WHO WPRO Reports 2 Recent H9N2 Cases From Chinese Mainland

 

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While case reports remain widely scattered, and there are no signs of human-to-human spread, Mainland China's summer uptick of H9N2 continues, with 2 more cases reported over the past 2 weeks. 

This follows 3 cases in June and 5 in July (see chart below), which I reported on 2 weeks ago. 

Last week, the WHO WPRO Avian Influenza Weekly Update # 1058: 21 August 2026 reported:

Human infection with avian influenza A(H9N2) virus

From 14 to 20 August 2026, one new case of human infection with avian influenza A(H9N2) virus was reported to WHO in the Western Pacific Region. The case is a male child under 5 years of age from Anhui Province, China, with symptom onset on 3 August 2026. The case was hospitalised and subsequently discharged. The case had exposure to live poultry market, and no additional cases were reported from close contacts.

Since 2015, a total of 179 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, 176 were reported from China, two were from Cambodia, and one was from Viet Nam.

This week, in Avian Influenza Weekly Update # 1059: 28 August 2026 they report:

Human infection with avian influenza A(H9N2) virus

From 21 to 27 August 2026, one new case of human infection with avian influenza A(H9N2) virus was reported to WHO in the Western Pacific Region. The case is a pediatric patient from Beijing Province, China,with symptom onset on 15 August 2026. The case has since recovered. The case had exposure to live poultry market, and no additional cases were reported from close contacts.

Since 2015, a total of 179 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,176 were reported from China, two were from Cambodia, and one was from Viet Nam.

I'm not sure why the case counts are not being incremented, but I assume it is just an oversight. Given the limits of surveillance and testing, these reported cases are assumed to represent a subset of the actual number of spillovers into humans.

Notably, both cases reportedly had exposure at a live poultry market, which has long been recognised as a risk factor. 

While H9N2 is rarely thought of as being in the same league as H5N1, the CDC lists two lineages (A(H9N2) G1 and A(H9N2) Y280) as having at least some pandemic potential, and several candidate vaccines have been developed.

In terms of risk of emergence, the H9N2 Y280 lineage is ranked higher than H5N1 

And as we've discussed often, most recently in EM&I: Genetic evolution, phylodynamics, geographic spread of H9N2 avian influenza viruses in China from 2014 to 2025: an increasing potential zoonotic risk, LPAI H9N2 appears to be evolving towards a more mammalian-adapted virus.  

Whether H9N2 has true pandemic potential is unknown, but this is definitely a virus worth keeping our eye on.

September Is National Preparedness Month (#NPM26)

 

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For more than 20 years September has been designated National Preparedness Month here in the U.S., and while we cover emergency preparedness issues year-round (recent examples include here, here, here, here, and here), over the next 30 days I'll be uploading a number of new, or updated, preparedness blogs. 

So far we've been lucky with a suppressed Atlantic Hurricane Season this summer, but we are about to experience a strong - perhaps record breaking - El Nino Fall and Winter. One which could produce extreme weather events (floods, ice storms, severe weather) in some parts of the country.

Other threats, ranging from earthquakes and tsunamis to cyber attacks and power failures know no season, and can strike without warning. Even aging infrastructure poses a risk.

In 2025 the U.S. Department of Energy published a 73-page report that warned that if current schedules for retirement of reliable power generation (especially baseload) continue, without enough firm replacement, the risk of blackouts by 2030 could increase dramatically.

And as we saw last week in UK National Risk Register 2026 - Urges Citizen Preparedness, many countries continue to put the emergence of a `Disease X' pandemic at the top of their threats list. 

How well you and your family will fare during any of these emergencies depends largely upon how well prepared you were when they started.  Our first stop today is the 2026 message from Ready.gov, which reads in part:

National Preparedness Month

Last Updated: 08/28/2026

FEMA’s Ready Campaign has observed National Preparedness Month since 2004 to encourage Americans to prepare for emergencies. The month is a great time to take small steps to make a big difference in being prepared.

Preparedness Starts at Home, the 2025 theme, focuses on getting back to the essentials of preparedness. In addition to sharing the tips, messages and graphics you can find on Ready.gov, there are four key actions you can take to prepare for any disaster you may face:

Know your risk

• Know what could happen where you and your family live. This helps you figure out what you need to do to stay safe. You can explore various disasters and emergencies on Ready.gov. 

Make a family emergency plan

• Making a plan early helps you reduce stress and save time and money. Follow four easy steps and create a free Family Emergency Plan quickly and easily with our fillable form.
• Disasters are costly but preparing for them doesn’t have to be. Taking time to prepare now can help save you thousands of dollars and give you peace of mind when the next disaster or emergency occurs. Visit Ready.gov’s low and no-cost tip page to see how you can be better prepared without spending a lot of money.

Build an emergency supply kit

• Having enough food, water and medicine can help you stay safe and comfortable until help arrives. Having what you need can also prevent injury and damage to your home.
• Build a go-bag with all the essentials you might need, so you don’t need to scramble in an evacuation situation. Find a list of supplies at Build A Kit.

Get involved in your community by taking action to prepare for emergencies

• Emergencies can happen fast, and emergency responders aren’t always nearby. You may be able to save a life by taking simple actions immediately. You can learn these steps when you take a first aid class through many organizations in your community..
• Join a Community Emergency Response Team program and get trained on basic disaster response skills, such as fire safety, light search and rescue, team organization and disaster medical operations.
• Take a free online independent study course through FEMA’s Emergency Management Institute or a CPR course through the American Red Cross to learn more about how to help your community become more prepared.

(Continue . . . )

Although I'm a huge proponent of having a good first aid kit (or three), emergency power options, and a full pantry, I can think of no prep more valuable than having one or more `disaster or flu'  buddies on whom you can rely in an emergency. 

While I first wrote about it 16 years ago, in In An Emergency, Who Has Your Back?, you find a more recent (2025) update at With A Potentially Severe Flu Season Ahead: Time to Line Up A `Flu Buddy'.

While I've no idea what challenges we as a nation will face in the coming year, I do know that individual preparedness is relatively cheap insurance.  So I hope you'll find some useful information in this year's crop of preparedness blogs.