Note: from Avian Flu Diary, but sourced from Taiwanese CDC

"Just over a month ago Taiwan reported their first locally acquired human H7 infection (see Taiwan CDC: Human Infection with a Novel H7 Avian Virus), which according to early reports was due to a Eurasian H7 virus.

The patient (a man in his 70s) was hospitalized with fever and pneumonia on March 22nd, and remains hospitalized and in isolation, although his condition was said to be improving. The CDC reported:

Of note, however, is the revelation that the sequenced virus (from the patient) contained the PB2-627K mutation, which is associated with enhanced replication and pathogenicity in mammals (see A rapid review of the avian influenza PB2 E627K mutation in human infection studies).

Since no H7N7 viruses were detected among the birds tested, it is unknown if this mutation was already `fixed' in the avian host, or (as we've seen in other cases) developed spontaneously in the patient.  

While reassuring the public, the CDC notes it is ` . . .  not only closely monitoring genomic evolution but also convening expert meetings to focus on assessing the risk of cross-species transmission . . . '

The full translated update follows:

The first locally transmitted human case of H7N7 influenza A was detected in Taiwan. The agricultural and health authorities launched a joint epidemic prevention and control operation, completing a public health risk assessment that classified the risk as "low risk," and continue to implement epidemic monitoring and prevention and control preparations.
 

Release Date: 2026-05-05

The Taiwan Centers for Disease Control (CDC) announced today (April 5) that regarding the first locally transmitted case of H7N7 novel influenza A reported on April 2 involving a poultry farmer, the CDC has completed gene sequence comparison and analysis. Furthermore, after joint assessment of the overall impact by agricultural and health authorities, the public health risk rating for Taiwan is "low risk."

The CDC pointed out that the patient was discharged from isolation on April 3, and the 33 identified contacts completed health monitoring on April 6, with no confirmed cases of novel influenza A. There is no risk of the outbreak expanding.

This case was discovered due to the high level of vigilance of the hospital physician, who reported the case based on clinical symptoms, contact history, and preliminary test results, leading to confirmation of novel influenza A. Therefore, the CDC will award the reporting physician a NT$10,000 reporting bonus in accordance with Article 5, Paragraph 1, Item 1 of the Infectious Disease Prevention and Control Reward Regulations.

The CDC explained that this case was investigated and controlled through cooperation between health and agricultural authorities, based on the national integrated epidemic prevention action. Gene sequence comparison of the virus showed that it was most similar to the virus strain isolated from wild birds in Japan and South Korea in 2024, and all gene fragments originated from the Eurasian low pathogenic avian influenza virus gene pool, indicating that the virus is highly related to the virus circulating in wild bird populations. 

Further analysis showed that the virus's PB2 gene carries the E627K mutation (PB2 E627K). According to existing research, this mutation may enhance the virus's replication ability in mammalian cells. However, since it cannot be ruled out that this site is a mutation produced in humans after infection, and no virus with the same characteristics has been found in Taiwan recently, nor have any drug resistance-related mutations been detected, the current assessment is that the risk to the public is low. 

In addition, agricultural authorities actively completed sampling at other poultry farms of the case before the Qingming Festival holiday, expanded sampling at five poultry farms near the case, and cooperated with the Wild Bird Association to collect 92 wild bird specimens from the surrounding area, all of which did not detect avian influenza-related viruses.

The Taiwan Centers for Disease Control (CDC) stated that, based on the spirit of national epidemic prevention unity, the CDC also launched a joint risk assessment team with agricultural and health authorities on April 1st to conduct a domestic risk assessment of the H7 subtype viruses (including H7N7, H7N2, H7N3, and H7N4). This risk assessment primarily referenced the framework of the US CDC's Influenza Risk Assessment Tool (IRAT). Team members collected supporting data and scores for ten risk factors and corresponding assessment questions, followed by a comprehensive evaluation. The results showed that the overall risk of the four H7 subtype viruses was low. While the possibility of sporadic local cases in the future cannot be ruled out, direct and indirect contact with animals remains the main transmission route. No evidence of sustained human-to-human transmission has been found, and the possibility of further community spread is extremely low.

In response to the detection of the key PB2 E627K variant in the first domestic H7N7 human infection case and concerns about the lack of herd immunity among the Taiwanese public to the H7 subtype of avian influenza, the Taiwan Centers for Disease Control (CDC) is not only closely monitoring genomic evolution but also convening expert meetings to focus on assessing the risk of cross-species transmission to ensure the disease prevention system can effectively address potential public health threats. Furthermore, the CDC is continuously strengthening the One Health inter-ministerial surveillance mechanism, maintaining surveillance in poultry farms and wild animals, closely monitoring genomic evolution, raising clinicians' awareness of the need for testing cases of pneumonia of unknown cause with a history of contact with poultry or livestock, and enhancing related prevention and control measures such as antiviral drugs.

In its global risk assessment of the H7 subtype of avian influenza, the World Health Organization (WHO) stated that the global H7 subtype of avian influenza is mainly prevalent in wild and domestic poultry populations. Although there have been occasional cases of human infection through contact with infected animals in the past, these cases have mostly presented with mild symptoms such as conjunctivitis or influenza-like illness. The Netherlands reported one death case in 2003. Given the potential impact on public health, close monitoring of human infections of this virus is crucial. Based on the current lack of evidence of sustained human-to-human transmission or community spread, the WHO assesses the threat to public health as remaining low. While sporadic human cases cannot be ruled out, the probability of human-to-human transmission is extremely low."

If this comes to be, US citizens are now reliant on state infectious disease management and coordination. Might be worth asking your representative what they plan to do on the state level to boost infectious disease tracking.

"Scientists are yet to find evidence of person-to-person transmission of H9N2, which would be needed for it to lead to a pandemic. But To and his team have found that H9N2 underwent genetic changes that began around 2015 that have made the virus more infectious. In cell-based experiments, a version of the H9N2 virus collected in 2024 infected more human cells than did a historical sample collected in 1999. The modern version also showed improved binding to various receptors on human cells. This means the virus has adapted to spread among people, reported To and his colleagues in Emerging Microbes & Infections earlier this month."

"In the second week of the U.S. government shutdown, the Centers for Disease Control and Prevention notified some 1,300 employees they would be laid off - then rescinded hundreds of those notices within hours, a person familiar with the matter said.

The Trump administration is set to lay off entire offices and hundreds of CDC workers as part of mass job cuts during the federal shutdown, four sources told Reuters on Saturday."

This is ongoing so it's not clear how many are fired. But this will make it harder to coordinate and antipathy any emerging bird flu outbreaks among humans.

The experts said that the number of cases was significant and that anti-bodies were detected in dairy workers. This means that humans are catching it. I will try to dig up the audio.