China - Hong Kong: CHP investigates case of influenza A (H9) infection (probably H9N2) - June 12, 2026

[sharon sanders]

hat tip Michael Coston



CHP investigates case of influenza A (H9) infection (with photo)
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The Centre for Health Protection (CHP) of the Department of Health (DH) is today (June 12) investigating a case of human infection with influenza A (H9) in collaboration with relevant departments. The patient is a two-year-old boy. His condition has remained mild and he is currently in stable condition. The CHP will send a letter to all doctors in Hong Kong to update them on the latest developments regarding avian influenza A and to urge them to remain vigilant and report any suspected cases.

Case information
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The boy lives in Sha Tin District. He developed a fever and mild diarrhoea on June 9. On the following day (June 10), he was brought to Prince of Wales Hospital and was admitted for treatment. His clinical specimen tested positive for the influenza A (H9) virus by the Public Health Laboratory Services Branch (PHLSB) of the CHP. The subtyping result is pending. His clinical diagnosis was novel influenza. He is currently in stable condition and has been admitted to an isolation ward at Princess Margaret Hospital for treatment.

The CHP's preliminary investigation revealed that the patient had no travel history during the incubation period. The case has been classified as a locally acquired case. The patient does not attend school or receive daycare services. He is primarily cared for by his family members and spends most of his time at home or nearby. His household does not keep poultry. According to information provided by his family members, he has neither consumed undercooked poultry nor come into contact with any patients. In early June, one of his family members took him to Wo Che Market on two occasions. During these visits, the patient stayed at a fresh provision shop in the market that sells live chickens to watch the poultry and touched the surroundings of the fresh provision shop. The CHP conducted an investigation with the Food and Environmental Hygiene Department (FEHD) and collected environmental samples from the shop concerned. The shop staff remained asymptomatic. The patient has six household contacts and they remain asymptomatic so far. The CHP has provided them with preventive medication and put them under medical surveillance.

The CHP is continuing to investigate the source of infection of the case and is conducting whole genome sequencing of the virus sample. The CHP will also report the case to the World Health Organization (WHO).

Humans are primarily infected with the influenza A virus through direct contact with infected poultry or through indirect contact with environments contaminated by their droppings. The CHP's epidemiological investigation indicated that the patient had visited a location where live poultry was sold. It cannot be ruled out that the patient was infected through indirect contact with a contaminated environment at the wet market. As young children have weaker immune systems and are incapable of maintaining good hand hygiene, the CHP advised parents to avoid taking young children to places where live poultry is sold. Transporting poultry may contaminate the ground and the surrounding environment. As young children are shorter in height and easy to be in contact with the surrounding environment, they are at greater risk of coming into contact with poultry droppings or contaminated areas.

In the past ten years, the WHO has received reports of a total of over 160 cases of human infection with influenza A (H9) worldwide. To date, most case of human infection with influenza A (H9) have presented with only mild clinical illness. According to the WHO's risk assessment, the influenza A (H9) virus has not acquired the ability for sustained human-to-human transmissions.

Government's comprehensive follow-up actions
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Novel influenza A infection, including influenza A (H9), is a notifiable infectious disease in Hong Kong. Compared to other highly pathogenic avian influenza strains such as H5N1 and H7N9, influenza A (H9) is a low-pathogenic avian influenza strain that causes milder illness. Excluding the aforementioned case, 10 cases of influenza A (H9N2) have been reported since 1999, including four locally acquired cases and six imported cases. No deaths have been recorded so far. In response to the latest local case, the CHP will issue a letter to all doctors in Hong Kong, reminding them of the latest situation of influenza A (H9), and urging them to remain vigilant and report any suspected cases.

Sporadic cases of human infection with avian influenza occur from time to time internationally. Although the current risk of an outbreak is low, the Hong Kong Special Administrative Region Government has consistently implemented preventive measures, including a disease surveillance system, the implementation of livestock control measures at farms, markets and ports, in order to prevent avian influenza.

The PHLSB of the CHP comprises laboratories with high biosafety standards, capable of conducting, testing for high-risk pathogens, and which also possess sufficient testing and genetic analysis capabilities and facilities. Hong Kong currently has sufficient reserve of antiviral medications.

Preventive measures to be taken by the public
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Humans are primarily infected with the avian influenza A virus through contact with infected birds, poultry or other animals (whether alive or dead), or through surfaces or environments contaminated with saliva, mucous and animal faeces (such as wet markets and live poultry markets). The virus has very low transmissibility among humans. People who have close contact with live poultry are more susceptible to contracting avian influenza. The elderly, children and people with chronic illnesses have a higher risk of developing complications such as bronchitis and pneumonia, if infected. Members of the public should remain vigilant and take the following measures to prevent avian influenza:

• Avoid contact with poultry, birds or their droppings. If contact has been made, thoroughly wash hands with soap and water;
• Poultry and eggs should be thoroughly cooked before eating;
• Perform hand hygiene at all times, especially before touching the mouth, nose or eyes; after contact with animals or their living environments; after touching public installations such as handrails or doorknobs; or when hands are contaminated with respiratory secretions, such as after coughing or sneezing;
• Cover the mouth and nose with tissue paper when sneezing or coughing. Dispose of soiled tissues into a lidded rubbish bin, then wash hands thoroughly;
• When having respiratory symptoms, wear a surgical mask, do not go to work or school, avoid crowded places and seek medical advice promptly;
• Avoid crowded public places or areas with poorly ventilated; high-risk individuals may consider putting on a surgical mask when staying in such places; and
• Travellers returning to Hong Kong from areas affected by avian influenza outbreaks should consult doctors promptly if they have flu-like symptoms, and inform the doctor of the recent travel history and wear a surgical mask to help prevent spreading of the disease.

The public may visit the CHP's webpages for more information: Avian Influenza Webpage, Avian Influenza Report, Avian influenza statistics and affected areas around the world, Facebook page and Youtube channel.

Ends/Friday, June 12, 2026
Issued at HKT 22:19

https://www.info.gov.hk/gia/general/202606/12/P2026061200852.htm

[Pathfinder]

(screenshots)

https://www.chp.gov.hk/files/pdf/letters_to_doctors_20260612.pdf

[Pathfinder]

Major H9 bird flu outbreak not likely: CHP

2026-06-15 HKT 17:45

The controller of the Centre for Health Protection (CHP), Edwin Tsui, said the H9 bird flu virus is unlikely to cause a major outbreak in Hong Kong.
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Speaking in a press briefing on Monday, Tsui said genetic analysis showed the boy contracted the H9N2 virus, a low-pathogenic avian influenza strain.

“The transmissibility between humans is still low. [The virus’s] appearance and behaviour is similar to the other H9N2 infection and H9N2 strains reported overseas,” he said.
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Tsui also said all 13 contacts of the boy were asymptomatic and tested negative for the virus.

Edited by Edmond Fong

https://news.rthk.hk/rthk/en/component/k2/1858584-20260615.htm%E2%80%8B

[Pathfinder]

CHP continues to actively follow up on a case of low-pathogenic avian influenza A (H9) infection and reminds the public of the possibility of "twin-peaks" for seasonal influenza and COVID-19 during summer
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The Centre for Health Protection (CHP) of the Department of Health (DH) today (June 15) continued to actively follow up on a case of human infection with influenza A (H9) in collaboration with the relevant government departments. Following whole genome sequencing and analysis of the patient's clinical specimens, the virus strain was confirmed to be a low-pathogenic avian influenza A (H9N2) virus. All of the virus genes were avian in origin and no significant genetic variations were detected. The patient is currently in stable condition and all six of his household contacts have remained asymptomatic. As the H9N2 avian influenza virus has long been present in local poultry with low mortality rate for birds, and that the H9N2 avian influenza virus involved in this case has not shown evidence of human-to-human transmission or significant genetic variation, the CHP currently assessed the risk of a local avian influenza pandemic as low. Nevertheless, the CHP once again strongly urged the public to maintain good personal and environmental hygiene at all times, avoid contact with live poultry, birds or their droppings, thoroughly cook poultry meat and eggs before consumption, and wash hands thoroughly after visiting places where live poultry is sold, so as to reduce the risk of avian influenza infection.

In addition, with the recent rise in the activity of seasonal influenza and COVID-19, the CHP does not rule out the possibility that the activity of these two respiratory diseases will continue to rise in the coming months, leading to a "twin-peaks" phenomenon. Members of the public, particularly high-risk individuals, are advised to receive vaccination in a timely manner to reduce the risk of severe disease and death.

Human infection with influenza A (H9) virus
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In relation to the recent influenza A (H9) infection in a two-year-old boy, the Public Health Laboratory Services Branch of the CHP conducted whole genome sequencing and analysis of the virus, confirming that the virus strain is a low-pathogenic H9N2 avian influenza virus and that no significant genetic variations were detected. The CHP has collected 17 environmental samples from the residence of the patient, the fresh provision shop at Wo Che Market he had visited, as well as a park in Fung Wo Estate. One sample collected from a metal tray placed at the bottom of a live chicken cage inside the shop that was used to collect chicken droppings was tested positive for the H9 avian influenza virus. The remaining 16 samples tested negative. The CHP will conduct further analysis on the positive environmental sample. The CHP believed that it is more likely for the boy to have contracted H9 avian influenza by touching a contaminated surface at the fresh food shop selling live poultry in Wo Che Market. Thorough disinfection and cleaning will be conducted at the fresh food shop in question.

The patient remains hospitalised in stable condition. His symptoms remain mild. Neither his family members nor the staff at the fresh provision shop concerned have developed any symptoms. The CHP has provided them with preventive medication and will continue to put them under medical surveillance.

Based on the above epidemiological and virological evidence, the CHP assessed that the recent local case of infection has not changed the current risk level. The risk of an influenza pandemic due to local avian influenza remains low. The Government's response level under the "Preparedness Plan for Influenza Pandemic" remains at "Alert" level.

Avian influenza viruses are generally classified as highly pathogenic or low pathogenic, and they mainly affect birds and poultry. Birds are also natural hosts for avian influenza viruses. In occasional circumstances, cross-species transmission may occur when human come into close contact with infected poultry or contaminated environments. However, there is currently no scientific evidence to suggest that the existing avian influenza viruses are capable of sustained and efficient human-to-human transmission. No novel influenza virus arising from genetic reassortment between human seasonal influenza viruses and animal influenza viruses has been found either.

Since 1999, a total of 11 cases of human influenza A (H9N2) have been recorded in Hong Kong, including five local cases and six imported cases. No fatal case has been recorded so far.

According to data published by the World Health Organization (WHO), more than 160 cases of human infection with influenza A (H9) have been recorded globally in the past decade. The vast majority of patients presented with mild symptoms. As poultry is a natural host of the virus in many regions, sporadic human infections caused by contact with infected poultry or contaminated environments are expected to continue occurring worldwide.

The CHP will continue to strengthen public education and publicity efforts to reduce the risk of avian influenza infection among the general public. A letter has been issued to all doctors in Hong Kong to update them on the latest situation regarding influenza A (H9), urging them to heighten vigilance and report any suspected cases.

Seasonal influenza and COVID-19
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Influenza activity in Hong Kong has increased in recent weeks but remains below the baseline level. Based on past experience, Hong Kong may experience two influenza seasons each year. The onset of summer influenza season began at a later time than usual last year, and sustained a longer period, extending from early September last year to early January this year, resulting in the absence of the winter influenza season that traditionally occurs in the first quarter of each year. Since the summer influenza season typically occurs between July and August, it cannot be ruled out that it may begin earlier than usual this year.

Regarding COVID-19, while overall local activity remains at a relatively low level, a slight increase has been recorded continually since early May. The COVID-19 activity levels fluctuate, with an upsurge period seen approximately every six to nine months in recent years. Each upsurge is associated with changes in predominant circulating variants and a decline in community herd immunity. It has been nearly a year since the end of the last periodic upsurge of COVID-19 activity in Hong Kong, and it cannot be ruled out that the overall COVID-19 activity will rise further in the coming one to two months.

Government's vaccination programmes
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Vaccination remains the most effective way to prevent seasonal influenza, COVID-19 and its complications. It also reduces the risk of hospitalisation and death.

The WHO has earlier announced its recommendations for the composition for seasonal influenza and COVID-19 vaccines in the upcoming season. Vaccine manufacturers are currently producing vaccines in accordance with the recommendations. A new batch of seasonal influenza vaccines will arrive in Hong Kong in this September, while COVID-19 vaccines will arrive in the fourth quarter.

The COVID-19 vaccine provided under the Government's COVID-19 Vaccination Programme (the Programme) for children and adults will expire in mid-July and early September this year respectively. As the production and delivery of COVID-19 vaccines to Hong Kong with the new composition take time, eligible persons will not be able to receive free COVID-19 vaccines through the Programme for a short period during the transition period before a new batch of vaccines arrive in Hong Kong. Therefore, those in need are advised to make appointments as early as possible. Existing vaccination services will continue until the following dates:

• Individuals aged six months to 11 years: COVID-19 vaccination services will be available until July 10, 2026.
• Individuals aged 12 or above: COVID-19 vaccination services will be available until September 5, 2026.

In addition, the shelf life of vaccines under the Government's Seasonal Influenza Vaccination (SIV) Programmes will expire at the end of July. The DH launched the 2025/26 SIV Programmes in September last year. With the government's active promotion and the cooperation of various stakeholders, over 2.03 million doses of vaccines have been administered. Members of the public who have not received vaccinations, particularly children, the elderly and chronic disease patients, should receive influenza vaccination as soon as possible.

To prevent respiratory diseases, members of the public should maintain good personal, hand and environmental hygiene at all times. Members of the public with respiratory symptoms, even if the symptoms are mild, should wear a surgical mask, avoid crowded places and seek medical advice promptly. They should maintain hand hygiene before putting on and after removing a mask. When there is a rise in activity levels of respiratory diseases, high-risk persons should wear surgical masks when visiting public places. The general public should also wear a surgical mask when taking public transport or staying in crowded places.

The public may visit the CHP's webpages for more information: Avian Influenza Webpage, Avian Influenza Report, COVID-19 Vaccination Programme, Seasonal Influenza Vaccination Programmes, Facebook page and Youtube channel.

Ends/Monday, June 15, 2026
Issued at HKT 22:10
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https://www.info.gov.hk/gia/general/202606/15/P2026061500852.htm?fontSize=1