A man arrived in Italy sick with a fever and cough, then one test result confirmed something Europe had never seen before

The World Health Organisation has confirmed the first human case of avian influenza A(H9N2) ever reported in the European region. The story came to light after an adult male arrived in Italy and sought emergency medical attention in mid-March, presenting with a fever and a persistent cough. As detailed by the WHO disease outbreak report and highlighted by Express, the case marks the first time this bird flu subtype has been imported into Europe in a human.

The patient had been living in Senegal for more than six months before traveling to Italy. Upon arrival at the hospital, medical staff collected a bronchoalveolar lavage specimen to determine the cause of his illness. The results were complex: the test confirmed a positive result for Mycobacterium tuberculosis while also detecting an un-subtypeable influenza A virus.

The hospital placed the man in a negative-pressure isolation room with airborne precautions. He was treated with both antitubercular medication and the antiviral drug oseltamivir. By 9:00 AM on April 9, the WHO reported his condition was stable and improving.

The patient had no known contact with animals, which made the result harder to explain

Subsequent next-generation sequencing identified the virus as influenza A(H9N2), a strain known to circulate in poultry populations across parts of Africa and Asia. What made this case unusual is that the patient reported no known history of direct exposure to animals, wildlife, or rural environments, and had no contact with anyone showing similar symptoms. Laboratory findings suggest the infection was likely acquired from an avian source linked to Senegal, where the virus has previously been detected in poultry and environmental samples.

Public health authorities moved quickly. Contact tracing was initiated immediately, and all identified contacts in Italy were monitored for symptoms. Every contact tested negative for the virus and completed their required period of active monitoring and quarantine, with oseltamivir provided as a precautionary measure.

The WHO’s guidance on environmental exposure remains consistent regardless of whether a case is travel-linked or domestic. The public is advised to avoid live animal markets, farms, and surfaces that may be contaminated by poultry, a reminder that also applies in cases like contaminated food product concerns where consumer exposure to unsafe goods prompted a public reaction. Respiratory protection is recommended for those in occupational or backyard-farming settings who handle live or dead poultry, and frequent handwashing or alcohol-based hand sanitiser use remains a top precaution.

Most human infections with H9N2 have historically been linked to direct contact with infected poultry or contaminated environments. While symptoms can range from mild upper respiratory illness to more severe disease, the WHO currently assesses the risk to the general public as low, noting that the virus has not acquired the ability for sustained human-to-human transmission. Sporadic cases are expected as long as the virus remains present in poultry populations, but community-level spread is considered unlikely.

The WHO has stated this case does not change current public health recommendations or surveillance guidance, and no travel or trade restrictions have been advised. Under the International Health Regulations, any human infection caused by a new influenza subtype is a notifiable event. Authorities in Italy, the National IHR Focal Point for Senegal, the WHO, and the European Centre for Disease Prevention and Control have all been coordinating through official channels, a process not unlike the rapid international response seen when a traveler fell severely ill after exposure at a foreign destination. No secondary transmission has been identified in this case.