Avian Influenza Surveillance Among Migratory Birds, Poultry, and Humans Around Nansi Lake, China, 2021-2024

Avian influenza A viruses (AIVs) pose a significant pandemic threat due to their cross-species transmission potential. However, AIV surveillance at the critical "migratory birds-poultry-exposed population" interface remains limited. Between 2021 and 2024, we implemented a prospective One Health surveillance program around Nansi Lake, monitoring AIVs in migratory birds, poultry, and environmental samples, as well as serological investigations against representative AIVs among migratory birds or poultry-exposed subjects. AIVs were detected in 2.1% (30/1417) of migratory bird samples and 10.2% (100/978) of poultry samples. Among these, we identified ten highly pathogenic avian influenza (HPAI) H5 subtype viruses, one HPAI H7N9 virus, and five low pathogenic avian influenza (LPAI) H9N2 viruses. Phylogenetic analysis revealed evidence of frequent genomic reassortment events involving H5 subtype viruses among migratory birds, poultry, and humans. Serological investigation also suggested that both migratory birds and the poultry-exposed population had a higher risk of getting AIV infection than the general control population, especially against the H9N2 virus. Our study emphasizes the importance of strengthening continuous prospective surveillance of AIVs among migratory birds, poultry, and their exposed individuals to prevent and control potential outbreaks.