Showing posts with label a/h9n2. Show all posts
Showing posts with label a/h9n2. Show all posts

Saturday, May 9, 2026

#Genetic and #biological characterization of #H9N2 avian #influenza viruses isolated from #swine in #China

 


Abstract

Background

H9N2 avian influenza virus (AIV) has been circulating in poultry in China for decades and are undergoing adaptation to mammals, posing potential pandemic risks. To investigate the prevalence of H9N2 AIVs in swine, we conducted surveillance in Shandong Province from 2021 to 2023.

Results

Two H9N2 influenza virus strains, A/swine/Shandong/417/2021(Sw/SD/417/21) and A/swine/Shandong/662/2022 (Sw/SD/662/22), were successfully isolated from swine and genetically characterized. Phylogenetic analyses showed that both isolates were reassortants containing gene segments from multiple H9N2 AIV lineages and closely related to currently circulating H9N2 AIV. Key molecular marker analysis revealed that both isolates carried mammalian-adaptive residues in the HA receptor-binding sites (183 N, 190 V, 226 L), a novel HA cleavage site variant (PSKSSRGL), PB2 mutations (A588V, E627V), and the M2 S31N substitution, suggesting potential adaptation to mammalian hosts and resistance to adamantane antivirals. Mice infection experiments demonstrated efficient viral replication in the respiratory tract, particularly in the lungs, but only mild histopathological changes were observed, with no significant weight loss or mortality, indicating low pathogenicity in mice. Serological surveillance of 3,172 swine serum samples showed a low prevalence of H9N2 influenza virus infection (0.44%), with positive samples sporadically distributed across regions and years.

Conclusion

In summary, although H9N2 AIV infection in swine is rare and generally mild, the presence of mammalian-adaptive markers and reassortant genomes highlights the potential risk of cross-species transmission and subclinical adaptation. Continuous avian–swine–human influenza surveillance is therefore essential to mitigate the potential threat posed by H9N2 AIV.

Source: 


Link: https://link.springer.com/article/10.1186/s12917-026-05501-z

____

Tuesday, May 5, 2026

Avian #Influenza #Report - April 26 – May 2 '26 (Wk 18) (HK CHP, May 5, 2026): 1 new #human #H5N1 case in #Bangladesh; 1 new #H9N2 case in #China

 


{Excerpt}

(...)

{H5N1}

-- Date of report: Late April 2026 

-- Country: Bangladesh 

-- Province / Region: Chattogram Division 

-- District / City: ...

-- Sex: ...

-- Age: Child 

-- Condition at time of reporting: Deceased 

-- Subtype of virus: H5N1

(...)


{H9N2}

1) Guangxi Zhuang Autonomous Region

-- A one-year-old boy with onset on April 12, 2026. 

(...)

Source: 


Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk18.pdf

____

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 21, 2026

Avian #Influenza #Report - Reporting period: April 12 - 18 '26 (Wk 16) (HK CHP, April 21 '26): 3 new #human cases of #H9N2 virus in #China

 


{Excerpt}

(...)

Avian influenza A(H9N2)

-- Guangdong Province

1) A five-year-old boy with onset on February 23, 2026.

-- Jiangxi Province

2) A two-year-old boy with onset on March 20, 2026. 

-- Yunnan Province:

3) A two-year-old girl with onset on March 3, 2026. 

(...)

Source: 


Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk16.pdf

____

Tuesday, April 14, 2026

Avian #Influenza #Report - Reporting period: April 5 – 11, '26 (Wk 15) (HK CHP April 14, 2026): 2 new #human #H9N2 influenza cases in #China

 


{Excerpt}

(...)

-- Avian influenza A(H9N2)

- Guangdong Province

1) A three-year-old boy with onset on January 20, 2026. 

- Guangxi Zhuang Autonomous Region

2) A 63-year-old man with onset on February 5, 2026. 

(...)

Source: 


Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk15.pdf

____

Friday, April 10, 2026

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

 


Situation at a glance

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

- Next generation sequencing confirmed Influenza A(H9N2). 

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

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

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

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

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


Description of the situation

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

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

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

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

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

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


Epidemiology

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

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

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

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


Public health response

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


WHO risk assessment

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

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


WHO advice

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

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

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

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


Further information

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

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

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

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

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

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

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

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

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

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

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

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

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

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

__

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

Source: 

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

____

Thursday, April 2, 2026

#Serological #Surveillance of Avian #Influenza Virus #H9N2 Subtype in #Occupational Populations Exposed to #Poultry Environment in #China During 2018–2023

 


Abstract

Background

Avian influenza virus (AIV) H9N2 has a major role in the emergence of influenza pandemic. We assessed the risk of AIV H9N2 to the human population and public health.

Method

The hemagglutination inhibition method was used to screen for hemagglutinin antibodies. Microneutralization tests were performed to confirm neutralizing antibodies against the AIV H9N2 subtype. Real-time polymerase chain reaction was conducted to detect the H9 subtype in environmental samples. GraphPad Prism software was used for mapping, and STATA software was used for statistical analysis.

Results

The nationwide seroprevalence among these populations was 0.76%. Seroprevalence was compared across regions, genders, and occupational exposure sites. The seroprevalence rates for males and females showed no significant difference. Significant differences were found across regions and occupational exposure environments (P < .05). The south and southwest regions had the highest seroprevalence rates at 1.58% and 1.38%, respectively. The highest seroprevalence was observed in individuals exposed to live poultry market (1.51%). Significant regional differences in H9 nucleic acid positive rates (NAPRs) were found (P < .05), with the southwest and central regions showing the highest rates at 25.99% and 24.35%, respectively. H9 NAPR in live poultry markets (LPMs), farms, and slaughterhouses varied significantly by region (P < .05).

Conclusions

Poultry-related environments have become a key factor in AIV H9N2 infection among occupational populations. Exposure to LPM showed the highest seroprevalence among occupational groups. The distribution characteristics of H9N2 across different poultry environments increased the risk of infection in occupationally exposed populations.

Source: 


Link: https://academic.oup.com/ofid/article/13/4/ofag144/8537381

____

Tuesday, March 31, 2026

Avian Influenza Report, Week 13 2026 (#HK SAR CHP, Published on March 31, 2026): One #Human Case of #Infection with #H9N2 #influenza virus in #Italy

 


{Excerpt}

(...)

Avian influenza A(H9N2)

-- Italy, Lombardy

1) An individual with co-existing medical conditions returning from a non-European country. 

- This is the first human case of avian influenza A(H9N2) reported in Europe

(...)

Source: 


Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk13.pdf

____

Wednesday, March 25, 2026

#Italy, First European imported #Human Case of an #H9N2 avian #influenza virus infection discovered in #Lombardy (Press Release, March 25 '26)

 


"Thanks to the epidemiological surveillance network active in the region, the first European {imported} case of avian influenza of the H9 subtype has been identified in a patient arriving from abroad," said the Regional Councilor for Welfare.

The Lombardy Region immediately activated coordination procedures with the Ministry of Health and the Istituto Superiore di SanitĂ  (ISS) to ensure the utmost rigor in managing the case and monitoring contacts.

The councilor added

"The patient is currently hospitalized in isolation at San Gerardo Hospital in Monza. In addition to treatment for the viral infection, the medical team is managing other comorbidities the patient is suffering from. The epidemiological investigation was promptly conducted by ATS Brianza, while the molecular analyses that allowed for the precise identification of the virus were performed by the University of Milan and confirmed by the Regional Center for Infectious Diseases (composed of the Directorate General for Welfare – Prevention Unit of the Lombardy Region, ASST Fatebenefratelli-Sacco and San Matteo di Pavia) and the ISS."

"The identification of the first European case of H9 influenza in Lombardy," ​​emphasized, "shouldn't be a cause for alarm for the public, but it is tangible proof that our prevention system is working with extreme precision. We acted very quickly." (LNews)

Source: 


Link: https://www.lombardianotizie.online/comunicato-stampa/lombardia-influenza-h9/

____

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

____

My New Space

Most Popular Posts