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/

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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

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Rift Valley #fever [#RVFV] - #Mauritania and #Senegal (#WHO, D.O.N., Nov. 6 '25)

 

Situation at a glance

Between 20 September and 30 October 2025, a total of 404 confirmed human cases of Rift Valley fever (RVF), including 42 deaths, were reported by national health authorities in two West African countries: Mauritania and Senegal. 

RVF is a zoonotic disease, which mainly affects animals, but can also infect humans. 

The majority of human infections result from contact with the blood or organs of infected animals, but human infections have also resulted from the bites of infected mosquitoes. 

To date, no human-to-human transmission of RVF has been documented. 

While RVF often leads to severe illness in animals, its impact in humans varies, ranging from mild flu-like symptoms to severe hemorrhagic fever that can be fatal. 

RVF is endemic in both countries, where recurrent outbreaks have been previously reported in both livestock and humans. 

The risk of further spread remains high, especially with environmental conditions favorable to the proliferation of mosquitoes, periods of heavy rains and increased mosquito activity, as well as movements of livestock within country and towards Mali and Gambia for grazing and trade. 

The response to RVF outbreaks requires a One Health approach, based on enhanced collaboration between the human health, animal health and environmental sectors, in both countries and at the regional level. 

WHO, in collaboration with the World Organization for Animal Health (WOAH), and the Food and Agriculture Organization of the United Nations (FAO), currently assesses the overall risk as high at the national levels, moderate at the regional level and low at the global level.

(...)

Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON584

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Joint #FAO / #WHO / #WOAH Rapid #Risk #Assessment of Rift Valley fever (#RVF) in #Senegal and #Mauritania: Implications for Public Health and Animal Health (Oct. 24 '25)

 

{Excerpt}

Risk statement

This risk assessment is based on the current epidemiological and epizootic situation of Rift Valley fever (RVF) in Senegal and Mauritania, from 20 September through 8 October 2025.

The risk assessment was conducted separately for each country. However, the findings indicate that the level of risk is the same for both countries across all levels, for both human and animal health.  

During this period, Senegal reported 119 confirmed human RVF cases, including 16 deaths, resulting in a case fatality rate (CFR) of 13.4%. Cases were recorded across eight health districts in three regions of Senegal, with the majority in Saint-Louis Region with 110 cases (92%) followed by Louga (four cases) and Matam (one case). 

The affected districts in Saint-Louis Region: Podor, Richard-Toll, Dagana, and Saint-Louis are located along the northern border with Mauritania along the Senegal River.  

The most affected age groups were 15- 35 years, accounting for 69 cases (58%), and 35-60 years with 34 cases (29%), with 77 % of cases occurring in males. 

Hemorrhagic symptoms were reported in 22 cases (18%) of which 13 resulted in death.  

Animal infections resulting in abortions and livestock mortality were also reported. 

On 23 September, 1122 blood samples and four abortion samples were collected from small ruminant herds in villages where human cases were reported. 

Of these, 36 samples tested positive across six herds. 

By 30 September, a total of 27 confirmed animal cases, two deaths have been reported to the World Organisation for Animal Health (WOAH) through the World Animal Health Information System (WAHIS). 

As of that date, five animal outbreaks have been confirmed in Saint-Louis Region, with four additional outbreaks expected to be included in a forthcoming follow-up report currently in draft.  

RVF is endemic in Senegal, with previous outbreaks affecting both humans and animals. 

The last confirmed human case before this outbreak occurred in January 2025 in Touba, located in the Diourbel region, while the last recorded human case in Saint-Louis region occurred in 2022.   

Between 27 September and 5 October 2025, Mauritania reported 17 confirmed human RVF cases, including eight deaths, resulting in a CFR of 47%. 

Cases were recorded across seven districts in five regions (wilayas), three of which have international borders: Assaba which borders Mali to the south, Brakna and Trarza both bordering Senegal along the Senegal River. 

Of 66 samples tested, the positivity rate was 25.7%.  

Multiple active outbreaks in animals have also been reported. According to the Ministry of Animal Resources of Mauritania, as of 6 October, 17 outbreaks across eight regions, with 86 out of 307 samples testing positive. 

The first animal cases, involving goats and camels, were reported in August 2025. A total of 39 clinical animal cases (including 16 deaths in two dromedaries and 14 goats) were reported in Aioun, Hodh-Gharbi region and Timbedra, Hodh-Charghi region, both are located in southeastern Mauritania near the Mali border, and in Maghta Lahjar, Brakna region, in central Mauritania.  

In Brakna region alone, 233 animal cases and 55 deaths have been reported to WOAH by 3 October 2025. 

Affected animals include sheep, goats, camels and cattle.  

RVF is endemic in Mauritania. The last major outbreak occurred in 2022, with 47 confirmed human cases, including 23 deaths (CFR 49%), mostly among animal breeders in nine of 15 regions. 

The virus also affected animals such as cattle, camels, and small ruminants, with sample positivity rates of around 24% tested during that outbreak period.  

The current outbreak in Senegal and Mauritania is unusual in both its magnitude and severity. It involves multiple districts in border regions, particularly along the Senegal River, increasing the risk of cross-border transmission between Senegal and Mauritania. 

In Mauritania, the outbreak also extends to eastern regions bordering Mali, raising concerns about potential regional spread beyond the Senegal River basin.  

A notably high proportion of severe and haemorrhagic cases has been reported. In Senegal, 18% of confirmed human cases presented with haemorrhagic symptoms, with 13 cases resulting in death.  

The situation is particularly concerning in Mauritania, where the CFR has reached 47%, reflecting both the severity of illness and potential gaps in early detection and clinical management. 

Further information is needed to better understand the factors contributing to this high fatality rate. 

Possible contributing factors include delayed access to adequate care, shortage of essential medical products and supplies and underreporting of mild cases, which may result in disproportionate detection of severe cases. However, additional factors should also be investigated.  

(...)

Source: World Health Organization, https://www.who.int/publications/m/item/joint-fao-who-woah-rapid-risk-assessment-of-rift-valley-fever-(rvf)-in-senegal-and-mauritania--implications-for-public-health-and-animal-health

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#Portimine A #toxin causes #skin #inflammation through ZAKα-dependent NLRP1 inflammasome activation

Abstract

In 2020–2021, a “mysterious illness” struck Senegalese fishermen, causing severe acute dermatitis in over one thousand individuals following exposure through drift-net fishing activity. Here, by performing deep analysis of the environmental samples we reveal the presence of the marine dinoflagellate Vulcanodinium rugosum and its associated cyclic imine toxins. Specifically, we show that the toxin PortimineA, strongly enriched in environmental samples, impedes ribosome function in human keratinocytes, which subsequently activates the stress kinases ZAKα and P38 and promotes the nucleation of the human NLRP1 inflammasome, leading to the release of IL-1β/IL-18 pro-inflammatory cytokines and cell death. Furthermore, cell-based models highlight that naturally occurring mutations in the P38-targeted sites of human NLRP1 are unable to respond to PortimineA exposure. Finally, the development and use of human organotypic skins and zebrafish models of PortimineA exposure demonstrate that the ZAKα-NLRP1 axis drives skin necrosis and inflammation. Our results exemplify the threats to human health caused by emerging environmental toxins and identify ZAKα and NRLP1 as important pharmacological targets to mitigate PortimineA toxicity.

Source: EMBO Molecular Medicine, https://www.embopress.org/doi/full/10.1038/s44321-025-00197-4

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Clinical #Features of #Human #Parvovirus B19-Associated #Encephalitis Identified in the #Dakar Region, #Senegal, and Viral Genome Characterization

Abstract

Neurological manifestations associated with human parvovirus B19 (B19V) infections are rare and varied. Acute encephalitis and encephalopathy are the most common, accounting for 38.8% of all neurological manifestations associated with human B19V. Herein, we report on the clinical features of 13 laboratory-confirmed human cases of B19V-associated encephalitis in Senegal in the framework of a hospital-based surveillance of acute viral encephalitis conducted from 2021 to 2023. Overall, B19V was detected from 13 cerebrospinal fluid samples using specific real time PCR. The mean age was 16.7 years among B19V-positive patients, with a higher prevalence in 0–5-year-old children and the sex ratio (male/female) was 2.25. The B19V-positive patients mainly exhibited hypoleukocytosis, normal glycorrhachia, and normal proteinorrachia in the cerebrospinal fluid. While the main neurological symptoms included meningeal and infectious syndromes. Furthermore, three complete B19V genome sequences were successfully characterized using next-generation sequencing. The newly characterized sequences belonged to the genotype 1a and represent, to date, the first complete B19V genome sequences from Senegal. These sequences could be useful not only in future phylodynamic studies of B19V but also in the development of prevention or treatment countermeasures. Our study is noteworthy for the identification of acute B19V-associated encephalitis in Senegal More investigations on the risk factors associated with B19V transmission in Africa are warranted.

Source: Viruses, https://www.mdpi.com/1999-4915/17/1/111

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#Genetic and #Molecular Characterization of Avian #Influenza A(#H9N2) Viruses from Live #Bird #Markets (LBM) in #Senegal

Abstract

Despite extensive experience with influenza surveillance in humans in Senegal, there is limited knowledge about the actual situation and genetic diversity of avian influenza viruses (AIVs) circulating in the country, hindering control measures and pandemic risk assessment. Therefore, as part of the “One Health” approach to influenza surveillance, we conducted active AIV surveillance in two live bird markets (LBMs) in Dakar to better understand the dynamics and diversity of influenza viruses in Senegal, obtain genetic profiles of circulating AIVs, and assess the risk of emergence of novel strains and their transmission to humans. Cloacal swabs from poultry and environmental samples collected weekly from the two LBMs were screened by RT-qPCR for H5, H7, and H9 AIVs. Subsequently, a subset of H9-positive samples was selected for whole sequencing. From December 2023 to October 2024, 499 samples were tested, and AIV was detected in 58.3% of them. Among these, A/H9N2 was the only subtype detected in both markets, with a detection rate of 47.7% (82/172) in Thiaroye and 35.3% (42/119) in Tilene, resulting in an overall positivity rate of 42.6% (124/291). Genome sequencing of 22 A/H9N2 isolates, including 11 poultry drinking water samples, 7 carcass wash water samples, 3 fecal samples, and 1 cloacal swab, yielded 7 complete and 15 partial genomic sequences. Phylogenetic analyses of the resulting sequences showed that the A/H9N2 isolates obtained in this study formed a monophyletic cluster and were closely related to the Senegalese human strain (A/Senegal/0243/2019) identified through the national influenza sentinel surveillance program. These strains were also closely related to the A/H9N2 viruses of the G1 lineage circulating in neighboring countries, suggesting cross-border transmission. The A/H9N2 strains carried the low pathogenicity RSSR/GLF motif at the HA cleavage site and possessed several key amino acid mutations, including HA-I155T and HA-Q226L, which are associated with human host adaptation, PB2-T105V, PB2-A661T, and PB2-A588V, which are linked to the human-to-human transmission and increased polymerase activity, NS2-T14M, NS2-M100I, NS1-I106M, NS1-V222M, NS1-E223A, NS1-I226V, NS1-E227G, and NS1-P228S, which are known to alter virulence (increased or reduced) in humans or mice, and M2-S31N, which promotes drug resistance. Seven potential N-glycosylation sites were predicted in the HA protein and six in the NA protein. The selection pressure analysis revealed that the A/H9N2 isolates were primarily under neutral evolution or purifying selection pressure. Overall, our findings highlight the potential for cross-species transmission of Senegalese A/H9N2 viruses, emphasizing the need for sustained monitoring of these viruses in both animal and human populations.

Source: Viruses, https://www.mdpi.com/1999-4915/17/1/73

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