Italy Reports Human Case of Bird Flu

Italy has reported the first human case of avian influenza A(H9N2) in the European Union and European Economic Area (EU/EEA). The case involves an adult male who returned to the Lombardy region of Italy from Senegal, where he had stayed for more than six months.

The National International Health Regulations (IHR) Focal Point for Italy notified the World Health Organization (WHO) of the identification on 21 March 2026. The patient sought medical attention at an emergency department after experiencing a fever and a persistent cough.

Medical evaluations included a bronchoalveolar lavage specimen collected on 16 March. This test resulted in a positive finding for Mycobacterium tuberculosis and the detection of an influenza A virus that was initially un-subtypeable. Subsequent next generation sequencing confirmed the virus as Influenza A(H9N2).

Patient Treatment and Status

The patient, who had co-existing medical conditions and was described as being in poor health prior to the infection, was placed in a negative-pressure isolation room with airborne precautions. He received a combination of antiviral oseltamivir and antitubercular medication.

According to the WHO, the patient’s condition was stable and improving by 9 April 2026.

Epidemiological Investigation

Italian public health authorities conducted contact tracing and initiated microbiological and epidemiological investigations to identify and control any potential onward transmission. Epidemiological findings indicated that the patient had no known history of exposure to poultry or any individual with similar symptoms before the onset of his illness.

The European Centre for Disease Prevention and Control (ECDC) noted that direct contact with contaminated environments or infected birds is typically the most likely source of human avian influenza infections. The ECDC is monitoring the situation and maintaining contact with Italian authorities.

Global Context of A(H9N2)

Avian influenza A(H9N2) is a low-pathogenicity virus. Between 1998 and 27 February 2026, 195 human cases were reported worldwide across 10 countries in Africa and Asia. Of these cases, only two were fatal.

The distribution of reported cases shows a high concentration in Asia, with approximately 90% of cases reported in China. Other countries with detections include India, Vietnam, and Cambodia. In Africa, cases have been recorded in Senegal, Ghana, and Egypt.

The most recent human cases prior to the Italian event were detected in China in February 2026. In the preceding year, 29 cases were reported from mainland China.

Public Health Risk Assessment

Both the WHO and ECDC have assessed the risk to the general population. The WHO describes the current risk posed by A(H9N2) viruses as low, while the ECDC assesses the risk for the general population in the EU/EEA specifically related to this event as very low.

Health authorities emphasize that there have been no documented instances of person-to-person transmission or clusters of human A(H9N2) infections reported to date. Human infections with this subtype typically result in mild illness.

Under the International Health Regulations (2005), any human infection caused by a novel influenza A virus subtype is considered an event with the potential for high public health impact and must be notified to the WHO.