Key facts
- Since the begining of November and as of 19 December 2025, WHO reported seven new cases of human infection with avian influenza A(H9N2), all in China.
- The cases had onset of symptoms in September, October and November 2025.
- Five cases were children and two were adults.
- Five cases had mild disease. Two elderly persons were hospitalised, one of whom with underlying conditions was hospitalised with severe pneumonia.
- All but one had exposure to birds (backyard poultry or live poultry market). Investigations are ongoing for one case.
- No new cases have been reported among contacts of these cases.
Overview
According to WHO monthly Influenza at the human-animal interface summary and assessment report, published on 19 December 2025, since 5 November and as of 19 December 2025, WHO reported seven new cases of human infection with avian influenza A(H9N2), all in China.
The cases were reported in Guangdong (1), Guangxi (3), Henan (1) and Hubei (2) provinces with onset of symptoms in September, October and November 2025. Five cases were children and two were adults. Five of the seven cases had mild disease, two elderly persons were hospitalised, of whom one with underlying conditions was hospitalised with severe pneumonia. All but one had exposure to birds either in backyard poultry (4) or live poultry market (2). Investigations are ongoing for one case to determine the source of infection.
No new cases have been reported among contacts of these cases. For some of the cases environmental samples tested positive to A(H9). All these cases are not epidemiologically related.
Background:
Overall, 190 human cases, including two deaths, of avian influenza A(H9N2) have been reported since 1998 from 10 countries. Since 2015, China has reported 149 human cases of avian influenza A(H9N2) virus infection to WHO, including two deaths (case fatality rate (CFR): 1.4%).
ECDC assessment
Sporadic human cases of avian influenza A (H9N2) have been observed outside the EU/EEA. Direct contact with infected birds or contaminated environments is the most likely source of human infection with avian influenza viruses. In most cases, influenza A(H9N2) leads to mild clinical illness. To date, no clusters of human A(H9N2) infections have been reported. According to WHO, the likelihood of human-to-human transmission of A(H9N2) is low, as there is no evidence that the virus has acquired the ability for sustained transmission among humans.
To date, there have been no human cases of avian influenza A(H9N2) reported in the EU/EEA, and the risk to human health in the region is currently considered very low.
Actions
ECDC monitors avian influenza strains through its epidemic intelligence and disease network activities. Together with EFSA and the EU Reference Laboratory for Avian Influenza, ECDC produces a quarterly report on the avian influenza situation. The most recent report was published in December 2025.