Rapid risk assessment: Human infections with avian influenza A viruses, China
This Rapid Risk Assessment summarises the latest information about human infections with avian influenza A viruses in China. It focuses on A(H7N9) and A(H5N1) but includes other avian influenza A viruses and assesses the risk to public health in the EU/EEA countries and to EU/EEA citizens.
In this Rapid Risk Assessment, ECDC summarises the latest information about human infections with avian influenza A viruses in China. It focuses on A(H7N9) and A(H5N1) and includes other avian influenza A viruses recently identified. It assesses the risk to public health in the EU/EEA countries and to EU/EEA citizens.
The severe nature of human infections and the persistence of avian influenzas A(H7N9) and A(H5N1) in poultry represents a significant long-term threat to humans, either through zoonotic transmission or potentially through developing pandemic capacity. However, the most likely current scenario for China is that these outbreaks remain zoonotic outbreaks in which the virus is transmitted sporadically to humans in close contact with the animal reservoir, similar to the influenza A(H5N1) situation.
The recent importation of A(H5N1) from China to Canada and A(H7N9) from China to Malaysia in travellers highlights the possibility of travel-related cases being detected also in Europe. This should be prepared for by the EU Member States. However, sporadic cases imported from China would not alter ECDC’s current risk assessment.
The A(H7N9) transmission pattern and the continued and increasing transmission of this novel reassortant avian influenza virus capable of causing severe disease in humans remains a cause for concern due to its pandemic potential. While likely human-to-human transmission of A(H7N9) and A(H5N1) in clusters of reported cases has been documented in a few instances, there is no indication of sustained human-to-human transmission.
The detection of other new avian influenza human cases, namely A(H10N8) and A(H6N1) likely reflects enhanced surveillance activities in China and Taiwan.
At present, the most immediate threat to EU citizens is to those living in China or visiting the country. It is advised to avoid live-bird markets and contact with live poultry in China.
This ECDC rapid risk assessment aims to:
- summarise the epidemiological, virological and environmental information about human infections with avian influenza A viruses in China of subtypes H7N9, H5N1, H10N8, and H6N1;
- assess the risk to public health in the EU/EEA and to EU/EEA citizens;
- anticipate development scenarios and provide options for prevention and control in the EU/EEA;
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24 Feb 2021 - This Threat Assessment Brief considers the risk of infection related to avian influenza A(H5N8) virus to the general population and the occupationally exposed.
Influenza A(H7N9) virus in China - implications for public health - 7th update, 3 July 2017
3 Jul 2017 - Since the notification of a novel reassortant influenza A(H7N9) virus on 31 March 2013, 1 548 laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus have been reported.
Genetic evolution of influenza A(H7N9) virus in China - implications for public health. Sixth update, 9 March 2017
10 Mar 2017 - This rapid risk assessment builds on the fifth update of the ECDC rapid risk assessments on avian influenza published on 27 January 2017  and on the recent public health development dated 24 February 2017.