{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:55:01Z","timestamp":1794005701553,"version":"4.8.0"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>H5N6 avian influenza has been a concern that can initiate the next global pandemic (called Disease X). Most infections have been among those in Asia, especially China, since the 2014 first human case. With a fatality rate of 61%, the virus is very deadly, even though the total number of human cases is relatively low. This paper aims to evaluate the epidemiological trends, genetic evolution, and zoonotic potential of H5N6, with a focus on its capacity to become a future pandemic agent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This narrative review is based on a comprehensive synthesis of published literature, including peer\u2010reviewed epidemiological studies, genetic analyses and clinical case reports. Key themes examined include viral evolution, host adaptation, transmission patterns, and disease pathogenesis, with particular attention to the zoonotic potential and public health implications of H5N6.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Genetically, H5N6 is still evolving and is moreover becoming increasingly adept at infecting birds and mammals. The epidemiology of the virus, its genetic mutations, and its patterns of transmission are examined with emphasis on how the virus can cross from animals to humans. H5N6, however, has demonstrated the capacity to bind to human respiratory cells, making this a potentially more likely vector of human\u2010to\u2010human transmission in the future. The virus is evolving, however, and while sustained transmission between people has not yet taken place, the developing risk is expanding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The only thing that should help here is that global health systems must be more vigilant by adding stronger bio\u2010security measures, more surveillance, and more common efforts toward vaccine research. The spread of H5N6 in both domestic and wild populations also means that a perpetually high level of monitoring, especially in high\u2010risk areas such as live poultry markets, is necessary. H5N6 could evolve to become a serious public health threat and this paper highlights the urgent need for preparedness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71526","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T05:59:37Z","timestamp":1763445577000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Next Disease X\u2010 H5N6 Avian Influenza's Evolving Threat to Human Health and Chances of Future Global Outbreak: A Narrative Review"],"prefix":"10.1002","volume":"8","author":[{"given":"Shoubeho Sadique","family":"Shandhi","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of Asia Pacific Farmgate 1205 Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mosiur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Asia Pacific Farmgate 1205 Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1230-7918","authenticated-orcid":false,"given":"Mohammad","family":"Shahriar","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Asia Pacific Farmgate 1205 Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8176-3072","authenticated-orcid":false,"given":"Ramisa","family":"Anjum","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Asia Pacific Farmgate 1205 Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"Episode #114\u2014Disease X. (n.d.). Retrieved October 9 2024 https:\/\/www.who.int\/podcasts\/series\/science-in-5\/episode--114---disease-x."},{"key":"e_1_2_14_3_1","unstructured":"What is Disease X | Johns Hopkins | Bloomberg School of Public Health. (2024 February 15).https:\/\/publichealth.jhu.edu\/2024\/what-is-disease-x."},{"key":"e_1_2_14_4_1","unstructured":"DISEASE X \u2010 What it is and what it is not | CEPI. (n.d.). Retrieved October 9 2024 https:\/\/cepi.net\/\/disease-x-what-it-and-what-it-not."},{"key":"e_1_2_14_5_1","unstructured":"Eyes on Disease X: Ranking the Next Pandemic | Think Global Health. (2024 March 27). Council on Foreign Relations.https:\/\/www.thinkglobalhealth.org\/article\/eyes-disease-x-ranking-next-pandemic."},{"key":"e_1_2_14_6_1","unstructured":"What Will the Next Disease X Be? \u2010 Blog. (n.d.). ISGLOBAL.https:\/\/www.isglobal.org\/healthisglobal\/-\/custom-blog-portlet\/-cual-sera-la-proxima-enfermedad-x-."},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy681"},{"key":"e_1_2_14_8_1","unstructured":"World Health Organization. Regional Office for the Western Pacific. (2024).Avian Influenza Weekly Update 2024(Press Releases Fact Sheets Newsletters Statements No. 382108).https:\/\/iris.who.int\/handle\/10665\/375483."},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2807.212482"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1398365"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/jvi.01145-24"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v50i12a09"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.2099"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02517-2016"},{"key":"e_1_2_14_15_1","unstructured":"Canada P. H. A. of. (2022 February 9).In\u2010Depth Analysis: Human Respiratory Disease Associated With Avian Influenza A(H5N6)[Research].https:\/\/www.canada.ca\/en\/public-health\/services\/surveillance\/human-emerging-respiratory-pathogens-bulletin\/2022\/january\/in-depth-analysis-avian-influenza-a-h5n6.html."},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14030263"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2709.210819"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid3006.240192"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2612.201201"},{"key":"e_1_2_14_20_1","unstructured":"CDC. (2024 October 4).Prevention and Antiviral Treatment of Avian Influenza A Viruses in People. Avian Influenza (Bird Flu).https:\/\/www.cdc.gov\/bird-flu\/prevention\/index.html."},{"key":"e_1_2_14_21_1","unstructured":"Influenza (Avian and other zoonotic). (n.d.).https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/influenza-(avian-and-other-zoonotic)."},{"key":"e_1_2_14_22_1","unstructured":"Guidance on human health issues related to avian influenza in Canada. (2023 July 7). [Guidance].https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/guidance-human-health-issues-avian-influenza.html."},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11030593"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.00127-16"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.71526","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.71526","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.71526","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T17:12:56Z","timestamp":1787245976000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.71526"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/hsr2.71526"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.71526","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-01-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71526"}}