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

Friday, May 1, 2026

Rapid #risk #assessment: #Chikungunya virus disease, #Global (WHO, 24 April 2026, v2, summary)



{Summary)

Overall Risk statement

-- This rapid risk assessment aims to assess the overall public health risk posed by chikungunya virus (CHIKV) transmission in 2026 at the global level

-- It considers the potential risk to human health, the likelihood of geographical spread, limitations in prevention and control capacities, and the influence of regional seasonal patterns that favour Aedes mosquito activity, which could drive outbreaks during the 2026 transmission season. 

-- Chikungunya virus poses a significant and growing global health risk due to large and widespread regional outbreaks in recent years, lack of specific treatment, limited use of vaccine, and climate- and conveyance-driven mosquito range expansion, with increasing international travel. 

-- While mortality remains relatively low, the CHIKV infection can cause prolonged arthritis with disability as well as severe illness in some patients.

-- In 2025, an overall of 502 264 CHIKV disease cases including 208 335 confirmed cases, and 186 deaths were reported globally from 41 countries and territories, including autochthonous and imported cases in travellers

-- From 1 January to 31 March 2026, Chikungunya transmission was reported by 18 countries, with the vast majority of cases occurring in the Region of the Americas

-- Brazil and Bolivia account for 87% of cases in the Region; together with Argentina, Suriname, and Cuba, these five countries represent approximately 99% of reported cases

-- The European Region reported the second-highest number of cases, predominantly reported from French overseas departments, particularly Mayotte and La Réunion

-- Global aggregation is limited due to incomplete reporting.

-- With the rainy season about to begin in many regions in the coming months, cases of CHIKV are expected to rise, as rainfall events create favourable conditions for Aedes mosquito breeding and increase the risk of CHIKV transmission, including in previously unaffected areas. 

-- Transmission dynamics will also be impacted by the population immunity acquired from outbreaks in recent years. 

-- Peak CHIKV transmission months in the respective WHO regions include:

• Southeast Asia & Western Pacific: May–October

• Americas: May–November (Northern hemisphere)/November–March (Southern hemisphere)

• Continental Europe: June–September (main season) (transmission in overseas departments aligns with climatic conditions within their geographic location/proximity)

• Africa & Eastern Mediterranean: During/after local rainy seasons (varies by country)

-- The global public health risk posed by CHIKV transmission is assessed as moderate

-- This takes into account the widespread transmission and outbreaks across multiple WHO regions in 2025, which continued into early 2026, including in areas with previously low or no transmission. 

-- Ongoing transmission in parts of the Indian Ocean region, such as Seychelles, Mauritius and Mayotte demonstrates continued regional activity. 

-- The resurgence and emergence of cases in new geographic areas are facilitated by the presence of competent Aedes mosquito vectors, limited population immunity, favorable environmental conditions, and increased human mobility coupled with under-performing/disrupted health systems, particularly in fragile, conflict-affected and vulnerable countries- leading to poor control measures.

-- The uneven distribution of cases across regions complicates the interpretation of a global trend but highlights significant localized transmission. 

-- Prevention and control capacities remain challenged by gaps in surveillance, equitable access to quality-assured diagnostics and laboratory confirmation, healthcare infrastructure, and sustained vector surveillance and control management.

(...)

Source: 


Link: https://www.who.int/publications/m/item/who-rapid-risk-assessment---chikungunya-virus-disease--global-v.2

____

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

Emergence of D1.1 #reassortant #H5N1 avian #influenza viruses in North #America

 


Abstract

Since 2021, highly pathogenic avian influenza viruses (HPAIVs) belonging to H5N1 clade 2.3.4.4b have circulated widely in North American wild birds and repeatedly spilled over into mammals. In 2025, the first H5N1-associated deaths in humans were recorded in the Western hemisphere, raising questions about how the ongoing evolution of the virus in wild birds impacts spillover risk. Here, our analysis of 21,471 H5N1 genomes identified an evolutionary shift in mid-2024, driven by interhemispheric migration from Asia and reassortment with new antigens. The genotypes that dominated the early years of North America's H5N1 epizootic traced their ancestry back to Europe, but Asia was the source of new "D1.1" genotype viruses that (a) spread faster, (b) have higher reassortment potential, (c) a broader host range, (d) repeatedly spill over to bovines, and (e) cause severe disease in humans, including non-farm workers.


Competing Interest Statement

The authors have declared no competing interest.


Funder Information Declared

Research Foundation - Flanders, https://ror.org/03qtxy027, G098321N, G0E1420N

European Union Horizon 2023 RIA project LEAPS, 101094685

DURABLE EU4Health project 02/2023-01/2027, 101102733

Fonds National de la Recherche Scientifique, F.4515.22

European Union Horizon 2020 project MOOD, 874850

Centers of Excellence for Influenza Research and Response, National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), Department of Health and Human Services, 75N93021C00014

Source: 


Link: https://www.biorxiv.org/content/10.64898/2025.12.19.695329v2

____

Saturday, April 18, 2026

#Taiwan #CDC issued a #statement regarding journal research on transmission of viruses from farmed #shrimp in #China to #humans (Apr. 18 '26)

 


Recently, online discussions have focused on a study published in the international journal *Nature Microbiology*, which suggests that *Cryptant Dead Noda Virus* (CMNV), found in aquatic animals, may have the potential to spread across species to humans, potentially causing persistent high-tension viral anterior uveitis (POH-VAU). 

The Centers for Disease Control (CDC) stated that currently only China has reported suspected human cases of CMNV, distributed across 18 provinces with high aquaculture activity

Major international public health organizations such as the WHO, the US CDC, and the European Centre for Disease Prevention and Control (ECDC) have not reported any CMNV-related cases or listed it as an urgent threat. 

The CDC assesses the risk of domestic transmission as extremely low and will continue monitoring with agricultural authorities.

The CDC further explained that the study infers that human infection with CMNV may be related to handling or consuming raw seafood; however, further evidence is needed to confirm whether this virus has the ability to effectively infect human eye tissue. 

The Taiwan Centers for Disease Control (CDC) emphasizes that there have been no large-scale human outbreaks or community transmission events caused by CMNV globally at present, and there is no evidence of infection through the general consumption of cooked seafood

The CDC will continue to monitor relevant international outbreaks, develop human specimen testing technologies and methods, and establish relevant sampling and testing conditions for risk monitoring and early warning.

According to the monitoring of the Animal and Plant Health Inspection and Quarantine Bureau of the Ministry of Agriculture, there have never been any CMNV outbreaks in shrimp farms in Taiwan. 

The CDC's overall assessment is that the risk of domestic transmission is extremely low, but both agriculture and health authorities will continue to strengthen monitoring. 

CMNV has been listed as an emerging infectious disease by the World Organisation for Animal Health, and infection cases have been reported in shrimp farms in China and Thailand

The CDC urges travelers to China and Thailand to take special precautions against CMNV, including thoroughly cooking seafood, avoiding raw seafood for high-risk groups (such as those with chronic diseases), wearing gloves when handling raw seafood, avoiding direct contact with raw food if hands are open, and washing hands thoroughly with soap and water after handling to reduce the risk of infection by various pathogens.

Source: 


Link: https://www.cdc.gov.tw/Bulletin/Detail/JAKoFRedyjAVo_zmdBsCfQ?typeid=9

____

Monday, April 13, 2026

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

 


ABSTRACT

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


IMPORTANCE

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

Source: 


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

____

#Genomic similarity to quantitatively evaluate the #reassortment #potential of #H7N9 with other subtypes of avian #influenza viruses

 


Abstract

Introduction

The H7N9 influenza virus poses a significant public health threat due to its potential for reassortment and cross-species transmission. This study aims to systematically evaluate the genomic similarity between H7N9 and other influenza A subtypes to identify strains with high reassortment potential and characterize their spatiotemporal and host distribution patterns.

Methods

We analyzed nearly 4,000 H7N9 sequences from GISAID and NCBI, alongside representative sequences of other influenza A subtypes. Open reading frames were extracted, and a genomic similarity index was constructed using Euclidean distance, dot product, and cosine similarity measures, with weights optimized via principal component analysis. The index was applied to quantify inter-subtype similarity and predict reassortment-prone strains.

Results

High sequence similarity was observed between H7N9 and cognate subtypes (e.g., H7N3, H15N9), with H7N3 exhibiting the highest similarity index (1.00). Validation using known reassortant strains, such as A/Yixing/805/2022 (H3N2), confirmed that strains with high reassortment potential showed significantly elevated similarity scores across all gene segments (p< 0.001). High-similarity outliers analysis identified 581 spillover events, temporally concentrated during 2014–2017, and spatially clustered in regions like the United States, Europe, and Hong Kong. Host analysis highlighted birds—especially chickens, ducks, and turkeys—as key reservoirs for reassortment.

Discussion

The genomic similarity index effectively identifies influenza A subtypes with high reassortment potential, supported by retrospective validation and spatiotemporal congruence with documented outbreaks. The concentration of high-similarity strains in specific hosts and regions underscores the role of ecological factors in viral evolution. These findings provide a predictive framework for monitoring emergent reassortants and inform targeted surveillance strategies.

Source: 


Link: https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2026.1777911/full

____

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

____

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

 


(...)

Key Points

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(...)

Source: 


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

____

Wednesday, April 8, 2026

#Genetic and #biological characterization of a #duck-origin clade 2.3.4.4b #H5N6 avian #influenza virus reveals partial #mammalian #adaptation

 


Highlights

• Duck-origin H5N6 virus A/Duck/Jiangsu/628/2022 shares high homology with the human strain A/Yangzhou/125/2022.

• The 628 strain shows mammalian adaptation markers: HA mutations enhance human receptors affinity and NA mutations reduce sensitivity to neuraminidase inhibitors.

• Limited airborne transmission but detectable droplet-mediated spread suggests increased mammalian transmission risk.


Abstract

Clade 2.3.4.4b H5Nx highly pathogenic avian influenza viruses (HPAIVs) have caused extensive outbreaks in poultry worldwide. H5 HPAIVs have caused sporadic but severe human infections in China, representing a persistent zoonotic threat. Here, we identified a duck-origin H5N6 HPAIV (A/Duck/Jiangsu/628/2022) through routine surveillance and assessed its biological characteristics and mammalian pathogenesis. Phylogenetic analysis revealed > 98% nucleotide identity between strain 628 and the concurrent human H5N6 strain A/Yangzhou/125/2022. Molecular characterization identified multiple mammalian adaptation markers: hemagglutinin substitutions (S137A, T160A, T192I) associated with enhanced human receptor binding; neuraminidase mutations (I117T, D198N) linked to reduced neuraminidase inhibitor susceptibility; and polymerase complex changes (PB1-D622G, PA-K142Q) conferring increased mammalian cell replication. In vitro studies demonstrated that 628 virus replicated more efficiently in mammalian than in avian cells and exhibited dual receptor-binding specificity. Mouse pathogenicity assays revealed moderate virulence with progressive lung pathology. Critically, transmission experiments confirmed both direct contact and airborne transmission capabilities of 628 in guinea pigs. These findings demonstrate that circulating H5N6 viruses have acquired partial mammalian adaptation while retaining avian fitness, significantly elevating pandemic potential. Enhanced surveillance of wild bird populations, poultry farms, and live poultry markets is urgently needed to develop effective prevention and control strategies.

Source: 


Link: https://www.sciencedirect.com/science/article/abs/pii/S037811352600146X?via%3Dihub

____

My New Space

Most Popular Posts