Italy has confirmed the first imported human case of avian influenza A(H9N2) in the European region, raising fresh concerns about zoonotic disease surveillance, although global health authorities insist the risk to the general public remains low.
The case, involving an adult male who recently returned from Senegal, was officially reported to the World Health Organization on March 21, 2026, by Italy’s National International Health Regulations (IHR) Focal Point.
According to the WHO, the patient had lived in Senegal for more than six months before travelling to Italy in mid-March. Shortly after arrival, he presented at an emergency department with symptoms including fever and persistent cough.
Medical investigations revealed a complex clinical picture. A bronchoalveolar lavage sample collected on March 16 tested positive for Mycobacterium tuberculosis, alongside an un-subtypeable influenza A virus. The patient was immediately placed in a negative-pressure isolation unit and commenced on antitubercular treatment and the antiviral drug oseltamivir.
By April 9, health authorities reported that his condition had stabilised and was improving.
Further laboratory analysis confirmed the presence of the A(H9N2) virus.
“Next-generation sequencing carried out on March 21 confirmed influenza A(H9N2), with genetic similarities to strains previously detected in poultry in Senegal,” the WHO said in its situation update.
Despite the confirmation, epidemiological investigations have so far failed to establish a clear source of infection. Notably, the patient had no known contact with poultry, animals, or symptomatic individuals prior to the onset of illness.
“This makes the case particularly important from a surveillance standpoint,” a WHO official noted, adding that “investigations into the source of exposure are still ongoing.”
Health authorities in Italy have since activated a coordinated public health response involving national and international partners, including the European Centre for Disease Prevention and Control.
Contact tracing was promptly initiated both in Italy and Senegal. All identified contacts in Senegal remained asymptomatic, while those traced in Italy tested negative for influenza and completed the required monitoring and quarantine period.
Preventive antiviral treatment with oseltamivir was also administered to contacts in Italy as a precautionary measure.
Experts say avian influenza viruses typically circulate among animal populations but can occasionally infect humans, often through direct or indirect exposure to infected poultry or contaminated environments.
“Infections in humans can range from mild respiratory illness to severe disease, and in some cases may be fatal,” the WHO explained, noting that symptoms may also include conjunctivitis, gastrointestinal complications, and, in rare instances, neurological conditions.
Human infections with A(H9N2) viruses have been reported mainly in parts of Africa and Asia, with the majority of cases documented in China. The virus is known to be endemic in poultry populations, particularly in live bird markets.
The WHO stressed that current evidence does not indicate sustained human-to-human transmission of the virus.
“Available epidemiological and virological data suggest that the likelihood of sustained human-to-human spread remains low at this time,” the agency said.
It added: “While sporadic cases may occur, especially in individuals exposed to infected birds or contaminated environments, broader community transmission is considered unlikely.”
The agency further emphasised that the case does not warrant any changes to existing public health measures or international travel guidelines.
“WHO does not recommend any travel or trade restrictions based on the current information available,” it stated.
However, it advised the public to maintain vigilance, particularly in high-risk environments.
“People should avoid contact with live animal markets or surfaces that may be contaminated by poultry droppings,” the WHO advised.
“Those handling poultry should use appropriate respiratory protection and practise good hand hygiene.”
Under the International Health Regulations (2005), all human infections caused by novel influenza A subtypes must be reported to the WHO due to their potential public health impact.
Public health experts say the development underscores the need for sustained global surveillance, especially as international travel increases the risk of cross-border transmission of emerging infectious diseases.
“This case highlights the importance of early detection systems and international cooperation in preventing potential outbreaks,” a European health official said.
WHO said it would continue to monitor the situation closely and reassess the risk if new epidemiological or virological data emerge.