The increased reports of A(H5N1) outbreaks in poultry and wild bird populations, and the emergence of a further evolved lineage of the virus in poultry in some countries, do not change the current assessment of the risk to human health.

Highly pathogenic avian influenza A(H5N1) infections are continuing to occur in poultry and humans in Egypt. However there is no evidence of a significant change in the pattern of human illness and deaths related to A(H5N1) virus infections in the country. Certainly there are no epidemiological data or analyses consistent with adaptation of these viruses to humans.

Following reports of a human fatality due to highly pathogenic avian influenza A(H5N1) virus infection in China’s Guangdong province, the European Commission requested an update to the assessment of risk of human-to-human transmission occurring. ECDC does not consider that there is any change to the previous assessments that the risk for EU/EEA countries is very low.

The results of two, as yet unpublished, investigations of laboratory-induced genetic changes in avian influenza A(H5N1) viruses have been reported to have found that a surprisingly few number of changes make the viruses transmissible between ferrets, the most commonly used model for the way influenza behaves in humans. The possibility that this could have resulted in the development in laboratories of A(H5N1) influenza viruses transmissible between humans has caused concern for public safety and generated unusually high levels of debate in the scientific community. This report summarises and explains the complex public health and scientific issues around these developments including the positive and negative aspects of some of the responses that have been proposed internationally.

The ECDC communicable disease threats report is a weekly bulletin intended for epidemiologists and health professionals in the area of communicable disease prevention and control. Summarising information gathered by ECDC through its epidemic intelligence activities regarding communicable disease threats of concern to the European Union, it also provides updates on the global situation and changes in the epidemiology of communicable diseases with potential to affect Europe, including diseases that are the focus of eradication efforts.

This second update to ECDC's initial risk assessment concludes that the risk of the disease spreading to Europe via humans or through poultry is still low at this time.

On 31 March 2013, the Chinese authorities announced the identification of a novel influenza A virus, A(H7N9), in three seriously ill people from two provinces presenting with respiratory infections. So far, no epidemiological link has been identified between those three patients. When testing for the influenza virus, the Chinese Center for Disease Control and Prevention identified genes from both A(H7N9) and A(H9N2) viruses, thus indicating a novel reassortant avian influenza A virus. In its initial assessment of the situation, the ECDC rapid risk assessment concludes that the risk of the spread of the virus in Europe can be considered low at this stage.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 10-16 November 2013, and includes updates on avian influenza, cholera, dengue, influenza, MERS, polio and salmonellosis.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 5-11 January 2014, and includes updates on avian influenza in humans, dengue, influenza, MERS and polio.

The document determines the risk to human health in Europe from highly pathogenic avian influenza viruses in birds and animals and identifies areas requiring additional scientific and public health work both as single pieces of work and for risk monitoring by ECDC and its partners.