#India - High pathogenicity avian #influenza #H5N1 viruses (Inf. with) (#poultry) - Immediate notification

 

Poultry farms in Andhra Pradesh State.

Source: 

Link: https://wahis.woah.org/#/in-review/7268

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#India - #Influenza A #H5N1 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

{By Pkspks - Own work, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=162556362}

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More than 300 House Crows in Bihar: Darbhanga, Patna, Bhagalpur, Katihar, Pashchim Champaran Regions. 

Source: 

Link: https://wahis.woah.org/#/in-review/7269

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#Baloxavir outperforms #oseltamivir, #favipiravir, and #amantadine in treating lethal #influenza #H5N1 HA clade 2.3.4.4b #infection in #mice

 

Abstract

Intercontinental spread of highly pathogenic avian influenza A(H5N1) viruses poses significant pandemic risks and necessitates strong protective countermeasures. We evaluated the therapeutic efficacy of the neuraminidase inhibitor oseltamivir, the polymerase inhibitors baloxavir and favipiravir, and an ion-channel blocker amantadine, against severe influenza A(H5N1) virus infection in female BALB/c mice. Baloxavir (≥10 mg/kg, 1 dose) fully protected mice from death, significantly reduced virus respiratory replication, and prevented neuroinvasion. Oseltamivir (≥100 mg/kg/day for 5 days) provided limited survival benefits, reduced lung titers but failed to prevent viral neuroinvasion. Favipiravir (≥100 mg/kg/day for 5 days) provided partial protection, although did not reduce viral titers in lungs and brain. Amantadine provided no benefits. Although all drugs inhibited A(H5N1) viruses in vitro, in vivo correlations did not extend beyond baloxavir. Our results indicate that baloxavir is the most reliable treatment to address both respiratory replication and systemic spread of contemporary A(H5N1) viruses in mice and should be considered in pandemic planning.

Source: 

Link: https://www.nature.com/articles/s41467-026-69721-5

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Evaluating the broader #impact of improved #influenza #vaccines: A full value of vaccine #assessment approach

 

Highlights

• Global Health Impact: Improved influenza vaccines have the potential to avert between 6.6 and 18 billion additional influenza cases, prevent 2.3 to 6.2 million additional deaths, and save 21 to 57 million disability-adjusted life years (DALYs) globally beyond those averted by current seasonal influenza vaccines

• Cost-Effectiveness: Depending on the price, coverage, and vaccine characteristics, improved influenza vaccines could be cost-effective in 9 to 48 % of countries, offering substantial global economic value under most scenarios

• Financial Viability: The development and commercialization of improved influenza vaccines present a robust financial value proposition, with positive net present value (NPV) across all vaccine profiles

• Policy and Decision Making: Vaccine efficacy, duration of protection, and breadth of protection are key factors influencing the adoption of improved influenza vaccines in national immunization programs

• Implementation Challenges: Addressing barriers such as vaccine hesitancy, financial constraints, and logistical difficulties is crucial for maximizing the health and economic benefits of improved influenza vaccines

Abstract

Seasonal influenza remains a significant global public health challenge, causing substantial morbidity and mortality each year and there remains a need for more effective and durable influenza vaccines. To direct and accelerate research efforts, a full value of vaccine assessment (FVVA) was initiated to quantify the value of next-generation, improved influenza vaccines and identify key challenges that may limit their uptake once available. The FVVA utilized a mixed-methods approach with rapid assessment of literature, stakeholder interviews, and surveys, and quantitative data analysis to estimate the full value of influenza vaccines with improved characteristics. These analyses found that if improved influenza vaccines are broadly employed, depending on their characteristics, using our demand forecast they could avert 6.6–18 billion additional influenza cases, 2.3–6.2 million additional influenza deaths, and 21–57 million disability-adjusted life years (DALYs) between 2025 and 2050 beyond those averted by current seasonal influenza vaccines. Under this scenario, introducing improved influenza vaccines could be cost-effective in 9–48 % of countries at the lowest assumed price point. However, uncertainties about price and future vaccine coverage may impact the potential cost-effectiveness. Furthermore, from the producer perspective, the FVVA highlighted the robust financial value proposition to develop and commercialize improved influenza vaccines, in both established and emerging markets. Strongly tiered prices could make these vaccines cost-effective in more countries and boost impact further. To ensure that improved influenza vaccines achieve the greatest public health benefit, effective collaboration between vaccine developers, vaccine manufacturers, donors, financiers, multilateral organisations, and policy- and decision-makers will be essential.

Source: 

Link: https://www.sciencedirect.com/science/article/pii/S0264410X25014641

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Impact of an #aminoacid #deletion detected in the #hemagglutinin (HA) #antigenic site of swine #influenza A virus field strains on HA antigenicity

 

ABSTRACT

Swine influenza A virus (swIAV) is an important pathogen with regard to both the swine industry and public health. The pandemic A(H1N1) 2009 outbreak was caused by the swine-origin pandemic A(H1N1) 2009 [A(H1N1)pdm09] virus. Several reports have shown that several amino acid substitutions in the hemagglutinin (HA) antigenic sites can alter HA antigenicity. However, the impact of the amino acid deletion at position 155 on HA antigenicity remains unknown. In this study, we have isolated 11 samples of swIAVs from seven pig farms in Japan and found an amino acid deletion at position 155 of the HA region in one of the isolates of the H1N2 subtype. To examine the impact of this amino acid deletion on viral replication and HA antigenicity, we generated recombinant influenza A viruses possessing the H1 HA gene encoding either an artificial insertion or deletion of glycine at position 155. The growth kinetics of these recombinant viruses in two different cell lines demonstrated that the effect of amino acid deletion at position 155 of H1 HA on viral replication is limited. In contrast, microneutralization assay-based neutralization titers revealed that amino acid deletion significantly altered HA antigenicity. These results demonstrate that a naturally occurring amino acid deletion at position 155 in an H1 HA antigenic site can markedly alter HA antigenicity with only a limited impact on replication in vitro, highlighting the need to monitor such variants in swine populations and to assess their zoonotic potential.

Source: 

Link: https://journals.asm.org/doi/full/10.1128/jvi.01820-25?af=R

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#Prognostic factors in #H7N9 avian #influenza: a systematic review based on case reports

 

Abstract

Objective

The H7N9 avian influenza virus, identified in China in 2013, has posed a significant threat to public health due to its high mortality rate. This systematic review aims to evaluate the clinical characteristics and mortality risk factors of H7N9 patients.

Methods

English and Chinese databases (PubMed, Web of Science, Embase, CNKI, VIP, Wanfang) were searched for studies on laboratory-confirmed H7N9 cases with available data on symptom onset, diagnosis time, clinical features, oseltamivir administration, and outcomes. Univariate and multivariate analyses were performed on the pooled case data to assess the relationship between clinical factors and mortality risk.

Results

A total of 166 studies including 237 H7N9 cases were analyzed, with an overall mortality rate of 41.77%. Univariate analysis showed higher mortality in patients with advanced age ≥ 66 years (62.50%), those with underlying diseases (60.20%), those who received oseltamivir ≥ 8 days after symptom onset (54.17%), and those diagnosed ≥ 11 days after onset (62.75%), whereas patients treated with oseltamivir within 2 days of onset had the lowest mortality (17.39%). Multivariate analysis identified advanced age ≥ 66 years (OR = 3.10, 95% CI: 1.07–8.99, P = 0.037) and delayed oseltamivir administration after symptom onset (OR = 4.63, 95% CI: 1.12–19.18, P = 0.034) as independent predictors of mortality, while sex, underlying diseases, and onset-to-diagnosis time were not statistically significant.

Conclusion

Older age and delayed initiation of oseltamivir are key independent predictors of mortality in H7N9 infection. Prompt diagnosis is crucial to facilitate early antiviral treatment, which may improve survival. Future prospective studies are needed to validate these findings and optimize clinical management.

Clinical trial registration

Not applicable.

Source: 

Link: https://link.springer.com/article/10.1186/s12879-026-12908-4

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Multiple Introductions of Highly Pathogenic Avian #Influenza Viruses into the High #Arctic: #Svalbard and Jan Mayen, 2022 - 2025

 

Abstract

Between 2022 and 2025, highly pathogenic avian influenza viruses (HPAIVs) of clade 2.3.4.4b, including four distinct H5 Eurasian (EA) genotypes, were detected in wild birds and mammals in the Svalbard Archipelago and on the island of Jan Mayen. We describe their epidemiology and genomic characteristics to improve understanding of HPAIV occurrence and transmission in the High Arctic. The initial cases in 2022 occurred during summer and involved a glaucous gull (Larus hyperboreus) and great skuas (Stercorarius skua) on Svalbard and Jan Mayen, representing the first detections of HPAIVs in the High Arctic. Three HPAIV genotypes were identified: EA-2020-C (H5N1), EA-2021-AB (H5N1), and EA-2021-I (H5N5). In 2023, HPAIVs were detected in a broader range of bird species, and retrospectively in an Atlantic walrus reported by another research group (Odobenus rosmarus rosmarus). Genotypes identified in 2023 were EA-2020-C (H5N1), EA-2021-I (H5N5), and EA-2022-BB (H5N1). No cases were reported in 2024. In 2025, EA-2021-I (H5N5) was detected in Arctic foxes (Vulpes lagopus) on Svalbard, without preceding detections in wild birds. The foxes exhibited neurological symptoms, and necropsy of one individual revealed the presence of feathers in its stomach. All sequenced viruses from the Arctic foxes uniquely carried the combination of PB2-E627K and PB1-H115Q, which is associated with mammalian adaptation. The detection of multiple genotypes indicates repeated and independent introductions of HPAIVs into these regions. The co-circulation of genetically distinct virus strains in areas of high bird density further suggests that Arctic breeding grounds may facilitate local viral amplification, reassortment, and subsequent dissemination along migratory flyways, including transcontinental spread.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

EU4Health, 101132473

The Research Council of Norway, https://ror.org/00epmv149, 352880

The SEAPOP program, 192141

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.02.17.706283v1

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#MPOX, Multi-Country: Rapid #risk #assessment, 7 February 2026, v6 (#WHO, Feb. 18 '26)

 

{Excerpt}

Overall Global Risk Statement  

-- This global rapid risk assessment (RRA) aims to assess the current public health risk associated with the 2024 upsurge of mpox in in Africa, in the context of the continuing global reporting of mpox cases in other regions since 2022, with a focus on updates since the previous RRA in September 2025.    

Global overview 

-- As of 28 January 2026, the monkeypox virus (MPXV) continues to spread globally, causing both localized and extended mpox outbreaks driven by various MPXV clades (Ia, Ib, IIa, and IIb) in diverse settings. 

-- Furthermore, recombination of MPXV clades has been documented, with two cases of a recombinant clade Ib/IIb MPXV strain reported in recent months.  

-- Globally, from 1 January 2022 to 31 December 2025 (latest global data available), 143 countries and territories across all WHO regions have reported 177 848 confirmed cases, including 477 deaths (case fatality ratio [CFR] – 0.3%). 

-- This marks an increase of five additional reporting countries (Kuwait, Mali, Madagascar, Namibia and Senegal), along with an additional 19 423 confirmed cases and 78 deaths since the last RRA in September 2025. 

-- Since the last RRA, an average of 616 new confirmed mpox cases per week have been reported across all affected countries.

-- In addition, in January 2026, the Comoros and the French departments of Mayotte and la Réunion have reported cases linked to travel to Madagascar.  

-- Previous versions of this RRA have categorized risk based on MPXV clade. However, in absence of substantial data suggesting differences in the mode of transmission between different MPXV clades, and with relatively limited data suggesting higher case fatality for clade Ia MPXV compared to other clades, this version of the RRA assesses the risk for three population groups:

- global risk for individuals with multiple sexual partners, 

- local risk for children in mpox historically endemic areas, and 

- global risk for all other individuals.   

Individuals with multiple sexual partners – global risk  

-- Since the start of the global mpox outbreak in 2022, sexual activity in linked sexual networks has been the primary driver of sustained transmission and geographic spread, particularly in newly affected areas. 

-- In Europe and the Americas, up to 96% of cases were among men who have sex with men driven by spread among individuals with multiple sexual partners in a short space of time and frequent partner change. 

-- While sexual behavior data for cases in newly affected African countries remain limited, the contribution of sexual transmission to the introduction, spread and establishment of mpox in communities has been recognized across all affected settings, as in the most recent outbreak in Madagascar. 

-- In several countries, transmission has involved sex workers and their clients, and sexual networks with frequent and multiple partner change.  

-- Sexual contact infection likely occurs during pre-symptomatic or less apparent stages of infection, the duration of which can vary between individuals. 

-- People with few or mild genital lesions might not even recognise the infection. 

-- Although the secondary attack rate for sexual contact is high (estimated at 16-73%), for the epidemic to spread it requires networks characterised by frequent partner change and high rates of partner turnover over short timeframe (days to few weeks). 

-- This pattern was observed during the initial spread of clade IIb among communities of men who have sex with men, as well as in more recent MPXV clade Ib oubtreaks driven – in part – by key populations such as female sex workers and their clients. 

-- We therefore consider within this group of multiple sexual partners, individuals with frequent partner change, and those who may engage in at-risk sexual behaviour, such as people who buy sex.  

(...)

Source: 

Link: https://www.who.int/publications/m/item/who-rapid-risk-assessment---mpox--global-v.6

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Zoonotic #Influenza #Preparedness: Dutch Medical #Labs Efficiently Detect Animal Influenza A Viruses - External #Quality #Assessment, 2023

 

Highlights

• Concern over H5N1 bird flu testing and detection in the Netherlands is increasing.

• 50 human laboratories in the Netherlands, Aruba, Bonaire, and Curacao were assessed.

• The laboratories detected animal influenza viruses with high performance.

• Few laboratories identified the animal subtype of detected influenza A viruses.

• National reference laboratory capacity to identify the animal subtype is critical.

Abstract

Background

Since 2022, highly pathogenic H5N1 influenza A virus clade 2.3.4.4b has caused global outbreaks among wild birds and poultry, with increasing mammalian and sporadic human infections. This elevates concerns about zoonotic transmission and pandemic risk, highlighting the need for accurate detection and identification of animal influenza A viruses by human clinical diagnostic laboratories (hCDL).

Methods

To evaluate routine diagnostic performance, an External Quality Assessment (EQA) panel containing inactivated influenza A viruses of avian (three subtype H5, one H7), swine (two H1, one H3), and human (one H1pdm09, one H3) origin was distributed to 50 hCDL in the Netherlands, Aruba, Bonaire, and Curaçao. Laboratories conducted their routine molecular influenza virus detection and, if available, subtyping workflows.

Results

A total of 118 detection workflows were reported. Of these, 109 (91%) successfully detected influenza A virus in all positive specimens. At least one workflow in 49/50 (98%) laboratories reliably detected all animal influenza viruses as type A influenza virus. Most false negatives occurred with swine H1N1v. Only 24 workflows from 20 laboratories attempted subtyping for one or multiple panel specimens (total 109 subtype-specific results reported): for human viruses, 37/39 results were correct; for avian viruses, 13/14 were correct (including 12/12 for H5); for swine viruses, only 2/56 were correct (both swine H3N2 using broad-reactive H3 assays).

Conclusions

hCDL in the Netherlands demonstrate high performance for detecting animal influenza A viruses. However, subtyping capacity is limited, necessitating referral of specimens of suspected zoonotic influenza cases to the National Influenza Centre for further characterization.

Source: 

Link: https://www.sciencedirect.com/science/article/abs/pii/S1386653226000168?dgcid=rss_sd_all

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Heard and McDonald Islands {#Australia} - #Influenza A #H5N1 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification [FINAL]

 

By Andrew Shiva / Wikipedia, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=46772024

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Samples were taken from dead wild animals during a research voyage to Heard Island, an Australian sub-Antarctic external territory. HPAI was detected from samples taken from two gentoo penguins. 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 during the second voyage in January 2026. Further sequencing and phylogenetic analysis is being undertaken.

Source: 

Link: https://wahis.woah.org/#/in-review/7261

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#Bhutan - High pathogenicity avian #influenza #H5N1 viruses (Inf. with) (#poultry) - Immediate notification

 

Backyard poultry in Chhukha Region.

Source: 

Link: https://wahis.woah.org/#/in-review/7263

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#Skuas as #sentinels of high pathogenicity avian #influenza #H5N1 on the #Antarctic Peninsula in the 2024/2025 austral summer

 

Abstract

Despite Antarcticas geographic isolation, the first incursion of high pathogenicity avian influenza (HPAI) H5N1 was detected in the 2023/24 austral summer. Surveillance for HPAI H5N1 in Antarctica remains patchy due to logistical, financial, and infrastructure challenges, with many suspected cases remaining unconfirmed, and few viral genomes sequences available to date. Through the 2024/25 austral summer we undertook five sampling expeditions to the South Shetland Islands and Antarctic Peninsula facilitated by cruise ships/operators. Across more than 500 faecal environmental samples collected from apparently healthy penguins and marine mammals, we found no detectable evidence of HPAI H5N1. However, HPAI H5N1 was detected in all but one of the skua carcasses sampled, which, in most cases, were found within meters of penguin sub-colonies. All HPAI H5N1 viral genomes sequences from skuas on the Antarctic Peninsula fell within a single lineage, which included those genomes from skuas sampled in the 2024/25 season from the South Shetland Islands. Genomes were in a different clade to those from the Antarctic Peninsula collected in the 2023/24 austral summer. Our results confirm although the prevalence may be low, HPAI H5N1 is established in Antarctica, emphasizing the need for ongoing surveillance to monitor and mitigate threats to wildlife, even in the planets most isolated regions.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

IAATO

Department of Health and Aged Care, https://ror.org/02swcnz29

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.02.15.706047v1

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#Cambodia notified one additional #human case of #infection with #H5N1 #influenza virus (HK CHP, Feb. 17 '26)

{Excerpt}

Avian Influenza Report - Reporting period: February 8, 2026 – February 14, 2026 (Week 7) 

(...)

- Date of report: 14/02/2026

- Country: Cambodia

- Province / Region: Kampot province

- District / City: Tuek Chhou district

- Sex: M

- Age: 30

- Condition at time of reporting: Recovered

- Subtype of virus: H5N1

(...)

Source: 

Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk07.pdf

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#Bhutan - High pathogenicity avian #influenza #H5N1 viruses (Inf. with) (#poultry) - Immediate notification

 

Backyard poultry in Zhemgang Region.

Source: 

Link: https://wahis.woah.org/#/in-review/7262

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Monitoring #influenza-like symptoms in the #UK through participatory #surveillance: insights from #FluSurvey over two winter seasons (2023-24 and 2024-25)

 

Abstract

FluSurvey is a participatory surveillance system used to monitor trends in influenza and other respiratory viruses through weekly symptom surveys among the UK population. We aimed to characterise the wider impact of influenza-like illnesses (ILI) among FluSurvey participants and assess correlations of ILI with other established influenza surveillance systems. We included data reported by FluSurvey participants over the 2023-24 and 2024-25 winter seasons. Using weekly symptoms surveys, we derived ILI episodes and estimated the proportion reporting healthcare service use, medication use, impact on daily life, absenteeism and use of tests. We applied existing data methods (omitting first report and weighting to the age-sex structure of England) and assessed cross-correlations of weekly FluSurvey ILI rates with the national surveillance of GP ILI consultations, influenza hospital admissions, and influenza PCR test positivity at time lags of up to +/-2 weeks. There were 3057 participants over two winter seasons (N2023-24=2540, 63% female, mean age 60 years; N2024-25=2273, 64% female, mean age 61 years). Of 1868 ILI episodes, only a minority contacted healthcare services (14%, most frequently visiting the GP). A large proportion of episodes reported medication use (89%), impact on daily life (75%) and missing school or work (47%). Notable differences in testing behaviour were apparent by season, with fewer reporting use of tests in 2024-25. FluSurvey ILI rates were strongly correlated with other influenza surveillance, predominantly leading GP ILI consultations (max r=0.73), coinciding with influenza hospital admissions (max r=0.88) and lagging influenza test positivity (max r=0.88). The majority of ILI reported to FluSurvey do not contact healthcare due to symptoms but experienced wider impacts on daily life. FluSurvey ILI corresponds well with other national influenza surveillance and provides broader context on community illness, supplementing the monitoring of influenza activity for public health response.

Competing Interest Statement

The Immunisations and Vaccine Preventable Diseases division at UKHSA has undertaken post-marketing surveillance and regulatory analyses requested by vaccine manufacturers for which cost-recovery charges have been made. No other conflicts of interest have been declared.

Funding Statement

This work was funded by the UK Health Security Agency. No external funding was received.

Source: 

Link: https://www.medrxiv.org/content/10.64898/2026.02.12.26345150v1

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History of Mass Transportation: the Swiss SBB Am 4/6 Gas Turbine Locomotive

 

By Unknown author - Schweizerische Bauzeitung, Band 119, Heft 20, Public Domain, https://commons.wikimedia.org/w/index.php?curid=29931439

Source: 

Link: https://en.wikipedia.org/wiki/Gas-turbine_locomotive#/media/File:SBB_Am_4-6.JPG

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#Mpox: #recombinant virus with genomic elements of clades Ib and IIb - Global (#WHO, Feb. 16 '26)

 

Situation at a glance

Recombination of monkeypox virus (MPXV) strains has been documented in recent months, with two cases of a recombinant strain comprising clade Ib and IIb MPXV reported. 

Recombination is a known natural process that can occur when two related viruses infecting the same individual exchange genetic material, producing a new virus. 

The first case was detected in the United Kingdom of Great Britain and Northern Ireland (hereafter “United Kingdom”), with travel history to a country in South-East Asia, and the second in India, with travel history to a country in the Arabian Peninsula. 

Detailed analysis of the virus genomes shows that the two individuals fell ill several weeks apart with the same recombinant strain, suggesting that there may be further cases than are currently reported. 

Both cases had similar clinical presentation to that observed for other clades. 

Neither patient experienced severe outcomes. 

Contact tracing for both cases in the reporting countries has been completed; no secondary cases were detected. 

Based on available information, the overall WHO public health risk assessment for mpox remains unchanged: the risk is assessed as moderate for men who have sex with men with new and/or multiple partners and for sex workers or others with multiple casual sexual partners, and low for the general population without specific risk factors.

Description of the situation

In December 2025, the United Kingdom detected the first reported case of a clade Ib/IIb MPXV recombinant strain.​​ After classification of this case and posting in a public database as a novel MPXV recombinant strain, a case of mpox detected in India in September 2025 was retrospectively reclassified as a closely-related recombinant strain based on sequencing data. To date, these are the only known cases of this recombinant virus.  

Case detected in the United Kingdom of Great Britain and Northern Ireland 

The case was identified following testing of a vesicular swab from a traveler who had returned from a country in the Asia Pacific region in October 2025. 

During laboratory confirmation, the virus was initially typed as clade Ib MPXV by qPCR. 

Subsequent whole genome sequencing revealed that the MPXV strain identified was distinct from other known clade Ib MPXV strains with phylogenetic analysis indicating that the genome had regions similar to both clade Ib and clade IIb MPXV reference sequences, suggesting that it is an inter-clade recombinant. 

To confirm this unusual finding, sequencing was repeated on the original extract from the primary sample, a fresh extract from the same primary sample, a second swab collected from the patient at the same time, and a cultured isolate derived from the initial swab. 

This repeat sequencing yielded identical viral genome sequences from the two clinical swabs and the cultured isolate, supporting the initial findings of a new recombinant strain, and showing that it can replicate and presents potential for onward transmission. 

This strain is a recombinant MPXV, containing genetic elements from both clade Ib and clade IIb MPXV. 

A small number of contacts were identified and followed up in the United Kingdom; none developed any clinical features of mpox. 

Health worker contacts had worn full personal protective equipment (PPE) during provision of medical care to the patient. 

The authorities of the United Kingdom continue to investigate the significance of this recombinant MPXV strain through phenotypic characterization studies. 

Case detected in India

On 13 January 2026, the National IHR Focal Point (NFP) of India notified WHO of a mpox case with an inter‑clade recombinant MPXV which was, upon whole-genome sequencing, found to have genomic elements of clades Ib and IIb MPXV.

The recombinant virus was found in samples from a man with mpox who had presented for care in September 2025. The patient had reported recent travel from a country in the Arabian Peninsula, where he resides as an overseas worker.

He developed symptoms on 1 September 2025, while still abroad. After his return to India, real‑time PCR confirmed MPXV infection on 11 September 2025. 

Clade differentiation PCR performed on 15 September 2025 initially identified this virus as clade II MPXV. Initial genomic sequencing analysis suggested features consistent with clade IIb MPXV. However, following the update of the global Nextclade database on 16 December 2025, which included the recombinant clade Ib/IIb MPXV strain reported by the United Kingdom, the virus from the patient in India was reclassified as belonging to the recombinant strain. 

Recombination analysis demonstrated mosaic patterns containing genomic regions derived from both parent clades.

Following the initial diagnosis, the patient was hospitalized, did not experience any medical complications, and fully recovered, testing negative for MPXV on 29 September 2025. The case reported no close contacts in India, and no known secondary cases were identified following this introduction of the recombinant clade Ib/IIb MPXV in India.

Full or near‑full genome retrieval (>99%) from both the sample and a sample-derived virus isolate enabled phylogenetic analysis showing >99.9% similarity to the recombinant strain detected in the United Kingdom. 

A total of 34 recombinant tracts were observed in the sequence reported by India, while 28 recombinant tracts were observed in the sequence reported by the United Kingdom; 16 recombinant tracts were common to both strains.  

This case in India therefore represents the earliest known detection of this recombinant strain globally, having preceded the event reported in the United Kingdom.

Consistent with the case reported in the United Kingdom, clinical presentation was consistent with cases due to clade I or clade II MPXV (non-recombinant MPXV) infection.

Epidemiology

Mpox is an infectious disease caused by the MPXV, which is part of the genus Orthopoxvirus, that includes the variola virus, the causative agent for smallpox. 

There are two known clades of MPXV: clade I (previously called the Congo Basin clade), which includes subclades Ia and Ib; and clade II (previously called the West Africa clade), which includes subclades IIa and clade IIb. 

Subclades Ia and Ib were defined after the emergence of subclade Ib in the South Kivu province of the Democratic Republic of the Congo in 2023, and subclade Ia encompasses all other strains of clade I that are not Ib.

As reported here, there have also been two cases of the clade Ib/IIb recombinant strain, detected in the UK and in India.

Mpox spreads among humans through direct close physical contact with an infected person, including sexual contact. 

Transmission can also occur through indirect contact (with contaminated materials), through infectious respiratory particles in limited cases, and from mother to child (vertical transmission).

Historically mpox was primarily characterized by zoonotic transmission, with outbreaks occurring in tropical rainforest regions of East, Central and West Africa, and occasional exportation of cases to other areas. 

In the context of zoonotic transmission, which continues to occur in historically endemic areas, MPXV is transmitted to humans through direct contact with infected wild animals (e.g., through hunting, trapping, or petting), and possibly through processing and consuming infected wild game or their body parts and fluids. 

To date, animal-to-human transmission has always been documented in or linked to known endemic regions of Africa. 

All other outbreaks in Africa or in other parts of the world are to date presumed to be due to human-to-human transmission, until proven otherwise. 

Symptoms of mpox in humans include: 

- swollen lymph nodes, 

- fever, and 

- a skin rash and/or mucosal lesions that may initially resemble those of other illnesses such as chickenpox (caused by the varicella virus), or sexually transmitted infections such as herpes or syphilis if the rash or lesions appear in the genital or anal region. 

The ongoing  global outbreak has shown that mpox can also present with few lesions, and asymptomatic infection can occur.​ The contribution of pre- and asymptomatic infection to transmission remains poorly understood. 

Public health response

WHO Response:

WHO maintains global mpox surveillance and continues to provide response guidance and support for all countries, including access to diagnostics and vaccines through multi-partner coordination including through the Access and Allocation Mechanism for mpox. WHO and partners are establishing the longer-term International Coordinating Group for mpox vaccine provision (ICG) to further accelerate timely outbreak response and ensure sustainable support for the future. Furthermore, WHO continues to evaluate available rapid diagnostic tests for field use.

Response measures in the United Kingdom:

The United Kingdom Health Security Agency (UKHSA) continues to work closely with the National Health Service England, public health agencies in Scotland, Wales and Northern Ireland, and is monitoring the situation in the United Kingdom and undertaking public health actions in accordance with the Mpox control: UK strategy 2025 to 2026 .

Public health information was made available to health care providers and the public. Contact tracing was completed in line with national guidance. Contacts were given appropriate health advice, offered vaccination, and monitored for symptoms.

All suspected mpox cases in the UK are tested using Orthopoxvirus-generic, MPXV-generic, and MPXV-specific PCR as primary testing, with clade differentiation assays performed on any positive samples. All samples identified as clade Ib, and selected samples identified as clade IIb cases undergo whole genome sequencing through Illumina-based workflows.

Response measures in India:

Public health measures, including contact tracing and monitoring, were implemented to prevent onward transmission. No secondary case was detected.

All suspected mpox cases in India are tested using Orthopoxvirus‑generic and MPXV‑specific PCR with clade differentiation assays. Positive cases undergo whole genome sequencing through Illumina‑based workflows.

WHO risk assessment

Mpox outbreaks must be considered in their local context, with meaningful involvement of affected communities, to ensure an in-depth understanding of the epidemiology, modes of transmission, risk factors for severe disease, viral reservoir and evolution, and relevance of strategic approaches and countermeasures for prevention and control.   

Multiple strains of MPXV are circulating through interconnected sexual networks across many countries and settings. Co-infection with different strains, that could lead to emergence of recombinant virus strains, while rare, can be expected. The case in India was infected with the same recombinant Ib/IIb MPXV strain detected in the United Kingdom. 

Symptom onset in the case reported in India occurred more than two months earlier than the case in the United Kingdom, and the great degree of similarity between their sequences suggests a common evolutionary history. This information has two important implications: i) the origin of the recombinant strain remains unknown; and ii) transmission of this recombinant virus already involves at least four countries in three WHO regions, and is therefore likely to be more widespread than currently documented.

For the cases in the United Kingdom and India, the initial clade differentiation PCR results indicated clade Ib and IIb MPXV, respectively. Thus, clade differentiation PCR assays alone may not reliably identify recombinant MPXV strains, and genomic sequencing is likely to be required for their detection.   

Due to the small number of cases found to date, conclusions about transmissibility or clinical characterization of mpox due to recombinant strains would be premature, and it remains essential to maintain vigilance regarding this development.

In light of the limited information available on this recombinant MPXV strain, the overall WHO public health risk assessment for mpox remains unchanged: the risk is assessed as moderate for men who have sex with men with new and/or multiple partners and for sex workers or others with multiple casual sexual partners, and low for the general population without specific risk factors.

All countries should remain alert to the possibility of MPXV genetic recombination. The public health risk posed by any newly detected recombinant strain should be assessed on a case-by-case basis, considering available epidemiological, clinical and genomic information.

WHO advice

Based on the information available, WHO recommends maintaining epidemiological surveillance, laboratory and genomic sequencing capacity for mpox, case management, infection prevention and control (IPC) measures, vaccination for people at risk, locally relevant risk communication and community engagement, and public health guidance for mpox.   

All recommendations are made in the context of ongoing transmission of clades Ib and IIb MPXV in key populations at risk in all WHO regions, including undetected or pre- and asymptomatic infections, as well as unreported cases. They additionally apply to settings where clades Ia and IIa MPXV continue to spread through a mix of zoonotic and human-to-human contact. There is likely to be wider circulation of this emerging recombinant strain of MPXV since at least September 2025 than reflected by the two cases documented and linked to four countries in three WHO regions. 

WHO advises Member States to:  

- maintain mpox surveillance and rapid reporting, including prompt IHR notification of any unusual events and imported cases in line with the WHO Standing Recommendations issued under the IHR (2005) and extended to August 2026; 

- continue to carry out genomic sequencing of all laboratory specimens from confirmed cases in early outbreak settings, and a representative sample of at least 10% of laboratory specimens from confirmed cases in settings experiencing community transmission, as per WHO guidance;  

- carry out targeted sample characterization for specific situations of interest, especially for cases who report recent travel to locations with clade I MPXV circulation or to locations which provide opportunities for sex tourism, prioritizing sequencing for cases in key populations at risk and for imported, unusual, or severe cases, and sharing sequences rapidly in public databases;  

- ensure quality case management and robust IPC practices and strengthen vaccination strategies, including ensuring access to mpox vaccines for key populations at risk;  

- continue to advance integration of HIV/STI and mpox health services to ensure early HIV testing and care for any person with suspected or confirmed mpox and rapid initiation or resumption of antiretroviral therapy in people living with HIV as needed for any person with mpox; 

- strive to eliminate human-to-human transmission of mpox where MPXV circulation remains low and ensure the maintenance of capacity for prompt outbreak response;  

- continue to provide information to travelers who may be at risk.

WHO recommends that no restrictions be applied for travel to, or trade with, the countries named in this report, based on the information available on the event reported here.  

Further information

1) World Health Organization. Mpox: fact sheet. 26 August 2024. Available from: http://www.who.int/news-room/fact-sheets/detail/monkeypox 

2) World Health Organization. Global mpox trends. Available from: https://worldhealthorg.shinyapps.io/mpx_global/ 

3) World Health Organization. Multi-country outbreak of mpox: external situation report no. 62. 23 January 2026. Available from: Multi-country outbreak of mpox, External situation report #62

4) World Health Organization. Fifth meeting of the International Health Regulations (2005) Emergency Committee regarding the upsurge of mpox 2024. 30 October 2025. Available from: https://www.who.int/news/item/30-10-2025-fifth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-upsurge-of-mpox-2024

5) World Health Organization. Standing recommendations for mpox issued by the Director-General of the World Health Organization in accordance with the International Health Regulations (2005). 21 August 2023. Available from: https://www.who.int/publications/m/item/standing-recommendations-for-mpox-issued-by-the-director-general-of-the-world-health-organization-(who)-in-accordance-with-the-international-health-regulations-(2005)-(ihr) 

6) World Health Organization. Extension of standing recommendations for mpox to August 2026, by the Director-General of WHO. 21 August 2025. Available from: https://www.who.int/publications/m/item/extension-of-standing-recommendations-for-mpox-by-the-director-general-of-who 

7) World Health Organization. Clinical management and infection prevention and control for mpox: living guideline. May 2025. Available from: https://www.who.int/publications/i/item/B09434 

8) World Health Organization. WHO recommends rapid treatment initiation for people living with HIV and mpox. 16 July 2025. Available from: https://www.who.int/news/item/16-07-2025-who-recommends-rapid-treatment-initiation-for-people-living-with-hiv-and-mpox 

9) World Health Organization. WHO mpox multi-country rapid risk assessment, version 5. 13 October 2025. Available from: https://www.who.int/publications/m/item/who-rapid-risk-assessment---mpox--global-v.5 

10) World Health Organization. Strategic framework for enhancing prevention and control of mpox (2024–2027). 24 May 2024. Available from: https://www.who.int/publications/i/item/9789240092907 

11) World Health Organization. Guidance on use of Smallpox and mpox vaccines, including WHO Position paper on mpox vaccines and other resources to support countries. 23 August 2024 https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/smallpox-and-mpox  

12) World Health Organization. Frequently Asked Questions (FAQ) on use of fractional dosing with intradermal administration of mpox MVA-BN vaccine in the context of vaccine supply-constrained outbreak response. 19 June 2025. https://www.who.int/publications/m/item/frequently-asked-questions-(faq)-on-use-of-fractional-dosing-with-intradermal-administration-of-mpox-mva-bn-vaccine-in-the-context-of-vaccine-supply-constrained-outbreak-response  

13) World Health Organization. LC16m8 (live-attenuated freeze-dried vaccinia) smallpox and mpox vaccine. Interim guidance. 22 April 2025. Available from:  https://iris.who.int/server/api/core/bitstreams/9b10eb01-fbfd-4f9f-81b7-9c29ddbcc560/content

14) World Health Organization. Prequalification of Smallpox and Mpox vaccine (Live Modified Vaccinia Virus Ankara), 2024 September 13. Available from:  https://extranet.who.int/prequal/vaccines/p/imvanexr

15) World Health Organization. Emergency use listing of LC16m8. 2024 November 19. Available from: https://extranet.who.int/prequal/vaccines/lc16-kmb

16) UK Health Security Agency, Institute of Ecology and Evolution, University of Edinburgh; Inter-clade recombinant mpox virus detected in England in a traveller recently returned from Asia. 7 December 2025: https://virological.org/t/inter-clade-recombinant-mpox-virus-detected-in-england-in-a-traveller-recently-returned-from-asia/1015  

17) UK Health Security Agency, Mpox outbreak: epidemiological overview. 11 December 2025: https://www.gov.uk/government/publications/monkeypox-outbreak-epidemiological-overview/mpox-outbreak-epidemiological-overview-11-december-2025   

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON595

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#USA, #Wastewater Data for Avian #Influenza #H5 (CDC, Feb. 16 '26)

 

{Excerpt}

Time Period: February 01, 2026 - February 07, 2026

-- H5 Detection: 8 site(s) (1.7%)

-- No Detection: 475 site(s) (98.3%)

-- No samples in last week: 166 site(s)

The H5 detections at sewershed IDs 809 and 912 in Michigan are false detections resulting from a data error. These will be corrected in the next update.

(...)

Source: 

Link: https://www.cdc.gov/nwss/rv/wwd-h5.html

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Rapid #Decline of #Nesting Peregrine #Falcons in the San Francisco Bay Region of #California Synchronous with an #H5N1 #Outbreak

 

Abstract

After rebounding from near extirpation during the organochlorine era, breeding Peregrine Falcons (Falco peregrinus) in California are again facing adversity, this time consistent with an outbreak of a highly pathogenic avian influenza. Following the first detection of the H5N1 variant clade 2.3.4.4b virus in California wild birds in July 2022, we assembled data from long-term monitoring (2000-2025) of peregrine breeding territory occupancy in the broad vicinity of San Francisco Bay to examine possible impacts on falcon populations. Prior to the outbreak, 47 focal breeding territories had shown nearly complete occupancy by pairs (98.5% of 390 site-years), with very few vacancies, single birds in attendance, or subadult pair members. Within 8 mo of the outbreak, occupancy had dropped to 65.1%, and 2 yrs later (2025), only 36.2% of sites remained occupied. An uptick in site-occupancy by single birds also occurred after the outbreak, but it is unclear whether these were survivors or floaters attempting to fill vacant territories where both pair members had perished. The high vacancy rates signaled an impact upon floaters (nonbreeding adults) that normally buffer breeding site-occupancy in healthy peregrine populations. From October 2022 through November 2025, 17 peregrine fatalities were diagnosed with H5N1 within the counties comprising our study area. Evidence that H5N1 caused these territory vacancies includes, (1) the striking temporal coincidence of occupancy loss with the outbreak, and (2) the lethality of the virus to peregrines and its confirmed presence in peregrine prey in our study area. Our study reaffirms the value of long-term territory occupancy monitoring in this sentinel species.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

Helen and Will Webster Foundation

Ahmanson Foundation, https://ror.org/01eywvb34

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.02.11.705416v1

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

 

Abstract

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

Competing Interest Statement

The Icahn School of Medicine at Mount Sinai has filed patent applications relating to SARS-CoV-2 serological assays, NDV-based SARS-CoV-2 vaccines influenza virus vaccines and influenza virus therapeutics which list FK as co-inventor and FK has received royalty payments from some of these patents. Mount Sinai has spun out a company, Castlevax, to develop SARS-CoV-2 vaccines. VS is listed on the patent for the SARS-CoV-2 serological assay. FK is co-founder and scientific advisory board member of Castlevax. FK has consulted for Merck, GSK, Sanofi, Gritstone, Curevac, Seqirus and Pfizer and is currently consulting for 3rd Rock Ventures and Avimex. The Krammer laboratory is also collaborating with Dynavax on influenza vaccine development.

Funding Statement

This work was funded through the NIAID Centers for Excellence in Influenza Research and Response (75N93021C00014 as well as option APOLLO Option 12A) and through philanthropic support from Titos Vodka. Work at the Medical University of Vienna was funded by Institutional Funds.

Source: 

Link: https://www.medrxiv.org/content/10.64898/2026.02.10.26346014v1

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