Outbreak Update: The Centre for Health Protection (CHP) in Hong Kong has confirmed three additional human cases of H9N2 avian influenza reported from the Chinese mainland. The latest figures, listed in the Hong Kong Weekly Avian Influenza Report, include one adult and two children from three separate provinces. (CHP Weekly Report)
These new cases add to the 13 reported over the past six months in China. Historically, over 100 human cases have been documented, though most infections tend to be mild. Seroprevalence studies suggest that many cases may go undiagnosed or unreported, indicating the possibility of a wider spread than currently recognized.
According to a CIDRAP report updated in the past 24 hours, all three cases had a history of poultry exposure. The infected individuals are recovering, and no evidence of human-to-human transmission has been found so far.
Health authorities emphasize that while H9N2 infections in humans are generally mild, the virus remains under close monitoring due to its potential for genetic reassortment. These recent cases have prompted enhanced surveillance in nearby regions to detect any signs of further spread. Local officials have also begun public awareness campaigns on safe poultry handling practices.
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Poor control of Avian Influenza in China
Despite vaccination efforts, H9N2 remains poorly controlled in China’s poultry industry. This lack of containment has contributed to the emergence of numerous viral genotypes. The virus is known for its ability to reassort with other influenza strains, such as H7N9, H5N1, and H5N6—often boosting their virulence and transmission potential.
Seven years ago, two notable studies published in the Emerging Infectious Diseases (EID) Journal highlighted how H9N2 continues to evolve away from current poultry and pre-pandemic vaccines. These findings raised concerns that the virus may be adapting more efficiently to human hosts.
Although H9N2 is classified as a low-pathogenic avian influenza (LPAI) virus and is not currently considered a top-tier pandemic threat, the U.S. Centers for Disease Control and Prevention (CDC) still includes two H9N2 lineages on its watch list of zoonotic influenza viruses with pandemic potential. In response, several candidate vaccines have been developed to address this emerging risk.
The World Health Organization’s latest Avian Influenza Weekly Update also noted increased detection of H9N2 in poultry in southern China, suggesting continued endemic circulation and highlighting the need for improved biosecurity measures.
The evolution and adaptability of H9N2 reinforce the need for continued surveillance and preparedness efforts, especially given its role in enhancing other dangerous influenza strains. International collaboration, updated vaccines, and public health education remain key to minimizing the risk posed by this persistent avian influenza subtype.
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