Showing posts with label risk assessment. Show all posts
Showing posts with label risk assessment. Show all posts

Friday, May 22, 2026

#Canada, Speaking #Remarks for the Chief Public Health Officer on #Ebola Disease and #Hantavirus Technical #Briefing (May 22 '26)

 


May 22, 2026 | 1:00pm EST


    Thank you for joining us today.

    Before we begin, I want to acknowledge that we are gathered on the unceded traditional territory of the Anishinaabe Algonquin Nation. I would like to take this moment to reflect on the history of Indigenous people and to honour the original stewards of the lands where we live and work.


Situation Update – Ebola Disease

    I will begin today with an update on the Ebola situation in Africa and what it means for Canada. And then, I will provide an update on Andes hantavirus.

    On May 15, Africa's Centres for Disease Control and Prevention declared an outbreak of Ebola disease in the eastern Democratic Republic of the Congo. Cases linked to this outbreak have also been reported in Uganda, including an imported case that was confirmed to be the Bundibugyo virus strain.

    On May 17, the Director General of the World Health Organization declared this outbreak a Public Health Emergency of International Concern due to the evidence of cross-border spread, uncertainty around the true size of the outbreak, the potential for wider regional and global impacts, and the need for global collaboration.

    It is important to be clear: while this is a serious and evolving situation, cases remain localized, and the global risk is low.

    This outbreak is occurring in an area with complex challenges, including proximity to urban centres, security concerns and high levels of population movement associated with mining activity. These factors can increase the potential for spread locally and across borders.

    We recognize the risk for people in the region is high, and our thoughts are with the individuals, families, communities and health workers who are directly bearing the brunt of this challenging outbreak.

    Canada stands ready to assist.


Risk to Canadians

    Based on the Public Health Agency of Canada's rapid risk assessment and in alignment with the World Health Organization, the risk to people in Canada is considered to be low at this time.

    There has never been a case of Ebola disease imported into Canada despite numerous Ebola outbreaks in the affected region.

    I do want to be transparent that, out of an abundance of caution, one individual in Ontario underwent precautionary testing. This individual recently returned from Ethiopia and reported symptoms consistent with a range of illnesses.

    Both initial testing conducted in Ontario and confirmatory testing at the National Microbiology Laboratory were both negative.

    This is a good example of how quickly measures are activated, even when the likelihood of Ebola is very low.

    Ebola disease is transmitted through direct contact with the body fluids of an infected individual who is showing symptoms, or through contact with infected animals or contaminated materials. It is not spread through casual contact, and it does not spread through the air like respiratory viruses.

    Those at highest risk are individuals providing care to patients with Ebola disease, participating in burial practices involving direct contact, or working in healthcare or laboratory settings where the virus is present.


Public Health Response

    While the risk in Canada remains low, we are taking this situation very seriously and are taking a precautionary approach.

    The Public Health Agency of Canada is actively monitoring the outbreak in close collaboration with international partners, including the World Health Organization, as well as provincial and territorial public health authorities.

    At our borders, we have strengthened screening measures. As of May 20, enhanced screening questions have been implemented at airport kiosks for travellers who have been in the Democratic Republic of the Congo or Uganda within the past 21 days.

    Travellers are now asked whether they have been in these countries and whether they are experiencing symptoms or may have been in contact with someone with Ebola disease.

    We have also deployed additional quarantine and screening officers at key airports, and we are maintaining a 24/7 centralized monitoring approach. Signage has been deployed at major airports across the country to ensure travellers know what to do if they feel unwell.

    These measures are supported under the Quarantine Act and are designed to identify potential risks early and ensure that appropriate follow-up actions are taken.

    On Wednesday, a flight was redirected to MontrĂ©al due to a passenger of concern. PHAC quarantine officers assessed the individual, determined they were asymptomatic, and appropriate border procedures were followed.

    For travellers, I want to emphasize the importance of checking the Government of Canada's Travel Advice and Advisories before departure.

    Individuals returning from affected regions should monitor their health for 21 days. If symptoms develop, it is critical that they isolate immediately, away from others and contact local public health authorities before seeking in-person care.


Laboratory and Preparedness Capacity

    Canada has strong laboratory and surveillance systems in place.

    Any suspected case in Canada would be immediately reported, with samples sent to the National Microbiology Laboratory in Winnipeg for confirmatory testing. Results are typically available within 24 hours once samples arrive at the lab.

    Our National Microbiology Laboratory continues to play a leading role globally in Ebola research, including work on vaccines, therapeutics, and diagnostics. Canadian scientists were instrumental in the development of the world's first Ebola vaccine, and they continue to contribute to preparedness and response efforts internationally.


International Collaboration

    This outbreak underscores the importance of global collaboration.

    Canada continues to work closely with international partners through established mechanisms such as the World Health Organization and the Global Outbreak Alert and Response Network.

    We stand ready to provide technical expertise and support if requested, as we have done in previous outbreaks. Our shared goal is to contain this outbreak at its source and reduce the risk of further spread.


Hantavirus Update

    I will now turn briefly to the situation regarding Andes hantavirus.

    Canada confirmed a case of Andes hantavirus linked to the MV Hondius cruise ship earlier this month. At this time, there have been no additional cases identified in Canada beyond the initial confirmed case in British Columbia, and all high-risk contacts continue to be monitored by local public health authorities.

    The overall risk to the general population in Canada remains low at this time.

    We continue to take a precautionary approach given the severity of this virus, while recognizing that person-to-person transmission of Andes hantavirus is rare and typically requires close, prolonged contact with someone who is symptomatic.

    Our thoughts are with the individual in hospital in British Columbia and their family. We thank our public health colleagues and the clinical team for the excellent care and support they are providing.


World Health Assembly and International Coordination

    This week, I had the opportunity to attend the World Health Assembly in Geneva, where I met with a number of my global counterparts, to discuss the public health challenges we all face.

    I also met Dr. Ghebreyesus, Director-General of the World Health Organization and members of his senior leadership team who are leading emergency response, including the Ebola response in DRC.

    These discussions reinforced the importance of transparency, timely information sharing, and coordination in responding effectively to emerging public health threats.

    The events of the past several weeks have demonstrated that strong global relationships are not only valuable, they are essential.


Conclusion

    In closing, we have robust systems in place for detection, prevention, and response. We are working in close collaboration with provincial and territorial partners, as well as with international organizations and governments, to ensure a coordinated and effective approach.

    We will continue to provide timely updates and clear guidance as new information becomes available.

    I would like to thank our public health partners across the country, our frontline healthcare workers, laboratory scientists, and our international colleagues for their dedication, expertise, and collaboration.

    Together, we are working to protect the health and safety of people in Canada and around the world.

    Thank you. Merci. Miigwetch.

Source: 


Link: https://www.canada.ca/en/public-health/news/2026/05/speaking-remarks-for-the-chief-public-health-officer0.html

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Thursday, May 21, 2026

#Ebola disease #outbreak caused by #Bundibugyo virus – #DRC and #Uganda – 2026, Threat Assessment (ECDC, May 21 '26, summary)

 



Summary  

    -- On 15 May 2026, Africa CDC reported an outbreak of Ebola disease in Ituri Province, DRC

    -- Laboratory analysis at Institut National de Recherche Biomedicale of DRC identified Bundibugyo virus (BDBV). 

    -- BDBV disease is a rare disease but can cause outbreaks with high case fatality rates. 

    -- Considering the available information, complicated context and the uncertainties on the epidemiological information WHO declared a Public Health Emergency of International Concern on 17 May 2026

    -- Africa CDC declared a Public Health Emergency of Continental Security on 18 May 2026.  

    -- This Threat Assessment Brief aims to assess the risk for people from the EU/EEA living in or travelling to affected areas and the overall risk of BDBV for the general population in the EU/EEA in the context of the ongoing outbreak of BDBV disease in DRC. 

    -- It is intended for public health authorities in EU/EEA countries and is based on currently available evidence. 

    -- It therefore carries considerable uncertainty

    -- Recommendations are also included for how public health authorities in the EU/EEA can strengthen preparedness and response capabilities. 


Epidemiological situation  

    -- Based on data reported by the World Health Organisation as at 20 May 2026, almost 600 suspected cases and 139 deaths among the suspected cases have been reported. 

    -- In DRC, 51 cases were confirmed in Ituri and North Kivu Provinces. 

    -- While two imported cases were confirmed in Kampala, Uganda

    -- At least five deaths had been reported among the confirmed cases as at 18 May, four in DRC and one in Uganda. 

    -- Due to the very recent declaration of the outbreak and the uncertainties related to the epidemiological information, it is probable that the outbreak is larger than what is currently being reported, not only regarding the number of affected cases but also to its geographical extent

    -- BDBV transmission requires direct contact with blood, or other bodily fluids of living or deceased infected people, or any surfaces and materials soiled by infectious fluids. 

    -- Transmission can also occur through contact with dead or live infected animals, including handling and/or consuming bushmeat, or by visiting caves or mines colonised by bats. 

    -- There are currently no licensed vaccines or specific treatments available for BDBV disease.  


Risk assessment 

    -- Although epidemiological information remains limited and there are important uncertainties, the likelihood of infection for people from the EU/EEA living in or travelling to affected areas is assessed as low, provided they adhere to the recommended precautionary measures. 

    -- Transmission requires direct contact with blood, secretions, organs, or other bodily fluids of dead or living infected people or animals; all unlikely exposures for the general EU/EEA travellers or expatriates in affected areas. 

    -- Staff members of humanitarian, religious and other organisations, particularly healthcare workers who are in direct contact with patients and/or local communities in the affected areas, are more likely to be exposed to the virus. 

    -- Provided they adhere to the appropriate infection prevention and control measures, the likelihood of infection for this group is also low.  

    -- The most likely route by which the virus could be introduced to the EU/EEA is through people with a BDBV infection travelling from affected areas to the EU/EEA. 

    -- During the Ebola disease outbreak in West Africa in 2013– 2016, which was the largest outbreak to date, where tens of thousands of cases were reported, with transmission in large urban centres, and hundreds of EU/EEA humanitarian and military personnel deployed to the affected areas, only a small number of imported cases to Europe were reported, most of them medically evacuated for treatment. 

    -- Based on this experience, it is expected that imported cases would be a rare event. 

    -- The likelihood of secondary transmission of BDBV within the EU/EEA and the occurrence of sustained chains of transmission within the EU/EEA is considered very low, as cases are likely to be promptly identified and isolated and recommended control measures would be implemented. 

    -- Although BDBV infection can cause severe disease in affected individuals, the population-level public health impact in the EU/EEA is expected to be very low because only very few cases would occur. 

    -- Therefore, the overall current risk of BDBV for the general population in the EU/EEA is assessed to be very low


Recommendations 

    -- EU/EEA countries should review and update the standard operating procedures on isolation and treatment for BDBV disease cases, and on contact tracing and quarantine for contacts of cases as needed.  

    -- EU/EEA public health authorities should

        1. Increase awareness among travellers to, and residents of affected areas, as well as returning travellers;  

        2. Increase awareness among health professionals on: 

            (i) the possibility of BDBV disease in travellers returning from affected areas;  

            (ii) the clinical presentation of the disease and the need to ask about the travel history and contacts of people returning from affected areas;  

            (iii) the availability of protocols for testing suspected cases;  

            (iv) infection prevention and control (IPC) procedures and appropriate management of suspected or confirmed cases.  

        3. Strengthen readiness to rapidly detect imported cases, promptly isolate them, and implement appropriate infection prevention and control measures. 

        4. Review testing capacity and BDBV diagnostic procedures. The EU reference laboratory for public health on Emerging, rodent-borne and zoonotic viral pathogens (EURL-PH-ERZV) offers diagnostic services to EU/EEA countries lacking capability to diagnose BDBV infection. 

        5. Minimise exposure in healthcare settings requires appropriate procedures, trained staff, and equipment for the safe management of BDBV cases. 

        6. Provide all returning travellers with clear information on symptoms, route of transmission, and what to do if symptoms develop after arrival in the EU/EEA: 

            - travellers who develop symptoms compatible with BDBV infection within 21 days after return should self-isolate, seek medical care promptly, and report their travel history and possible exposures. 

            - Exit screening in affected countries, including symptom checks and exposure assessment, is crucial as it contributes to risk reduction by identifying symptomatic travellers before boarding and preventing travel while symptomatic. 

            - Exit screening also helps dissuade ill people from travelling and enhance public and stakeholder confidence. However, it cannot fully prevent exportation of cases, because absence of symptoms at departure does not exclude subsequent onset of disease.  


ECDC actions 

    -- ECDC is monitoring the outbreak through its epidemic intelligence activities to provide epidemiological updates, situational awareness and assess the risk for the EU/EEA. 

    -- ECDC has deployed an expert through the EU Health Task Force to the Africa Centres for Disease Control and Prevention (Africa CDC) headquarters in Addis Ababa to support coordination and operational planning.  

    -- ECDC is in discussions with the European Civil Protection and Humanitarian Aid Operations (ECHO) and the Global Outbreak Alert and Response Network (GOARN) regarding the deployment of additional experts to support response activities in DRC and Uganda. 

    -- The European Union Reference Laboratory for public health on emerging, rodent-borne and zoonotic viral pathogens (EURL-PH-ERZV) offers support to the EU/EEA national reference laboratories for the diagnosis of BDBV infection, biosafety advice for handling and inactivation of samples, and also offers diagnostic services to EU/EEA countries for BDBV infection. 

(...)

Suggested citation: European Centre for Disease Prevention and Control. Threat assessment brief. Ebola disease outbreak caused by Bundibugyo virus, Democratic Republic of the Congo and Uganda – 2026. 21 May 2026. ECDC: Stockholm; 2026.    

© European Centre for Disease Prevention and Control, Stockholm, 2026  

ISBN 978-92-9498-886-7 | doi: 10.2900/9658441 | Catalogue number TQ-01-26-031-EN-N 

Source: 


Link: https://www.ecdc.europa.eu/en/publications-data/threat-assessment-brief-ebola-disease-outbreak-caused-bundibugyo-virus-democratic

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Wednesday, May 20, 2026

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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Sunday, May 17, 2026

Rapid #risk #assessment, acute event of potential public health concern: #Hantavirus #outbreak caused by #Andes virus (WHO, summary)

 


Risk statement

    -- This risk assessment provides an updated analysis of the current situation related to the hantavirus outbreak associated with the cruise ship MV Hondius

    -- The initial rapid risk assessment was issued on 5 May 2026 to the National International Health Regulations (IHR) Focal Points via the secure Event Information Site.

    -- The public health risk has been reassessed with the most current information available, and the global risk remains low

    -- The risk for passengers and crew who were onboard the cruise ship remains moderate, as individuals exposed prior to the implementation of control measures may still develop illness during the incubation period and should therefore be closely monitored. 

    -- This assessment takes into account that all the passengers have now disembarked and are under monitoring, although the ship continues with a reduced crew and a medical team to its home port. 

    -- It should also be noted that some passengers had disembarked in a limited number of other locations before the outbreak was identified and have likewise been placed under monitoring. 

    -- Additionally, identified passengers and crew members who travelled on associated flights are also under monitoring. 

    -- The assessment further considers identified risks, operational limitations, and the potential implications for ongoing public health response activities.

    -- Globally, hantavirus infections are considered a serious but generally low-incidence public health threat, primarily associated with environmental exposure to rodents and their excreta, with limited but important outbreak potential in specific geographic regions. 

    -- There are several variants of hantavirus, but Andes virus is the only hantavirus to have documented human-to-human transmission, which has been observed mainly in outbreaks in southern Argentina and Chile

    -- Hantavirus infection caused by Andes virus may cause hantavirus pulmonary syndrome (HPS; also called hantavirus cardiopulmonary syndrome, HCPS) and may lead to rapidly progressive severe respiratory distress and cardiogenic shock

    -- The case fatality rate (CFR) can reach up to 50%. 

    -- There is currently no approved antiviral treatment, and early clinical management remains primarily supportive.

    -- The current event is related to the notification on 2 May 2026, by the United Kingdom IHR National Focal Point to WHO of a cluster of severe acute respiratory illness cases aboard the Dutch-flagged cruise vessel MV Hondius. 

    -- The cluster initially included two deaths and one critically ill passenger, with the cause unknown at the time of notification. 

    -- On the same day, laboratory testing confirmed hantavirus infection in the critically ill passenger hospitalised in Johannesburg, South Africa. 

    -- Confirmation that the outbreak was caused by Andes virus was subsequently obtained on 5 May 2026 at the Geneva University Hospitals (HUG) laboratory in Geneva from a passenger that had disembarked earlier from the ship and returned to his home country with presentation of symptoms.

    -- The vessel departed from Ushuaia, Argentina on 1 April 2026, with 114 passengers and 61 crew, and followed an itinerary across the South Atlantic, including multiple stops in remote and ecologically diverse regions such as mainland Antarctica, South Georgia, Nightingale Island, Tristan da Cunha, Saint Helena, and Ascension Island. 

    -- During this period several passengers disembarked and embarked the ship at different stops, resulting in a total of 187 persons who were on the ship at some point during the journey. 

    -- From 11 April to 2 May, three passengers died

    -- On 3 May, MV Hondius moored off the coast of Cabo Verde where local health authorities visited the vessel to assess the condition of two remaining symptomatic individuals. These individuals and a high-risk contact were evacuated from the ship on 6 May, and the ship continued to the Canary Islands, Spain.

    -- The vessel arrived at the port of Granadilla, in Tenerife, Canary Islands, on 10 May, carrying 150 individuals, including 86 passengers, 60 crew members, and 4 health professionals from WHO, ECDC and the Netherlands. Passengers and crew represented 25 nationalities: Argentina, Australia, Belgium, Canada, the Democratic Republic of the Congo, France, Germany, Greece, Guatemala, India, Italy, Ireland, Japan, Montenegro, the Netherlands, New Zealand, Philippines, Poland, Portugal, the Russian Federation, Spain, TĂ¼rkiye, Ukraine, the United Kingdom, and the United States. 

    -- Passengers and most of the crew disembarked on 10 and 11 May and were repatriated to their respective countries of residence or transit points via specially arranged non-commercial flights, with WHO and partners supporting the disembarkation process. The ship left the Canary Islands on 11 May and is sailing to the Netherlands, with 25 crew members remaining on board, along with two Dutch health care workers to conduct their health monitoring and provide any healthcare that may be necessary.

    -- As of 15 May 2026, 10 cases (eight confirmed, and two probable cases), including three deaths (two confirmed and one probable), have been reported (CFR 30%). The contact from the United States of America that was previously reported as inconclusive has now been determined to be negative by serology.

    -- Of the eight laboratory-confirmed cases, three were genetically sequenced and identified as Andes virus

    -- Since the last RRA published on 5 May 2026, two additional confirmed cases (France=1, Spain=1) have been reported among the passengers. No secondary cases have been reported outside of the ship.

         Epidemiological investigations traced the travel history of the first two cases, a couple who had spent approximately five months birdwatching across South America. This included visits to several areas where Oligoryzomys are known to occur and includes areas where Andes cases have been recorded in the past. Evidence suggests subsequent human-human transmission onboard the ship. This is also supported by a preliminary analysis of the sequences, which show a near-identical sequence from different cases.

        • Andes virus outbreaks that human-to-human transmission is limited, tends to remain clustered, and generally requires prolonged exposure. It can also be rapidly contained with control measures in place. However, infectious diseases pose an increased risk on cruise ships due to close living quarters, shared enclosed spaces, prolonged exposure, and frequent interpersonal contact, all of which can facilitate transmission. As a result, additional sporadic cases may still occur among previously exposed passengers and crew members.

        • While additional cases may still occur among passengers and crew members exposed before containment measures were implemented, the risk of onward transmission is expected to be reduced following disembarkation and the implementation of control measures, including rapid identification and isolation of suspected cases. There is no approved antiviral treatment for HPS; suspected cases require prompt medical evaluation, close monitoring, and supportive management, including intensive care where necessary.

    -- Consequently, the overall risk at the global level remains assessed as Low.

    -- The epidemiological situation will continue to be monitored, and the risk assessment will be updated as needed.

(...)

Source: 


Link: https://www.who.int/publications/m/item/who-rapid-risk-assessment---hantavirus-outbreak-caused-by-andes-virus--global-v.2

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