#19,096
With a hat tip to Pathfinder on FluTrackers who posted a media story, I've tracked down the Italian MOH's statement on what appears to be the first H9N2 human infection to be reported in Europe.
At least one media report identifies the patient as a 'a boy who returned from Africa and was hospitalised a few days after his arrival at Milan Malpensa', although I have yet to find official confirmation.Details are vague, but this appears to have been someone who recently arrived from a `non-European' country where they were likely exposed.
(Translated)
Influenza A (H9N2) virus case identified in Lombardy. Routine surveillance and prevention procedures activated.
Press release number 8
Press release date March 25, 2026
The Ministry of Health informs that the Lombardy Region has identified a case of infection with the low-pathogenicity avian influenza A(H9N2) virus of animal origin, in a frail person with concomitant illnesses, who came from a non-European country where he contracted the infection, and is currently hospitalized.
This is the first human case of H9N2 avian influenza detected in Europe. Based on the scientific information available to date, infection occurs through direct exposure to infected poultry or contaminated environments or materials. Human cases are characterized by mild illness, and human-to-human transmission has never been reported.
All the required checks were promptly carried out and the relevant contacts were identified, as part of the ordinary prevention and surveillance activities.
The Ministry of Health immediately activated coordination with the Lombardy Region, the Istituto Superiore di Sanità, and the national reference laboratory expert group, and ensured the coordination and updating of the relevant international bodies.
Currently, no critical issues have been identified and the situation is being constantly monitored.
While 90% of the human H9N2 cases reported have come from China, we've seen sporadic cases in places like Cambodia, Vietnam, and India. We've also seen a handful of cases in Africa (4 in Egypt, 1 in Senegal, and the most recent in Ghana).
The Asian Y280/G57 lineages have shown increasing signs of mammalian adaptation (see EM&I: Enhanced Replication of a Contemporary Avian Influenza A H9N2 Virus in Human Respiratory Organoids)), while the African and Middle Eastern Lineages (mostly European G1-like) are older and less evolved.
Worth noting, LPAI H9N2 has also been detected in African bats (see Preprint: The Bat-borne Influenza A Virus H9N2 Exhibits a Set of Unexpected Pre-pandemic Features).
Given their relatively scarcity outside of Asia, WGS (Whole Gene Sequencing) and antigenic characterization of this latest case will be of considerable interest.
