Updated joint FAO/WHO/WOAH public health assessment of recent influenza A(H5) virus events in animals and people - Assessment based on data as of 1 Ju

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Overview


At the present time, based on available information, FAO-WHO-WOAH assess the global public health risk of influenza A(H5) viruses to be low, while the risk of infection for occupationally or frequently exposed (e.g., with backyard poultry) persons is low to moderate depending on the risk mitigation and hygiene measures in place and the local avian influenza epidemiological situation.

Transmission between animals continues to occur and, to date, a growing yet still limited number of human infections are being reported. Although additional human infections associated with exposure to infected animals or contaminated environments are expected to occur, the overall public health impact of such infections at a global level, at the present time, is considered minor. The assessment could change if and when additional epidemiological or virological information becomes available.
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Key points

At the present time, based on available information, FAO-WHO-WOAH assess the global public

health risk of influenza A(H5) viruses to be low, while the risk of infection for occupationally or

frequently exposed (e.g., with backyard poultry) persons is low to moderate depending on the risk

mitigation and hygiene measures in place and the local avian influenza epidemiological situation.

Transmission between animals continues to occur and, to date, a growing yet still limited number of

human infections are being reported. Although additional human infections associated with

exposure to infected animals or contaminated environments are expected to occur, the overall

public health impact of such infections at a global level, at the present time, is considered minor. The

assessment could change if and when additional epidemiological or virological information becomes

available.

This risk assessment from FAO, WHO and WOAH updates the assessment of the risk of zoonotic

transmission (for example, animal to human) considering additional information made available

since the previous assessment of 17 April 2025. This update is limited to the inclusion of additional

information being made available globally. Due to the potential risk to human health and the far-

reaching implications of the disease on the health of wild birds, poultry, livestock and other animal

populations, timely notification to global authorities and the use of a One Health approach are

essential to tackle avian influenza effectively, to monitor and characterize virus circulation, to

prevent transmission within species and to new species to reduce spread among animals, and to

prevent human infections from exposure to animals.

Continued: https://cdn.who.int/media/docs/defa...july-2025.pdf?sfvrsn=fe76b74e_1&download=true
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Excerpt from above report: [emphasis is mine]


Member States and national authorities are also recommended to:

• increase surveillance and timely reporting efforts for the early detection of A(H5) influenza

viruses in domestic birds, wild birds and mammals47;

• include infection with an A(H5) influenza virus as a differential diagnosis, in non-avian

species, including cattle, swine and other livestock and farmed domestic and wild animal

populations, with high likelihood of exposure to A(H5) viruses;

• implement preventive and early response measures to break the chain of infection among

domestic animals (for example, poultry and dairy cattle), including considering the use of

vaccination to reduce circulation in poultry as per national policies and according to

guidance provided by animal health organizations48,49;

• promptly report high pathogenicity avian influenza (HPAI) events in all animal species,

including cattle (according to the WOAH case definition50) and other domestic and wild

mammals, to WOAH and other international organizations such as FAO;

• conduct genetic sequencing and share genetic sequences of influenza viruses and associated

metadata in publicly available databases;

• protect animals by mitigating the risk of introduction and spread of the disease through

implementation and/or strengthening biosecurity in livestock holdings/premises and along

the value chain;

• protect persons by employing good production and hygiene practices when handling animals

and animal products; and

• protect persons in contact with suspected/infected animals by providing appropriate

personal protective equipment and communicating and educating on the importance and

proper use of personal protective equipment and providing information and access to

testing.
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Additional sets of recommendations related to avian influenza viruses with zoonotic potential can be

found here:

• Global strategy for the prevention and control of high pathogenicity avian influenza (2024–

2033)

• WOAH Statement on High Pathogenicity Avian Influenza in Cattle, updated 6 December

2024

• FAO Recommendations for the surveillance of influenza A(H5N1) in cattle with broader

application to other farmed mammals, published 27 November 2024

• FAO alert on avian influenza: Risk of upsurge and regional spread through wild birds in Latin

America and the Caribbean in English and Spanish

• FAO recommendations for Global Avian Influenza Viruses with Zoonotic Potential

• FAO EMPRES Watch entitled ‘A(H5N1) influenza in dairy cattle in the United States of

America’

• WHO Practical interim guidance to reduce the risk of infection in people exposed to avian

influenza viruses

• Surveillance for human infections with avian influenza A(H5) viruses: objectives, case

definitions, testing and reporting

• Considerations for the use of human A(H5) influenza vaccines during non-pandemic period

• CDC Information for Workers Exposed to H5N1 Bird Flu

Additional studies/surveillance, applying One Health principles are warranted, which could provide

information to enhance confidence in the risk assessment. These may include serological studies in

high-risk animal populations, in high-risk human populations, and epidemiological investigations.

Anyone who may have been exposed to infected or potentially infected animals or contaminated

environments should be advised to promptly seek health care if they feel unwell, and to inform their

health care provider of their possible exposure. Following prompt testing, early and appropriate

clinical management should be initiated, and precautionary measures put in place to assess and

prevent potential further spread among humans and animals.

Clinicians should also be alerted to potential zoonotic infection in patients with an exposure history

to birds or animals especially in areas where A(H5N1) viruses are known or suspected to be

circulating in animals but also in areas where surveillance in animals may be limited.

Routine epidemiologic and virologic surveillance for influenza should be conducted ideally year-

round using a standard case definition in healthcare facilities according to WHO guidance.51

Timely sharing of information and sequence data from both the human and animal health sectors

from all regions should continue to be strongly recommended and is critical for rapid and robust

joint risk assessment. The rapid sharing of virus materials with WHO Collaborating Centres of GISRS

continues to be essential to conduct a thorough risk assessment and develop or adjust targeted

response measures. The Tool for Influenza Pandemic Risk Assessment (TIPRA) provides an in-depth
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assessment of risk associated with some zoonotic influenza viruses – notably the likelihood of the

virus gaining human-to-human transmissibility, and the impact should the virus gain such

transmissibility. TIPRA maps relative risk amongst viruses assessed using multiple elements.52 Data

pertaining to the risk elements within TIPRA should be generated and shared with WHO.

Efforts to reduce human exposure to birds, livestock, and other mammals infected with or

potentially infected with avian and other animal influenza viruses should be implemented and

enhanced to minimize the risk of zoonotic infections. Individuals with activities that involve exposure

to infected animals and/or contaminated environments are at higher risk and should take necessary

precautions to prevent infection.53

Those who are exposed to potentially infected animals should have access to, be trained in their use

under different environmental conditions, and wear personal protective equipment including eye

protection.54 If they develop respiratory symptoms or conjunctivitis, they should be rapidly tested,

and precautionary infection control measures should be put in place to prevent potential further

spread among humans and to animals. For detailed guidance on treatment, refer to relevant global

and national guidance.55

Some manufacturers have initiated production of an A(H5) human vaccine that matches current

circulating strains. Although a few countries are procuring vaccine to vaccinate occupationally

exposed persons, this is not currently being recommended as a global strategy considering the

limited number of human infections with A(H5N1) 2.3.4.4b viruses.

Investigations are ongoing to understand the risk to humans from consuming raw/unpasteurized

milk contaminated with A(H5N1) virus. FAO, WHO and WOAH advise consuming pasteurized milk,

instead of raw/unpasteurized milk. Due to the potential health risks from many dangerous zoonotic

pathogens, raw/unpasteurized milk consumption should be avoided.56 If pasteurized milk is not

available, heating raw milk until it boils makes it safer for consumption.57
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Excerpt from above report (Post #1)

Detections in humans

Since the last joint assessment of April 2025 and as of 1 July 2025, an additional 16 human cases of

infection with A(H5N1) viruses have been detected. Of these, nine were detected in Cambodia, two

were detected in Bangladesh and India, and single cases were detected in China, Mexico and Viet

Nam. Of the nine cases detected in Cambodia, four died. The cases detected in India and Mexico

were also fatal. All but two cases reported direct or indirect exposure to domestic birds. The source

of infection of the case in Mexico was determined as likely indirect exposure to either domestic or

wild birds and the exposure information for one case in India was not available. No human-to-

human transmission was suspected associated with these confirmed cases. The viruses from

the case in India and from both cases in Bangladesh belong to HA clade 2.3.2.1a viruses. Viruses

from all the cases from Cambodia belong to clade 2.3.2.1e viruses. The viruses from the cases in

China and Mexico belong to clade 2.3.4.4b viruses.
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