Tracking Emerging Public Health Challenges – January 26, 2026 – Bird Flu
The first case is a five-year-old male from Hubei Province, with an onset of symptoms on 30 November 2025; the second case is an eight-year-old female from Jiangsu Province, with an onset date on 4 December 2025; the third case is a one-year-old male from Guangxi Province, with an onset date on 7 December 2025.
Only the first case had exposure to backyard poultry whereas the other two cases reported no known exposure to live poultry.
The parents of the second case visited a store selling freshly slaughtered poultry, and the third case also had indirect exposure to freshly slaughtered poultry. All three cases have now recovered.
Since December 2015, a total of 155 cases of human infection with avian influenza A(H9N2), including two deaths (both with underlying conditions), have been reported to WHO in the Western Pacific Region. Of these, 152 were reported from China, two were from Cambodia, and one was from Viet Nam.
H9N2 avian influenza is a common, low-pathogenicity bird flu virus endemic in poultry worldwide, especially in Asia.
People get infected primarily through direct contact with infected birds or contaminated environments.
Symptoms in humans range from mild (fever, cough, sore throat, runny nose, headache) to severe (pneumonia, difficulty breathing, conjunctivitis, gastrointestinal issues).
Its prevalence in poultry, especially in China, makes it a significant public health concern, requiring robust monitoring.” (1)
“In the United States, the term bird flu has become synonymous with a particular virus that has devastated poultry and dairy farms over the past few years. But that virus, called H5N1, is not the only form of bird flu in circulation.
Concerned scientists are keeping a close eye on other types, including a fast-changing flu virus called H9N2.
In a study published in November, researchers in Hong Kong showed that over the last decade, this virus has acquired mutations that allow it to spread more efficiently among people and to cause more severe disease.
H9N2 is often discounted as a threat, because it causes only mild symptoms in poultry. But in people, especially children, the virus can cause more severe illness than the seasonal flu.
There have been fewer than 200 reported cases of H9N2 in humans since 1998, but the number has been rising sharply. China reported 29 human cases of H9N2 last year, compared with 11 in 2024.
Those numbers, though, are likely to be underestimates, because many infected people are never tested and the virus may spread undetected, Dr. Kelvin To, a clinical microbiologist who led the November study, said.
“If it continues to be widely circulating in poultry, mammals and humans, it may certainly one day evolve into something very serious,” Dr. To said.
Researchers like Dr. To have long feared that the next pandemic will be caused by a flu virus, and the new report suggests that mutating H9N2 bears watching. But it is not the only one.
H5N1 is “the headline stealer,” said Richard Webby, an influenza expert at St. Jude Children’s Research Hospital in Memphis. It has infected poultry and mammals worldwide, leaving behind economic devastation.” (2)
1.H9N2 avian influenza cases reported in China, Robert Herriman, https://outbreaknewstoday.substack.com/p/h9n2-avian-influenza-cases-reported
2.Bird Flu Viruses Raise Mounting Concerns Among Scientists, By Apoorva Mandavilli, https://www.nytimes.com/2026/01/10/health/bird-flu-viruses-health.html
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai