Gene flow and its sporadic spillover: H10 and N5 avian influenza viruses from wild birds and the H10N5 human cases in China.

On January 30, 2024, China announced the first human case of H10N5 influenza infection. Prior to this, human cases of H10N7 and H10N8 had been reported. It is now appropriate to re-examine the evolution and future epidemiological trends of the H10 and N5 subtypes of avian influenza viruses (AIVs). In this study, we analyzed the reassortment characteristics of the first human-derived H10N5 AIV (A/Zhejiang/ZJU01/2023), as well as the evolutionary dynamics of the wild bird-derived H10 and N5 subtypes of AIVs over the past decade. Our findings indicate that the human-derived H10N5 AIV exhibited low pathogenicity. A/bean_goose/Korea/KNU-10/2022(H10N7) and A/mallard/Novosibirsk_region/962k/2018(H12N5) were identified as the potential reassortment parents. The virus has existed since 2022 and several isolations have been reported in Bangladesh. Phylogenetic analysis showed that H10Ny and HxN5 AIVs in China are clustered differently based on the East Asian-Australian (eastern) and Central Asian-Indian (western) migratory flyways. The H10Ny and HxN5 AIV reassortant strains may cause human infections through accidental spillover. It is possible that another center of AIV evolution, mutation, and reassortment may be developing along the migratory flyways in northeastern Asia, distinct from Europe, the Americas, and China's Yangtze River Delta and Pearl River Delta, which should be closely monitored to ensure the safety of the public.