Avian influenza in humans: Virology, transmission, and clinical priorities
Year: 2026
Type: article
Abstract: Avian influenza continues to evolve as a zoonotic threat with important implications for clinical practice and global health preparedness. Sustained circulation in wild birds, repeated spillover into poultry, and an increasing number of infections across diverse mammalian hosts have reshaped exposure pathways and broadened the risk landscape for human infection. For clinicians, this evolving ecology translates into atypical presentations and increased diagnostic uncertainty. Recent global activity has been characterised by widespread animal outbreaks and the emergence of new transmission interfaces, including occupational exposures and livestock-associated events. Human infections remain largely zoonotic and geographically heterogeneous, with patterns influenced by surveillance intensity, exposure context, and healthcare access. We synthesise current evidence on the virology, transmission, global epidemiology, clinical manifestations, diagnosis, treatment, and prevention of avian influenza in humans. We highlight evolving mammalian adaptation and changing risk interfaces that complicate risk assessment. Improved clinician awareness, early diagnosis, and integrated One Health surveillance remain central to strengthening preparedness for future influenza threats.
Source: QJM
Institutions: Manipal Academy of Higher Education, European Society of Clinical Microbiology and Infectious Diseases, Kasturba Medical College, Manipal, University of Liverpool, Liverpool University Hospitals NHS Foundation Trust, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Hospital Universitario La Paz, University of Belgrade, Univerzitetski Klinički Centar Srbije, Statens Serum Institut, Inserm, Université Paris Cité, Assistance Publique – Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Infection, Anti-microbiens, Modélisation, Evolution, Amsterdam Public Health, Amsterdam University Medical Centers, University of Amsterdam, National and Kapodistrian University of Athens, University of Cambridge, NIHR Cambridge Biomedical Research Centre
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,382
OpenAlex ID: W7162756255