild birds and nine outbreaks occurred in bovines.  

H5 clade 2.3.2.1 viruses 

    -- Between 1 July 2025 and 1 March 2026, A(H5N1) clade 2.3.2.1a viruses were detected in poultry in Bangladesh and India, while A(H5N1) clade 2.3.2.1e viruses were detected in poultry in Cambodia 

H5 clade 2.3.4.4b viruses 

    -- Detections of A(H5) in wild and domestic mammals and wild and domestic birds continued to be reported in many countries worldwide. 

    -- During the period of September-November 2025, Europe experienced an exceptional and early season and a high incidence of HPAI A(H5) activity in wild birds, with more than 3200 detections reported across 28 countries. 

    -- This represents a ten-fold increase compared to the same period in 2024. 

    -- Based on genetic data available so far, the A(H5N1) HPAI viruses identified in Europe all fall into clade 2.3.4.4b, and the majority belong to the genotype EA-2024.DI2.12,{3} 

    -- This surge has disproportionately affected migratory waterfowl and colonial species, with widespread A(H5N1) virus infections confirmed in key migratory hosts (e.g., Eurasian wigeons, Northern pintails, Mute swans, Greylag geese) and severe mass mortality events in Eurasian cranes (Grus grus).{4}  

    -- In Africa, poultry outbreaks of A(H5N1) clade 2.3.4.4b viruses have been reported in Nigeria and South Africa since September 2025. 

    -- Several other countries in sub-Saharan Africa consider HPAI to be present in their territories. 

    -- Detections of A(H5N1) were also made in wild birds in Namibia and South Africa. 

    -- A(H5N1) clade 2.3.4.4b viruses are considered endemic in Egypt’s poultry populations.   

    -- In Asia, clade 2.3.4.4b viruses have been reported in several countries. 

    -- In India, recent poultry outbreaks have involved A(H5N1), while in Kazakhstan, A(H5N1) was detected in wild birds. 

    -- In the Republic of Korea, detections include A(H5N1), A(H5N6), and A(H5N9), while in Japan A(H5N1) and A(H5N5) viruses have been reported. 

    -- In North America, substantial activity of clade 2.3.4.4b A(H5) viruses has continued since the last assessment. 

    -- In the United States of America, more than 3700 A(H5) detections in wild birds and over 400 A(H5) HPAI outbreaks in poultry were reported, while Canada reported nearly 500 A(H5N1) detections in wild birds and over 80 A(H5) HPAI outbreaks in poultry.{5,6} 

    -- A(H5N1) detections in terrestrial and marine mammals have also been reported. 

    -- Notably, A(H5N1) clade 2.3.4.4b was detected for the first time in northern elephant seals in February 2026 in California, involving a virus of the A3 genotype.{7} 

    -- In central America, Mexico reported H5N1 outbreaks in backyard poultry in October 2025 and A(H5N1) detections in wild birds in November. 

    -- A(H5N1) detections of American genotype D1.1 viruses were reported in domestic birds in the Cayman Islands and Guatemala during the second half of 2025. Genotype D1.1 was the most frequently detected A(H5N1) genotype in North America in 2025, affecting wild birds, poultry and multiple mammalian species, including wild and domestic felids and marine mammals. 

    -- A(H5N2) clade 2.3.4.4b viruses belonging to the K.5 genotype were detected in poultry in Mexico.  

    -- In South America, A(H5N1) has continued to spread, with detections in both poultry and wild birds across multiple countries. 

    -- In late 2025, A(H5N1) outbreaks were reported from Argentina, Brazil and Colombia. 

    -- Where sequence data are available, viruses belong to clade 2.3.4.4b.{8} 

    -- In 2026, additional outbreaks occurred across the region. HPAI A(H5) outbreaks occurred in Peru in backyard poultry and in Uruguay in wild birds, although detailed genetic information for these events is not yet available. 

    -- Between 1 February and 1 March 2026, Argentina detected at least 12 A(H5N1) events across domestic and wild birds, while further A(H5N1) outbreaks occurred in backyard and wild birds in Brazil, and in backyard birds in Colombia and Peru.  

    -- Although the full extent of ongoing circulation and establishment in wild bird populations across South America remains uncertain, evidence suggests that A(H5N1) viruses circulating have continued to diversify through reassortment. 

    -- Viruses detected in Brazil in mid- to late 2025 belonged to two distinct genotypes, K.8 and N.1. 

    -- The K.8 genotype is related to “triple reassortant” viruses{9} identified in Argentina in early 2025, combining North American B3.6- and B3.13-like genomes but with multiple internal gene segments derived from South American low pathogenicity avian influenza viruses (LPAIVs).{10,11} 

    -- Its continued presence is consistent with sustained regional spread. 

    -- In contrast, the N.1 genotype clusters with recent North American B3.2 viruses but contains a PB2 segment derived from South American low pathogenicity avian influenza viruses. 

    -- This suggests a separate, more recent introduction of A(H5N1) viruses to South America, followed by reassortment with locally circulating viruses.{12} 

    -- In the Antarctic peninsula and sub-Antarctic islands, A(H5N1) clade 2.3.4.4b viruses have been repeatedly detected in the region, including in sea birds such as skuas and penguins, following their introduction during the 2023–2024 austral summer.{13} 

    -- Detections in wild birds and mammals in the region have continued through 2025–2026. This includes outbreaks in additional sub-Antarctic territories, such as Heard Island, where A(H5N1) was detected in Antarctic fur seals, gentoo penguins and southern elephant seals.{14,15} 

    -- This follows initial detections in southern elephant seals on an earlier voyage in October 2025. 

    -- There was no further evidence of ongoing mass mortality detected on this second voyage in January 2026. 

    -- Further sequencing and phylogenetic analysis are being undertaken. 

    -- The extensive circulation of clade 2.3.4.4b A(H5) viruses in wild and domestic bird populations has resulted in multiple spillover events into wild terrestrial mammals, both carnivorous and omnivorous, wild marine mammals, and domestic cats and dogs.{16} 

    -- Amino acid changes potentially associated with increased virulence, transmission, or adaptation to mammalian hosts have been sporadically identified.{17,18,19}  

    -- Since 2024 and as of 1 March 2026, 1088 dairy herds in 19 states of the United States of America have tested positive for A(H5N1). 

    -- Since the last assessment of 28 July 2025, 14 additional A(H5N1) detections have been reported in the country, with the latest detection confirmed in December 2025 in Wisconsin.{20} 

    -- Analyses of virus sequence data suggest that there have been at least four independent spillovers of A(H5N1) into dairy cattle with the most recent occurring in December 2025.{21} 

    -- In January 2026, Netherlands (Kingdom of the) reported the detection of A(H5N1) HPAI antibodies in the milk of a dairy cow at a dairy farm in Friesland Province, following the investigation of a cat living on that dairy farm that died from an A(H5N1) infection.{22} 

    -- The virus detected in the cat belonged to clade 2.3.4.4b genotype EA-2024.DI2.1—which is distinct from the B3.13 and D1.1 genotypes detected in dairy cattle in the United States of America. No evidence of active infection was found in  the herd, but antibodies were later detected in four additional cows on the same farm, therefore, they do not constitute a case according to the WOAH case definition.  

    -- Mammalian detections of A(H5N5) clade 2.3.4.4b viruses have also been reported in recent years, particularly those belonging to the A6 genotype. 

    -- Since 2023, detections have been reported in terrestrial carnivora (northern racoon, striped skunk, red fox, Eurasian lynx, Eurasian Otter, American mink, Arctic fox and domestic cats) across North America and Europe and in marine mammals. 

    -- For the latest information on avian influenza situation in animals worldwide, see the FAO Global Avian Influenza Viruses with Zoonotic Potential situation update and the WOAH situation reports on HPAI, as well as WOAH’s World Animal Health Information System. 

Detections in humans 

    -- Since the last joint assessment of July 2025 and as of 1 March 2026, nine additional human cases of A(H5N1) virus infections, and single cases of A(H5), A(H5N2), A(H5N5) virus infections have been detected (based on date of reporting) in Bangladesh, Mexico and the United States of America. 

    -- Eight A(H5N1) cases were detected in Cambodia, and one was detected in Bangladesh. 

    -- All cases reported direct or indirect exposure to domestic birds or contaminated environments. 

    -- No human-to-human transmission was suspected associated with these confirmed cases. 

    -- The viruses from two cases in Bangladesh belong to clade 2.3.2.1a viruses, viruses from six of the cases from Cambodia belong to clade 2.3.2.1e, and viruses from the cases in Mexico and the United States of America belong to clade 2.3.4.4b.  

Virus characteristics  

    -- Routine monitoring and screening of viral sequences from birds have rarely identified markers of mammalian adaptation in A(H5) viruses, and when detected, these have primarily involved the polymerase proteins. 

    -- Such mutations have been observed more frequently in viruses isolated from mammals. 

    -- The PB2 D701N amino acid mutation has been identified in genotype D1.1 viruses detected in poultry (including chickens and turkeys), wild birds, cats, dairy cattle and wild mammals such as red foxes.{23} 

    -- The PB2 E627K mutation has been detected in some B3.13 viruses identified in dairy cattle and in clade 2.3.2.1 and 2.3.4.4 A(H5) viruses detected in poultry, cats and wild birds across multiple regions. 

    -- Some genetic markers in A(H5N1) virus sequences from human cases have been linked to potentially lower lab-based susceptibility to common antivirals like oseltamivir or baloxavir marboxil; the clinical significance of some of these markers remains uncertain.{24} 

    -- Experimental studies with A(H5N1) clade 2.3.4.4b viruses have generally not demonstrated efficient transmission via respiratory droplets.{25,26,27,28,29,30,31} 

    -- Ferret studies conducted by the US CDC using a D1.1 A(H5N1) virus (A/Washington/239/2024) did not show respiratory droplet transmission.{32} 

    -- Overall, currently circulating A(H5N1) viruses would require additional genetic changes to acquire efficient human-to-human transmission via respiratory droplets, consistent with the current low public health risk. 

    -- Based on limited seroprevalence information available on A(H5) viruses, human population immunity against the HA of A(H5) viruses is expected to be minimal; human population immunity targeting the N1 neuraminidase is found to be present although the impact of this immunity is yet to be understood.{33}  

Candidate vaccine viruses (CVV) 

    -- The WHO Global Influenza Surveillance and Response System (GISRS), in collaboration with animal health partners (FAO, WOAH, OFFLU (Joint WOAH-FAO network of expertise on animal influenza), continue to evaluate candidate vaccine viruses for pandemic preparedness purposes both biannually and on an ad hoc basis. 

    -- Regular genetic and antigenic characterization of contemporary zoonotic influenza viruses are published here with the most recent update on A(H5) CVVs published in February 2026 following the WHO Consultation on the Composition of Influenza Virus Vaccines for Use in the 2026-2027 Northern Hemisphere Influenza Season.  

 

Assessment of current public health risk posed by influenza A(H5N1) viruses{34} 

    -- Despite continued detections of A(H5) viruses in animals and ongoing human exposure at the human-animal-environment interface, relatively few human infections have been reported to date. 

    -- Since the beginning of 2021, the vast majority of reported human A(H5) infections have been associated with direct or indirect exposure to infected animals such as milking cows on an infected dairy farm or participating in mass culling and disposal events at poultry farms, or contaminated environments, such as live poultry markets, or beaches with sick and dying wild birds and marine mammals.{35,36} 

    -- Illness severity has ranged from mild to fatal. 

    -- To date, no human-to-human transmission has been identified through epidemiologic, virologic and serologic investigations, although investigations for some of cases are ongoing. 

    -- Current evidence indicates that these viruses remain avian-adapted, without established mammalian adaptive mutations or the capacity for sustained human-to-human transmission.  

    -- Based on currently available information, FAO/WHO/WOAH assess the global public health risk posed by currently circulating influenza A(H5) viruses as low and unchanged from the previous risk assessment, while the risk of infection for occupationally or frequently exposed persons remains low to moderate depending on local epidemiological conditions and mitigation measures in place. 

    -- However, as influenza viruses are constantly evolving and spreading in animal populations, zoonotic influenza risk assessments require continuous review and may change rapidly. 

    -- WHO, together with FAO and WOAH, continues to evaluate A(H5) viruses closely and will re-assess the risk associated with the currently circulating A(H5) viruses as more information becomes available. 

    -- Further antigenic characterization of A(H5) viruses, including in relation to the existing CVVs, and development of specific reagents are being prioritized at the WHO Collaborating Centres and Essential Regulatory Laboratories of GISRS in collaboration with public health, animal health, and veterinary sector colleagues. 

Recommended actions  

    -- It is recommended that Member States and national authorities: 

        • increase surveillance and vigilance, and assess the risk in human populations, especially amongst occupationally exposed persons, for the possibility of zoonotic infections, particularly through National Influenza Centres (NICs) and other influenza laboratories associated with GISRS, using such methods as active case finding and molecular and serologic methods; 

        • reduce the risk among occupationally exposed persons by reducing environmental exposures and providing adequate and appropriate personal protective equipment; and 

        • conduct epidemiological investigations including case finding around suspected and confirmed human cases to determine if there are additional cases or indications of humanto-human transmission.  

    -- Under the International Health Regulations (IHR) (2005),{37} States Parties are required to notify WHO within 24 hours of any laboratory-confirmed case of human influenza caused by a new subtype according to the WHO case definition.{38} 

    -- WHO has published the case definition for human infections with avian influenza A(H5) virus requiring notification under IHR (2005).{39}  

    -- Avian influenza is a WOAH-listed disease. Based on Chapter 10.440 of the Terrestrial Animal Health Code, three categories of avian influenza should be notified to WOAH by national Veterinary Authorities through WAHIS. It includes infection with HPAI in poultryii, infection of birds other than poultry including wild birds, and infection of domestic and captive wild birds with low pathogenicity avian influenza (LPAI) viruses having proven natural transmission to humans associated with severe consequences. 

    -- Member States and national authorities are also recommended to: 

        • conduct joint epidemiological investigations in and around suspected and confirmed outbreak areas in animals to determine the extent of spillover; 

        • increase surveillance, including joint/collaborative genomic surveillance, and sharing surveillance data applying One Health principles;  

        • timely reporting efforts for the early detection of A(H5) influenza viruses in domestic birds, wild birds and wild mammals{41}; 

        • include infection with an A(H5) influenza virus as a differential diagnosis, in non-avian species, including cattle, swine and other livestock and farmed domestic and wild animal populations, with high likelihood of exposure to A(H5) viruses; 

        • implement preventive and early response measures to break the chain of infection among domestic animals (for example, poultry and dairy cattle), including considering the use of vaccination to reduce circulation in poultry as per national policies and according to guidance provided by animal health organizations{42,43}; 

        • promptly report high pathogenicity avian influenza (HPAI) events in all animal species, including cattle (according to the WOAH case definition{44}) and other domestic and wild mammals, to WOAH and other international organizations such as FAO;  

        • conduct genetic sequencing and share genetic sequences of influenza viruses and associated metadata in publicly available databases in a timely manner; 

        • protect animals by mitigating the risk of introduction and spread of the disease through implementation and/or strengthening biosecurity in livestock holdings/premises and along the value chain; 

        • protect persons by employing good production and hygiene practices when handling animals and animal products; and 

        • protect persons in contact with suspected/infected animals by providing appropriate personal protective equipment and communicating and educating on the importance and proper use of personal protective equipment and providing information and access to testing. 

    -- Additional sets of recommendations related to avian influenza viruses with zoonotic potential can be found here: 

        • FAO and WOAH Global strategy for the prevention and control of high pathogenicity avian influenza (2024–2033) 

        • Recommendations from the FAO Global Dialogue - Tackling high pathogenicity avian influenza together. Foz do Iguaçu, Brazil – 11 September 2025 

        • FAO recommendations for Global Avian Influenza Viruses with Zoonotic Potential 

        • FAO Recommendations for the surveillance of influenza A(H5N1) in cattle. With broader application to other farmed mammals 

        • WOAH Surveillance of High Pathogenicity Avian Influenza for Smallholder Poultry Systems in Resource-Limited Settings 

        • WHO Practical interim guidance to reduce the risk of infection in people exposed to avian influenza viruses 

        • WHO Surveillance for human infections with avian influenza A(H5) viruses: objectives, case definitions, testing and reporting 

        • WHO Considerations for the use of human A(H5) influenza vaccines during non-pandemic period 

        • WHO guidance on the use of licensed human influenza A(H5) vaccines for the interpandemic and emergence periods 

    -- Additional studies/surveillance, applying One Health principles are warranted, which could provide information to enhance confidence in the risk assessment. 

    -- These may include serological studies in high-risk animal populations, in high-risk human populations, and epidemiological investigations.  

    -- Anyone who may have been exposed to infected or potentially infected animals or contaminated environments should be advised to promptly seek health care if they feel unwell, and to inform their health care provider of their possible exposure. 

    -- Following prompt testing, early and appropriate clinical management should be initiated, and precautionary measures put in place to assess and prevent potential further spread among humans and animals.

    -- Clinicians should also be alerted to potential zoonotic infection in patients with an exposure history to birds or animals especially in areas where A(H5) viruses are known or suspected to be circulating in animals but also in areas where surveillance in animals may be limited.  

    -- Routine epidemiologic and virologic surveillance for influenza should be conducted ideally yearround using a standard case definition in health care facilities according to WHO guidance.{45}  

    -- Timely sharing of information and sequence data from both the human and animal health sectors from all regions should continue to be strongly recommended and is critical for rapid and robust joint risk assessment. 

    -- The rapid sharing of virus materials with WHO Collaborating Centres of GISRS continues to be essential to conduct a thorough risk assessment and develop or adjust targeted response measures. 

    -- 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 elements.{46} 

    -- Data pertaining to the risk elements within TIPRA should be generated and shared with WHO.  

    -- Efforts to reduce human exposure to birds, livestock, and other mammals infected with or potentially infected with avian and other animal influenza viruses should be implemented and enhanced to minimize the risk of zoonotic infections. 

    -- Individuals with activities that involve exposure to infected animals and/or contaminated environments are at higher risk and should take necessary precautions to prevent infection. 

    -- Those who are exposed to potentially infected animals should have access to, be trained in their use under different environmental conditions, and wear personal protective equipment including eye protection.{47} 

    -- If they develop respiratory symptoms or conjunctivitis, they should be rapidly tested, and precautionary infection control measures should be put in place to prevent potential further spread among humans and to animals. 

    -- For detailed guidance on treatment, refer to relevant global and national guidance.{48} 

    -- Some manufacturers have initiated production of an A(H5) human vaccine that matches current circulating strains. 

    -- Updated WHO guidance on the use of licensed human influenza A(H5) vaccines for the interpandemic and emergence periods were published in December 2025.{49} 

    -- FAO, WHO and WOAH advise consuming pasteurized milk, instead of raw/unpasteurized milk. Due to the potential health risks from many dangerous zoonotic pathogens, raw/unpasteurized milk consumption should be avoided.{50} 

    -- If pasteurized milk is not available, heating raw milk until it boils makes it safer for consumption.{51}  

___

{i} An event includes all related epidemiologically related outbreaks reported from the time of the immediate notification through to the final report. Separately the total number of outbreaks is also stated. 

{ii} All birds reared or kept in captivity for the production of any commercial animal products or for breeding for this purpose, fighting cocks used for any purpose, and all birds used for restocking supplies of game or for breeding for this purpose, until they are released from captivity. Birds that are kept in a single household, the products of which are used within the same household exclusively, are not considered poultry, provided that they have no direct or indirect contact with poultry or poultry facilities. Birds that are kept in captivity for other reasons, including those that are kept for shows, racing, exhibitions, zoological collections and competitions, and for breeding or selling for these purposes, as well as pet birds, are not considered poultry, provided that they have no direct or indirect contact with poultry or poultry facilities. 

References 

{1} WHO. Genetic and antigenic characteristics of zoonotic influenza A viruses and development of candidate vaccine viruses for pandemic preparedness. February 2026 (https://cdn.who.int/media/docs/default-source/vcm-northern-hemisphere-recommendation-20262027/c.-27-feb-2026_zoonotic_vaccinvirus-update.pdf?sfvrsn=8532151e_5). 

{2} European Food Safety Authority (EFSA), European Union Reference Laboratory (EURL) for Avian Influenza, Ducatez M, Fusaro A, Gonzales J L, Kuiken T, et al. Unprecedented high level of highly pathogenic avian influenza in wild birds in Europe during the 2025 autumn migration. EFSA Journal 2025;23(11):9811, 9 pp (https://doi.org/10.2903/j.efsa.2025.9811). 

{3} EURL. Avian flu data portal. 2026 (eurlaidata.izsvenezie.it/epidemio.php). 

{4} EFSA, European Centre for Disease Prevention and Control (ECDC), EURL for Avian Influenza; Buczkowski H, Ducatez M, Fusaro A, et al. Avian influenza overview September-November 2025. EFSA J. 2025 Dec 18;23(12):e9834 (efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa.2025.9834).  

{5} United States Department of Agriculture (USDA). 2026. Highly Pathogenic Avian Influenza (HPAI) Detections in Wild Birds (www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/wild-birds?page=1). 

{6} Canada Food Inspection Agency (CFIA). 2026. National Avian Influenza dashboard (cfiancr.maps.arcgis.com/apps/dashboards/89c779e98cdf492c899df23e1c38fdbc). 

{7} GISAID: EPI_ISL_20420880, EPI_ISL_20420879, EPI_ISL_20420878. 

{8} FAO. FAO alert on avian influenza – risk of upsurge and regional spread through wild birds in Latin America and the Caribbean, 8 April 2026 (https://openknowledge.fao.org/server/api/core/bitstreams/02a3ab2c-0f8d-427f-a71a-3f378a6474bd/content). 

{9} GISAID: EPI_ISL_19752381 and EPI_ISL_19823059–68. 

{10} Vanstreels R, Nelson MI, Artuso MC, Marchione VD, Piccini LE, Benedetti E, et al. Novel Highly Pathogenic Avian Influenza A(H5N1) Virus, Argentina, 2025. Emerg Infect Dis. 2025;31(12):2279-2283 (https://doi.org/10.3201/eid3112.250783).  

{11} Benedetti, E, Artuso, MC, Byrne, AMP, Garibotto, MDB, Avaro, M, Piccini, LE et al.  Emergence and Evolution of Triple Reassortant Highly Pathogenic Avian Influenza A(H5N1) Virus, Argentina, 2025. Preprint (https://doi.org/10.20944/preprints202512.0962.v1). 

{12} Rivetti AV Jr, Reischak D, Carnegie L, Otaka JNP, Domingues CS, Cardoso FG et al. Genomic diversity and reassortment of highly pathogenic avian influenza A/H5N1 virus (clade 2.3.4.4b) in Brazil: Evidence of multiple introductions and intra-epidemic reassortment in 2025. Virology. 2026 Feb;615:110751 (https://doi.org/10.1016/j.virol.2025.110751). 

{13} Steinfurth A, Lynton-Jenkins JG, Cleeland J, Mollett BC, Coombes HA, Moores A et al. Investigating high pathogenicity avian influenza virus incursions to remote islands: detection of H5N1 on Gough Island in the South Atlantic Ocean. Emerg Microbes Infect. 2026 Dec;15(1):2627076 (https://doi.org/10.1080/22221751.2026.2627076). 

{14} WOAH. World Animal Health Information System (WAHIS). Heard and McDonald Islands - Influenza A viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification [FINAL] ( https://wahis.woah.org/#/inreview/7261?fromPage=event-dashboard-url). 

{15} WOAH. Sharing other important animal health information with WOAH (https://www.woah.org/en/what-we-do/animal-health-andwelfare/disease-data-collection/sharing-other-important-animal-health-information-with-woah/). 

{16} OFFLU. Beyond poultry: Rethinking monitoring and control of HPAI H5Nx anticipating spillover risks for mammals. 2026 (https://offlu.org/publications/beyond-poultry-rethinking-monitoring-and-control-of-hpai-h5nx-anticipating-spilloverrisks-for-mammals/). 

{17} Puryear W, Sawatzki K, Hill N, Foss A, Stone JJ, Doughty L, et al. Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in New England Seals, United States. Emerg Infect Dis. 2023;29(4):786-791 (https://doi.org/10.3201/eid2904.221538). 

{18} Uhart MM, Vanstreels RET, Nelson MI, Olivera V, Campagna J, Zavattieri V et al. Epidemiological data of an influenza A/H5N1 outbreak in elephant seals in Argentina indicates mammal-to-mammal transmission. Nat Commun 15, 9516 (2024) (https://doi.org/10.1038/s41467024-53766-5). 

{19} OFFLU. Beyond poultry: Rethinking monitoring and control of HPAI H5Nx anticipating spillover risks for mammals. 2026 (https://offlu.org/publications/beyond-poultry-rethinking-monitoring-and-control-of-hpai-h5nx-anticipating-spilloverrisks-for-mammals/). 

{20} USDA. Highly Pathogenic Avian Influenza (HPAI) Detections in Livestock. 2026 (www.aphis.usda.gov/livestock-poultrydisease/avian/avian-influenza/hpai-detections/livestock). 

{21} USDA. Update: Genetic sequencing results for Wisconsin dairy herd detection of highly pathogenic avian influenza. 19 December 2025 (www.aphis.usda.gov/news/agency-announcements/update-genetic-sequencing-results-wisconsin-dairy-herd-detection-highly). 

{22} Rijksoverheid (Government of the Netherlands). Antibodies Against the Avian Influenza Virus Found in Dairy Cow. News, 23 January 2026 (www.rijksoverheid.nl/actueel/nieuws/2026/01/23/antistoffen-vogelgriepvirus-gevonden-bij-melkkoe). 

{23} GISAID. 

{24} US CDC. CDC A(H5N1) Bird Flu Response Update November 18, 2024 (www.cdc.gov/bird-flu/spotlights/h5n1-response-11152024.html). 

{25} US CDC. CDC Reports A(H5N1) Ferret Study Results. 7 June 2024 (www.cdc.gov/bird-flu/spotlights/ferret-study-results.html). 

{26} Pulit-Penaloza JA, Brock N, Belser JA, Sun X, Pappas C, Kieran TJ et al. Highly pathogenic avian influenza A(H5N1) virus of clade 2.3.4.4b isolated from a human case in Chile causes fatal disease and transmits between co-housed ferrets. Emerg Microbes Infect. 2024 Mar 17:2332667 (https://doi.org/10.1080/22221751.2024.2332667). 

{27} Eisfeld AJ, Biswas A, Guan L, Gu C, Maemura T, Trifkovic S et al. Pathogenicity and transmissibility of bovine H5N1 influenza virus. Nature (2024) (https://doi.org/10.1038/s41586-024-07766-6). 

{28} Restori KH, Septer KM, Field CJ, Patel DR, VanInsberghe D, Raghunathan V et al. Risk assessment of a highly pathogenic H5N1 influenza virus from mink. Nat Commun 15, 4112 (2024) (https://doi.org/10.1038/s41467-024-48475-y). 

{29} Pulit-Penaloza JA, Belser JA, Brock N, Kieran TJ, Sun X, Pappas C et al. Transmission of a human isolate of clade 2.3.4.4b A(H5N1) virus in ferrets. Nature. Published online October 28, 2024. (https://doi.org/10.1038/s41586-024-08246-7). 

{30} Gu C, Maemura T, Guan L, Eisfeld AJ, Biswas A, Kiso M et al. A human isolate of bovine H5N1 is transmissible and lethal in animal models. Nature (2024). (https://doi.org/10.1038/s41586-024-08254-7). 

{31} Brock N, Pulit-Penaloza JA, Belser JA, Pappas C, Sun X, Kieran TJ, et al. Avian Influenza A(H5N1) Isolated from Dairy Farm Worker, Michigan, USA. Emerg Infect Dis. 2025;31(6):1253-1256 (https://doi.org/10.3201/eid3106.250386). 

{32} US CDC. Influenza Risk Assessment Tool (IRAT) - Virus Report. Highly pathogenic avian influenza A(H5N1) virus; clade 2.3.4.4b Viruses: A/California/147/2024 and A/Washington/239/2024. Date of Evaluation: March 14, 2025 (www.cdc.gov/pandemicflu/media/pdfs/2025/IRATA-California-Washington.pdf). 

{33} Daulagala P, Cheng S, Chin A, Luk L, Leung K, Wu JT, et al. Avian Influenza A(H5N1) Neuraminidase Inhibition Antibodies in Healthy Adults after Exposure to Influenza A(H1N1)pdm09. Emerg Infect Dis. 2024;30(1):168-171 (https://doi.org/10.3201/eid3001.230756). 

{34} WHO. (2012). Rapid risk assessment of acute public health events (iris.who.int/handle/10665/70810). 

{35} Garg S, Reinhart K, Couture A, Kniss K, Davis CT, Kirby MK et al. Highly Pathogenic Avian Influenza A(H5N1) Virus Infections in Humans. N Engl J Med. 2025 Feb 27;392(9):843-854 (https://doi.org/10.1056/nejmoa2414610). 

{36} Pardo-Roa, C., Nelson, M.I., Ariyama, N. et al. Cross-species and mammal-to-mammal transmission of clade 2.3.4.4b highly pathogenic avian influenza A/H5N1 with PB2 adaptations. Nat Commun 16, 2232 (2025) (https://doi.org/10.1038/s41467-025-57338-z). 

{37} WHO. 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_2014-2022-2024-en.pdf). 

{38} WHO. Case definitions for the four diseases requiring notification to WHO in all circumstances under the IHR (2005). 2009 (www.who.int/publications/m/item/case-definitions-for-the-four-diseases-requiring-notification-to-who-in-all-circumstances-under-theihr-(2005)). 

{39} WHO. WHO case definition for human infections with avian influenza A(H5) virus requiring notification under IHR (2005). 2024 (www.who.int/teams/global-influenza-programme/avian-influenza/case-definitions). 

{40} WOAH. Terrestrial Animal Health Code Chapter 10.4 Infection with high pathogenicity avian influenza viruses (https://www.woah.org/en/what-we-do/standards/codes-and-manuals/, cited on 05/05/2026). 

{41} El Masry I, Delgado AH, Silva GOD, Dhingra M, Lyons NA. 2024. Recommendations for the surveillance of influenza A(H5N1) in cattle – With broader application to other farmed mammals. FAO Animal Production and Health Guidelines, No. 37. Rome, FAO (https://doi.org/10.4060/cd3422en). 

{42} OFFLU. OFFLU Avian Influenza Vaccine Matching (AIM) for poultry vaccines: H5Nx executive summary, September 2025 (https://offlu.org/publications/offlu-aim-technical-report-september-2025/). 

{43} WOAH. Avian influenza vaccination: why it should not be a barrier to safe trade, December 2023 (www.woah.org/app/uploads/2023/12/en-woah-policybrief-avianinfluenzavaccinationandtrade.pdf). 

{44} WOAH. Case definition for infection of bovines with influenza a viruses of high pathogenicity in poultry (high pathogenicity avian influenza in cattle), 29 October 2025 (https://www.woah.org/app/uploads/2025/03/2025-10-case-definiton-hpai-cattle-2.pdf). 

{45} WHO. Implementing the integrated sentinel surveillance of influenza and other respiratory viruses of epidemic and pandemic potential by the Global Influenza Surveillance and Response System: standards and operational guidance. 2024 (https://iris.who.int/handle/10665/379678). 

{46} WHO. Tool for influenza pandemic risk assessment. 2026 (www.who.int/teams/global-influenza-programme/avian-influenza/tool-forinfluenza-pandemic-risk-assessment-(tipra)). 

{47} Animal and Plant Health Inspection Service (APHIS), USDA. APHIS Recommendations for Highly Pathogenic Avian Influenza (HPAI) H5N1 Virus in Livestock For Workers, 12 April 2024 (www.aphis.usda.gov/sites/default/files/recommendations-workers-hpai-livestock.pdf). 

{48} WHO. Guidelines for the clinical management of severe illness from influenza virus infections. 2022 (https://apps.who.int/iris/handle/10665/352453). 

{49} WHO. WHO guidance on the use of licensed human influenza A(H5) vaccines for the interpandemic and emergence periods. Weekly Epidemiological Record, 100(51), 643 - 660 (https://iris.who.int/handle/10665/384548). 

{50} FAO. Preliminary rapid risk assessment of foodborne avian influenza A (H5N1) virus. 14 June 2024 (https://openknowledge.fao.org/server/api/core/bitstreams/ca83524e-b3f9-4abe-b52b-dea213227fcf/content). 

{51} Joint FAO/WHO Codex Alimentarius Commission. Codex Alimentarius: Code of hygienic practice for milk and milk products (http://www.fao.org/fileadmin/user_upload/livestockgov/documents/CXP_057e.pdf). 

DISCLAIMER 

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO) or of the World Organisation for Animal Health (WOAH) concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. All reasonable precautions have been taken by WHO, FAO and WOAH to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO, FAO and WOAH be liable for damages arising from its use. 

© FAO, WHO, WOAH, 2026 

Source: 

Link: https://www.who.int/publications/m/item/updated-joint-fao-who-woah-public-health-assessment-of-recent-high-pathogenicity-avian-influenza-a(h5)-virus-events-in-animals-and-people

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Cross-reactive #human #antibody responses to #H5N1 #influenza virus #neuraminidase are shaped by immune history

 

Abstract

H5N1 highly pathogenic avian influenza viruses have spread globally and pose a pandemic risk. Prior studies suggest that early life exposures to group 1 influenza viruses (H1N1 and H2N2) prime antibodies that cross-react to the hemagglutinin of H5N1, which is also a group 1 virus. However, less is known about how immune history affects antibody responses against the H5N1 neuraminidase (NA). We measured NA inhibition antibodies against multiple H5N1 viruses using sera from 155 individuals born between 1927 and 2016. Individuals likely primed in childhood with H1N1 viruses possessed higher levels of antibodies that cross-react with the NA of H5N1 viruses compared to those primed with H2N2 or H3N2 viruses. While young children rarely possessed cross-reactive N1 antibodies, childhood infections with contemporary H1N1, but not H3N2, viruses elicited them. We also measured antibodies against an H5N5 virus (A6 genotype) that recently caused a fatal infection in the United States. Consistent with the lack of circulation of N5 viruses in humans, we found low levels of antibodies against the N5 NA. Our data suggest that immune history greatly impacts the generation of cross-reactive NA antibodies, and that reassortment with other NAs may increase the risk of H5 infection of humans.

Source: 

Link: https://www.nature.com/articles/s41467-026-72941-4

____

#Fatal #Human Case of #Influenza #H5N5 in a Backyard Flock Owner — #Washington {State}, November 2025

 

Summary

-- What is already known about this topic?

- Since 2022, highly pathogenic avian influenza (HPAI) A(H5) viruses have circulated among wild birds in the United States. Seventy human cases of influenza A(H5), most with mild illness, have been reported in the United States since 2024; 14 human influenza A(H5N1) cases were previously identified in Washington.

-- What is added by this report?

- In November 2025, Washington reported the first human case of HPAI A(H5N5) infection worldwide. A positive laboratory result was obtained from a lower respiratory sample after multiple negative upper respiratory sample results; the patient experienced respiratory failure and died 28 days after symptom onset. The public health investigation identified approximately 135 exposed persons.

-- What are the implications for public health practice?

- Symptom management and testing of exposed persons are critical to monitoring for human-to-human transmission of novel influenza infection. Environmental and animal investigations, including genomic analysis, can identify epidemiologic risk factors.

Abstract

Clade 2.3.4.4b influenza A(H5N1) viruses have circulated across migratory bird flyways in the United States since 2022, including in Washington, where backyard flock detections have been reported annually. In November 2025, a Washington resident died from acute respiratory failure after receiving a positive influenza A(H5) test result at a hospital laboratory. Washington Public Health Laboratories confirmed influenza A(H5), and genomic sequencing identified influenza A(H5N5) virus (A6 genotype). Polymerase chain reaction testing detected highly pathogenic avian influenza A(H5) virus clade 2.3.4.4b from an apparently healthy backyard flock of ducks and sediment from a watering basin on the patient’s property. Six of eight gene segments from the environmental sample and one duck sample (partial neuraminidase segment) were highly genetically similar to the patient’s virus sequence. Although existing wild bird surveillance had not detected influenza A(H5N5) virus (A6) in the U.S. Pacific Flyway, introduction via wild birds into the environment of the backyard flock was likely the source of the patient’s exposure. The public health investigation identified approximately 135 exposed persons; symptom monitoring and influenza testing detected no additional cases. The overall risk for avian influenza A remains low among the general U.S. population; however, novel avian influenza A virus infection should be considered in persons with symptoms of influenza and potential exposures.

Source: 

Link: https://www.cdc.gov/mmwr/volumes/75/wr/mm7517a2.htm?s_cid=OS_mm7517a2_e&ACSTrackingID=USCDC_921-DM155047&ACSTrackingLabel=Week%20in%20MMWR%3A%20Vol.%2075%2C%20May%207%2C%202026&deliveryName=USCDC_921-DM155047

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#Population #immunity to clade 2.3.4.4b #H5N1 is dominated by anti - #neuraminidase #antibodies

 

ABSTRACT

Clade 2.3.4.4b highly pathogenic avian influenza A(H5N1) viruses continue to expand geographically and across mammalian hosts, raising concern about pandemic potential. The degree and specificity of pre-existing immunity in humans are key determinants of this risk. We analyzed hemagglutinin (HA)- and neuraminidase (NA)-specific antibody responses in 300 sera collected from adults in New York City. While HA directed binding antibodies to clade 2.3.4.4b H5 were low and hemagglutination-inhibiting antibodies were absent, we detected widespread binding and functional NA antibodies against N1 neuraminidases from clade 2.3.4.4b H5N1 viruses. Neuraminidase inhibition (NI) titers were highest against North American D1.1 genotype N1 viruses and correlated strongly with neutralizing activity, whereas HA-binding antibodies did not. An additional N-linked glycosylation site, as found in the NA of a human D1.1 isolate from British Columbia, reduced susceptibility to NI antibodies. Antibodies titer to N5 from H5N5 were low to minimal. These findings indicate that population-level immunity to clade 2.3.4.4b H5 viruses is dominated by NA-directed antibodies, with important implications for pandemic risk assessment.

IMPORTANCE

Understanding how pre-existing human immunity shapes susceptibility to emerging influenza viruses is central to pandemic preparedness. Here, we determined that human sera contain widespread, functional antibodies targeting H5N1 neuraminidase, which correlate with virus neutralization, whereas HA-directed responses are limited. We further show that acquisition of an NA glycosylation site reduces antibody inhibition, highlighting a potential pathway for immune evasion. These results identify neuraminidase-specific immunity as a major immunological barrier to severe H5N1 disease in humans and emphasize the need to incorporate NA antigenicity into influenza surveillance, risk assessment, and next-generation vaccine design.

Source: 

Link: https://journals.asm.org/doi/10.1128/mbio.00445-26

____

#Denmark - #Influenza A #H5N5 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

 

{A black headed gull. By © Hans Hillewaert, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=5548312}

__

According to article 10.4.1.4 of the Terrestrial Animal Health Code, Member Countries should not impose bans on the trade in poultry commodities in response to notification on the presence of any influenza A virus in birds other than poultry

A wild black-headed gull.

Source: 

Link: https://wahis.woah.org/#/in-review/7385

____

Recommended #composition of #influenza virus #vaccines for use in the 2026 – 2027 northern hemisphere influenza season (#WHO, Feb. 27 '26)

 

February 2026 

WHO convenes technical consultations {1} in February and September each year to recommend viruses for inclusion in influenza vaccines {2} for the northern hemisphere (NH) and southern hemisphere (SH) influenza seasons, respectively. 

This recommendation relates to the influenza vaccines for use in the NH 2026-2027 influenza season. 

A recommendation will be made in September 2026 relating to vaccines that will be used for the SH 2027 influenza season. 

WHO guidance for choosing between the NH and SH formulations for countries in tropical and subtropical regions is available on the WHO Global Influenza Programme website {3}.  

National or regional authorities approve the composition and formulation of influenza vaccines used in each country. 

National public health authorities are responsible for making recommendations regarding the use of the vaccine. 

WHO has published recommendations on the prevention of influenza {4}.  

Seasonal influenza activity 

From September 2025 through January 2026, influenza activity was reported in all transmission zones. 

Overall influenza virus detections were higher compared to the same reporting period in 2024-2025 but peaked in December 2025 for this recent period compared to February 2025 for the previous period. 

During this reporting period, influenza A viruses predominated, although the proportion of virus detections varied among transmission zones. 

In Africa, influenza activity increased during the start of the reporting period, with a predominance of influenza A viruses in all transmission zones. 

In Eastern, Northern, and Western Africa, among subtyped influenza A viruses, A(H1N1)pdm09 viruses accounted for the majority of detections early in the reporting period while A(H3N2) viruses predominated later in the reporting period. 

Influenza detections peaked in November in Western Africa and December in Eastern and Northern Africa. 

In Middle Africa, influenza detections remained low throughout the reporting period with a slight predominance of A(H1N1)pdm09 viruses early in the reporting period. 

In Southern Africa, influenza detections remained low throughout the reporting period, with a predominance of influenza A viruses. 

In Northern and Middle Africa, there was low and sustained influenza B activity throughout the reporting period. 

In Asia, influenza activity increased during the start of the reporting period in South East and Western Asia, from October in Central and Eastern Asia, and from November in Southern Asia, with a predominance of influenza A viruses in all transmission zones. 

Most influenza detections were reported from Eastern Asia, where activity peaked in early December. 

In Southern Asia, influenza activity also peaked in December; in Central Asia influenza activity peaked in November, and in Western and South East Asia, influenza activity peaked in October. 

Among subtyped influenza A viruses, A(H3N2) viruses accounted for the majority of detections in all transmission zones; detections of A(H1N1)pdm09 and influenza B viruses remained low in most transmission zones throughout the reporting period, except in Eastern Asia where there was a substantial rise in influenza B viruses in recent weeks. 

In Europe, influenza activity increased from mid-September in Northern Europe, from October in South West Europe and from mid-November in Eastern Europe, with a predominance of influenza A viruses in all transmission zones. 

Influenza detections peaked in December in Northern and South West Europe but remained elevated through January. 

Influenza detections continued to increase through January in Eastern Europe. 

Among subtyped influenza A viruses, A(H3N2) viruses predominated. 

In South West Europe, detections of A(H1N1)pdm09 viruses slightly increased in mid-November. 

In Eastern and Northern Europe, detections of A(H1N1)pdm09 and influenza B viruses remained low throughout the reporting period.  

In the Americas, influenza activity increased from the start of the reporting period in Temperate and Tropical South America and from November in North America and Central America Caribbean. 

Influenza A viruses accounted for most detections, and influenza B virus detections remained low throughout the reporting period in all transmission zones, except in North America where there was a substantial rise in influenza B viruses in recent weeks. 

In North America, activity peaked in late December. 

Among subtyped influenza A viruses, there was a predominance of A(H3N2) viruses. 

In Central America Caribbean, influenza activity remained elevated through mid-January with A(H3N2) virus detections predominant from December. 

In Tropical South America, influenza activity peaked in early November and slowly declined until the end of the reporting period. 

Among subtyped influenza A viruses, A(H3N2) predominated through November then co-circulated at similar proportions to A(H1N1)pdm09 until the end of the reporting period. 

In Temperate South America, influenza activity peaked in mid-November and among subtyped influenza A viruses, A(H3N2) viruses predominated throughout the reporting period.  

In Oceania, influenza activity decreased until mid-October, increased in December and decreased since mid-December. A(H1N1)pdm09 and B viruses were detected at similar levels until mid-September and A(H3N2) virus detections predominated since then. 

Influenza A 

Globally, influenza A virus detections greatly outnumbered those of influenza B. 

Among subtyped influenza A viruses, A(H3N2) viruses predominated throughout the reporting period in most transmission zones. 

In Eastern, Northern, Western Africa, Central America Caribbean and Oceania, influenza A(H1N1)pdm09 virus detections predominated during the first part of the reporting period, and A(H3N2) virus detections predominated in the latter part of the reporting period. 

Influenza A(H1N1)pdm09 virus detections increased slightly towards the latter part of the reporting period in Eastern and South West Europe, Central America Caribbean and Tropical South America. 

The overall number of influenza detections was low in Middle and Southern Africa. 

Influenza B 

Globally, influenza B virus detections remained low throughout the reporting period. 

Increases in influenza B virus detections in January were reported in North America and Eastern Asia. 

All influenza B viruses where lineage was confirmed belonged to the B/Victoria lineage. 

(...)

Zoonotic influenza  

From 23 September 2025, sporadic zoonotic influenza infections were reported, in most cases, following exposure to infected birds, swine or contaminated environments. 

Single cases of A(H5N1) from Bangladesh, A(H5N2) from Mexico, and A(H5N5) from the United States of America were reported. 

Three A(H5N1) cases were reported from Cambodia. 

Fourteen cases of A(H9N2) and one case of A(H10N3) were reported from China. 

Single cases of A(H1N1)v and A(H1N2)v were reported from China, a case of A(H1N2)v from the United States of America, and a case of A(H3N2)v from Brazil. 

Genetic and antigenic characteristics of recent seasonal influenza viruses, human serology and antiviral susceptibility 

Influenza A(H1N1)pdm09 viruses  

Since September 2025, A(H1N1)pdm09 viruses circulated globally, but did not predominate in any region. 

The haemagglutinin (HA) genes of viruses that were genetically characterized belonged to the 5a.2a and 5a.2a.1 clades. 

Viruses from clade 5a.2a subclades C.1, C.1.9 and C.1.9.3 circulated in low numbers, with the largest proportion of detections in Africa {5}. 

Since September 2025, clade 5a.2a.1 subclades D.3.1 and D.3.1.1 viruses circulated globally. 

The D.3.1 subclade with substitutions T120A, I372V, I460T and V520A predominated in Western Pacific, Africa, South East Asia and several countries in the Americas. 

D.3.1.1 viruses characterized by R113K and more recently acquired substitutions A139D, E283K and K302E predominated in some countries in Europe, the Middle East and North America. 

The antigenic properties of A(H1N1)pdm09 viruses were assessed in haemagglutination inhibition (HI) assays with post-infection ferret antisera. 

HI results for viruses with collection dates since September 2025 showed that ferret antisera raised against cell culture-propagated A/Wisconsin/67/2022-like and eggpropagated A/Victoria/4897/2022-like viruses from the 5a.2a.1 clade recognized viruses in both 5a.2a and 5a.2a.1 clades well. 

However, post-infection ferret antisera raised against viruses from clade 5a.2a showed some reduction in recognition of the now predominating D.3.1 and D.3.1.1 subclade viruses. 

Post-infection ferret antisera raised against viruses from subclade D.3.1 (e.g., A/Missouri/11/2025) recognized recently circulating viruses from both 5a.2a and 5a.2a.1 clades well.  

Human serology studies used 15 serum panels from children, adults (18 to 64 years) and older adults (≥65 years) who had received egg-propagated inactivated (standard, high dose or adjuvanted), cell culture-propagated inactivated or recombinant trivalent or quadrivalent vaccines with NH 2025-2026 influenza vaccine formulations. 

-- NH 2025-2026 egg-based vaccines contained A/Victoria/4897/2022 (H1N1)pdm09like, 

-- A/Croatia/10136RV/2023 (H3N2)-like, 

-- B/Austria/1359417/2021-like (B/Victoria lineage) and, in quadrivalent vaccines, 

-- B/Phuket/3073/2013-like (B/Yamagata lineage) virus antigens. 

Cell culture-propagated and recombinant vaccines contained A/Wisconsin/67/2022 (H1N1)pdm09-like, A/District of Columbia/27/2023 (H3N2)-like and B/Austria/1359417/2021-like (B/Victoria lineage) virus antigens. 

Recent A(H1N1)pdm09 viruses with HA genes from clades 5a.2a (subclade C.1.9.3) and 5a.2a.1 (subclades D.3.1 and D.3.1.1) were analysed in HI assays using these human serum panels. 

When compared to the responses to cell culture-propagated A/Wisconsin/67/2022 (H1N1)pdm09-like vaccine reference viruses, post-vaccination geometric mean titres (GMTs) were significantly reduced for some recently circulating viruses from D.3.1 and D.3.1.1 subclades. 

Of 1 161 A(H1N1)pdm09 virus clinical samples and isolates examined by genetic and/or phenotypic analyses, 15 viruses showed evidence of reduced susceptibility to neuraminidase inhibitors (NAIs): seven had an H275Y neuraminidase (NA) substitution and eight had I223V and S247N substitutions. 

Of 1 331 A(H1N1)pdm09 viruses examined by genetic and/or phenotypic analyses, no viruses showed evidence of reduced susceptibility to the endonuclease inhibitor baloxavir marboxil. 

Influenza A(H3N2) viruses  

Phylogenetic analysis of the HA gene sequences of A(H3N2) viruses collected since September 2025 showed that the vast majority of viruses belonged to one of the J.2 subclades {6}, expressing HA N122D and K276E substitutions. 

HA genes have diversified with many subclades; J.2.2 (characterized by S124N), J.2.3 (characterized by N158K, K189R and S378N), J.2.4 (characterized by T135K [a potential loss of an N-glycosylation site] and K189R), and K (formerly designated as J.2.4.1; characterized by K2N, S144N [a potential addition of an N-glycosylation site], N158D, I160K, Q173R, T328A and S378N). 

During this reporting period, subclade K viruses were detected in all regions and predominated in many countries. 

There was still circulation of other J.2 subclades, notably J.2 or J.2.3 in South America, J.2.2 or J.2.4 in Africa and Asia.  

Post-infection ferret antisera raised against cell culture-propagated A/District of Columbia/27/2023-like and egg-propagated A/Croatia/10136RV/2023-like (clade 2a.3a.1, subclade J.2) viruses, representing the A(H3N2) component for the NH 2025-2026 influenza vaccines, showed poor recognition with recently circulating subclade J.2.3 (e.g., A/Netherlands/10685/2024), J.2.4 (e.g., A/Sydney/1359/2024) and K (e.g., A/Darwin/1415/2025) viruses. 

Ferret antisera raised against reference viruses from J.2.3 subclades showed good recognition of viruses expressing HA from J.2.3, but poor recognition of other subclades.  

Post-infection ferret antisera raised against cell culture-propagated A/Sydney/1359/2024-like and eggpropagated A/Singapore/GP20238/2024-like J.2.4 viruses, representing SH 2026 influenza vaccines, recognized most J.2.4 viruses and many subclade K viruses well. 

However, subclade K viruses and J.2.4 viruses with HA substitutions F79V, S144N (addition of a potential N-glycosylation site), N158D, I160K, T328A were better recognized by post-infection ferret antisera raised against cell culture-propagated A/Darwin/1415/2025-like and egg-propagated A/Darwin/1454/2025-like (subclade K) viruses. 

Human serology studies were conducted using the serum panels as described above by HI and virus neutralization (VN) assays with recent circulating A(H3N2) viruses with HA genes from subclades J.2, J.2.2, J.2.3, J.2.4, J.2.5 and K. 

When compared to titres against cell-propagated A/District of Columbia/27/2023-like vaccine reference viruses, post-vaccination HI GMTs or VN GMTs against many of the recent viruses in all subclades tested were significantly reduced in many serum panels.  

(...)

Of 4 458 influenza A(H3N2) viruses examined by genetic and/or phenotypic analyses, two viruses showed evidence of reduced susceptibility to NAIs; both had an NA E119V substitution. 

Of 4 828 A(H3N2) viruses examined by genetic and/or phenotypic analyses, nine viruses showed evidence of reduced susceptibility to the endonuclease inhibitor baloxavir marboxil: three had a PA I38T substitution, three had a PA I38I/T substitution, two had a PA I38I/M substitution and one had a PA E199E/G substitution.  

Influenza B viruses  

Since September 2025, influenza B viruses were detected in all WHO regions, and all those characterized belonged to the B/Victoria lineage. 

There have been no confirmed detections of circulating B/Yamagata lineage viruses after March 2020.  

All HA genes of B/Victoria lineage viruses characterized during this reporting period belonged to clade 3a.2 with HA substitutions A127T, P144L, and K203R. 

Viruses with clade 3a.2 HA genes have diversified further, forming several subclades (C.1-C.5)7. 

Viruses designated as C.5, C.5.1, C.5.6, C.5.6.1 and C.5.7, all of which had the HA substitution D197E, circulated at varying proportions in different regions. 

Viruses designated as C.3 have HA substitutions E128K, A154E and S208P. 

Subclade C.3.1 viruses shared additional mutations D197N (addition of a potential N-glycosylation site) and P208S. 

Recent C.3 viruses which had additional changes D197N (addition of a potential N-glycosylation site), S255P and I267V and C.3.1 viruses have been detected in increasing proportions in Eastern Asia and North America in recent weeks. 

Antigenic analysis showed that post-infection ferret antisera raised against B/Austria/1359417/2021-like viruses (3a.2), representing the vaccine viruses for the SH 2026 and NH 2025-2026 influenza seasons, recognized viruses within the C.5.1, C.5.6, C.5.6.1 and C.5.7 subclades well. 

C.3 and C.3.1 subclade viruses with the HA substitution D197N were recognized poorly. 

Post-infection ferret antisera raised against cell culture-propagated viruses from subclade C.3.1 (e.g., B/Pennsylvania/14/2025) recognized recently circulating viruses from C.3, C.3.1 and other 3a.2 subclades well. 

All available egg isolates for subclade C.3 and C.3.1 viruses acquired substitutions that remove the potential N-glycosylation site at HA 197 to 199. 

Post-infection ferret antisera raised against egg-propagated viruses from subclade C.3.1 (e.g., B/Tokyo/EIS13-175/2025, B/Tokyo/EIS13-011/2025, B/Perth/115/2025) showed reduced recognition of recently circulating viruses from C.3 and C.3.1 subclades compared to that of the cell equivalent.  

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In human serology studies, recently circulating B/Victoria lineage viruses with HA genes from clade 3a.2 subclades C.3, C.3.1, C.5.1, C.5.6, C.5.6.1 and C.5.7 were tested using the serum panels described above. 

When compared to titres against egg- or cell culture-propagated B/Austria/1359417/2021-like vaccine reference virus, titres against most viruses with HA genes from C.5.1, C.5.6, C.5.6.1 and C.5.7 subclades were not significantly reduced; however, titres against viruses with HA genes from C.3 and C.3.1 were significantly reduced in most serum panels. Serology studies were not performed for B/Yamagata lineage viruses.  

Of 549 influenza B/Victoria lineage viruses examined by genetic and/or phenotypic analyses, two showed evidence of reduced or highly reduced susceptibility to NAIs, both with an NA M464T substitution. 

Of 760 B/Victoria lineage viruses examined by genetic and/or phenotypic analyses, no viruses showed evidence of reduced susceptibility to the endonuclease inhibitor baloxavir marboxil.  

Recommended composition of influenza virus vaccines for use in the 2026-2027 northern hemisphere influenza season  

Since September 2025, A(H1N1)pdm09 viruses circulated globally. The majority of viruses had HA genes belonging to the 5a.2a.1 clade which has further diversified into the D.3.1 and D.3.1.1 subclades. 

Postinfection ferret antisera raised against the northern hemisphere (NH) 2025-2026 A(H1N1)pdm09 vaccine viruses (cell culture-propagated A/Wisconsin/67/2022 and egg-propagated A/Victoria/4897/2022) and the southern hemisphere (SH) 2026 A(H1N1)pdm09 vaccine viruses A/Missouri/11/2025 recognized D.3.1 and D.3.1.1 viruses well. 

In human serology studies, post-vaccination geometric mean titres (GMTs) were significantly reduced for some recently circulating A(H1N1)pdm09 viruses when compared to the responses to cell culture-propagated A/Wisconsin/67/2022 A(H1N1)pdm09-like vaccine reference viruses. 

Since September 2025, A(H3N2) viruses circulated and predominated globally. 

The vast majority of A(H3N2) viruses collected had HA genes from subclades of J.2 and have continued to diversify with subclade K (previously designated as J.2.4.1) viruses predominating in most regions. 

Post-infection ferret antisera raised against NH 2025-2026 influenza season vaccine viruses (cell culture-propagated A/District of Columbia/27/2023 and egg-propagated A/Croatia/10136RV/2023) recognized some J.2 viruses well but showed poor recognition of viruses from subclades J.2.3, J.2.4 and K. 

Post-infection ferret antisera raised against subclade K viruses (cell culture-propagated A/Darwin/1415/2025 and egg-propagated A/Darwin/1454/2025) showed improved recognition of K viruses compared to post-infection antisera raised against NH 2025-2026 and SH 2026 A(H3N2) vaccine viruses. 

When compared to titres against cell culture-propagated A/District of Columbia/27/2023-like vaccine reference viruses, human post-vaccination haemagglutinin inhibition (HI) GMTs or virus neutralisation (VN) GMTs against many of the recent viruses in J.2.3, J.2.4 and K subclades were significantly reduced. 

Since September 2025, influenza B virus detections remained low globally, although some countries had increased detections in recent weeks. All circulating influenza B viruses characterized belonged to the B/Victoria lineage, and had HA genes belonging to clade 3a.2 with substitutions A127T, P144L and K203R. 

Post-infection ferret antisera raised against B/Austria/1359417/2021-like viruses (3a.2), representing the vaccine viruses for the SH 2026 and NH 2025-2026 influenza seasons, recognized viruses within the C.5.1, C.5.6, C.5.6.1 and C.5.7 subclades well. C.3 and C.3.1 subclade viruses with HA substitution D197N were recognized poorly. 

Post-infection ferret antisera raised against cell culture-propagated viruses from subclade C.3.1 (e.g., B/Pennsylvania/14/2025) recognized recently circulating viruses from C.3, C.3.1 and other 3a.2 subclades well. All available egg isolates for subclade C.3 and C.3.1 viruses (e.g., B/Tokyo/EIS13-175/2025) acquired egg-adaptive mutations that remove the potential N-glycosylation site at HA 197 to 199, leading to post-infection ferret antisera raised against egg-propagated viruses from subclade C.3.1 (e.g., B/Tokyo/EIS13-175/2025) showing reduced recognition of recently circulating viruses from C.3 and C.3.1 subclades compared to that of the cell equivalent. 

Human serology assays showed that post-vaccination titres against most recent B/Victoria lineage viruses with HA genes from subclades C.5.1, C.5.6, C.5.6.1 and C.5.7 were not significantly reduced when compared to titres against egg- or cell culturepropagated B/Austria/1359417/2021-like vaccine reference viruses. Titres against viruses with HA genes from subclade C.3 and C.3.1 were significantly reduced in most serum panels.  

For vaccines for use in the 2026-2027 northern hemisphere influenza season, WHO recommends the following:  

Egg-based vaccines  

• an A/Missouri/11/2025 (H1N1)pdm09-like virus;  

• an A/Darwin/1454/2025 (H3N2)-like virus; and  

• a B/Tokyo/EIS13-175/2025 (B/Victoria lineage)-like virus.  

Cell culture-, recombinant protein- or nucleic acid-based vaccines  

• an A/Missouri/11/2025 (H1N1)pdm09-like virus;  

• an A/Darwin/1415/2025 (H3N2)-like virus; and  

• a B/Pennsylvania/14/2025 (B/Victoria lineage)-like virus.  

Lists of prototype viruses for egg-, cell culture-, recombinant protein- and nucleic acid-based vaccines together with candidate vaccine viruses (CVVs) suitable for the development and production of human influenza vaccines are available on the WHO website {8}. 

A list of reagents for vaccine standardization, including those for this recommendation, can also be found on the WHO website.  

CVVs and reagents for use in the laboratory standardization of inactivated vaccines may be obtained from:  

• Therapeutic Goods Administration, P.O. Box 100, Woden, ACT, 2606, Australia (email: influenza.reagents@health.gov.au; website: http://www.tga.gov.au).  

• Medicines and Healthcare products Regulatory Agency (MHRA), Blanche Lane, South Mimms, Potters Bar, Hertfordshire, EN6 3QG, the United Kingdom of Great Britain and Northern Ireland  • (email: enquiries@mhra.gov.uk; website: http://www.nibsc.org/science_and_research/virology/influenza_resource_.aspx). 

• Division of Biological Standards and Quality Control, Center for Biologics Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland, 20993, the United States of America (email: cbershippingrequests@fda.hhs.gov).  

• Research Centre for Influenza and Respiratory Viruses, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashi-Murayama, Tokyo 208-0011, Japan (email: flu-vaccine@nih.go.jp).  

Requests for reference viruses should be addressed to:  

• WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, Peter Doherty Institute, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia (email: whoflu@influenzacentre.org; website: http://www.influenzacentre.org).  

• WHO Collaborating Centre for Reference and Research on Influenza, National Institute of Infectious Diseases, Japan Institute for Health Security 4-7-1 Gakuen, Musashi-Murayama, Tokyo 208-0011, Japan (email: whocc-flu@nih.go.jp).  

• Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop H17-5, Atlanta, GA 30329, the United States of America (email: InfluenzaVirusSurvei@cdc.gov; website: http://www.cdc.gov/flu/).  

- WHO Collaborating Centre for Reference and Research on Influenza, The Francis Crick Institute, 1 Midland Road, London NW1 1AT, the United Kingdom of Great Britain and Northern Ireland (Tel: +44 203 796 1520 or +44 203 796 2444, email: whocc@crick.ac.uk;  • website: http://www.crick.ac.uk/research/worldwideinfluenza-centre).  

• WHO Collaborating Centre for Reference and Research on Influenza, National Institute for Viral Disease Control and Prevention, China CDC, 155 Changbai Road, Changping District, 102206, Beijing, China. (tel: +86 10 5890 0851; email: fluchina@ivdc.chinacdc.cn; website: https://ivdc.chinacdc.cn/cnic/en/).  

WHO provides weekly updates {9} of global influenza activity. Other information about influenza surveillance, risk assessment, preparedness and response can be found on the WHO Global Influenza Programme website {10}.  

Acknowledgements  

The WHO recommendation on vaccine composition is based on the year-round work of the WHO Global Influenza Surveillance and Response System (GISRS). We thank the National Influenza Centres (NICs) of GISRS, and non-GISRS laboratories including the World Organization for Animal Health (WOAH) and the Food and Agriculture Organization of the United Nations (FAO) Network of Expertise on Animal Influenza (OFFLU), who contributed information, clinical specimens, viruses and associated data; WHO Collaborating Centres of GISRS for their in-depth characterization and comprehensive analysis of viruses; University of Cambridge for performing antigenic cartography and phylogenetic analysis; WHO Essential Regulatory Laboratories of GISRS for their complementary virus analyses and contributions from a regulatory perspective; and laboratories involved in the production of high growth/yield reassortants as candidate vaccine viruses. We also acknowledge the GISAID Global Data Science Initiative for the EpiFluTM database and other sequence databases which were used to share gene sequences and associated information; modelling groups for virus fitness forecasting; and the Global Influenza Vaccine Effectiveness (GIVE) Collaboration for sharing estimates of influenza vaccine effectiveness on a confidential basis.  

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{1} Recommendations for influenza vaccine composition: https://www.who.int/teams/global-influenza-programme/vaccines/who-recommendations 

{2} Description of the process of influenza vaccine virus selection and development: http://www.who.int/gb/pip/pdf_files/Fluvaccvirusselection.pdf 

{3} Vaccines in tropics and subtropics: https://www.who.int/teams/global-influenza-programme/vaccines/vaccine-in-tropics-and-subtropics 

{4} Vaccines against influenza WHO position paper – May 2022. Wkly Epidemiol Rec 2022; 97 (19): 185 - 208. Available at: https://iris.who.int/handle/10665/354264 

{5} Real-time tracking of influenza A(H1N1)pdm09 evolution: https://nextstrain.org/seasonal-flu/h1n1pdm/ha/2y?c=subclade 

{6} Real-time tracking of influenza A(H3N2) evolution: https://nextstrain.org/seasonal-flu/h3n2/ha/2y?c=subclade 

{7} Real-time tracking of influenza B/Victoria lineage evolution: https://nextstrain.org/seasonal-flu/vic/ha/2y?c=subclade 

{8} Candidate vaccine viruses: https://www.who.int/teams/global-influenza-programme/vaccines/who-recommendations/candidate-vaccine-viruses 

{9} Current respiratory virus update: https://www.who.int/teams/global-influenza-programme/surveillance-and-monitoring/influenza-updates 

{10} Global Influenza Programme: https://www.who.int/teams/global-influenza-programme 

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Source: 

Link: https://www.who.int/publications/m/item/recommended-composition-of-influenza-virus-vaccines-for-use-in-the-2026-2027-northern-hemisphere-influenza-season

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