{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:14:14Z","timestamp":1790079254860,"version":"4.0.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>\n                    Highly pathogenic avian influenza (HPAI) A(H5N1) clade 2.3.4.4b viruses have undergone an unprecedented expansion of host range since 2021, moving from wild birds and poultry into dairy cattle, domestic cats, and other mammals, with sporadic human infections in Europe and North America (\n                    <jats:xref>Food and Agriculture Organization et\u00a0al., 2025a<\/jats:xref>\n                    ;\n                    <jats:xref>Rolfes et\u00a0al., 2025<\/jats:xref>\n                    ). This expansion is underpinned by well-characterised molecular mechanisms of influenza A virus evolution \u2014 antigenic drift, gene segment reassortment, and receptor-binding adaptation \u2014 that shape the frequency and direction of cross-species spillover (\n                    <jats:xref>McDonald et al., 2016<\/jats:xref>\n                    ;\n                    <jats:xref>Steel and Lowen, 2017<\/jats:xref>\n                    ;\n                    <jats:xref>Man et\u00a0al., 2026<\/jats:xref>\n                    ). Norwegian wild-bird and mammalian surveillance data document recurrent incursions of clade 2.3.4.4b viruses, and international risk assessments continue to describe low, but non-zero, human risk concentrated among individuals with close animal contact (\n                    <jats:xref>World Health Organization, 2025\u20132026<\/jats:xref>\n                    ;\n                    <jats:xref>Ytrehus et\u00a0al<\/jats:xref>\n                    ;\n                    <jats:xref>European Food Safety Authority et\u00a0al., 2025a<\/jats:xref>\n                    ). Translating this fast-moving virological and epidemiological evidence into everyday protective behavior for children, adolescents, and families remains an underdeveloped link in pandemic preparedness, compounded by documented gaps in adolescent One Health literacy (\n                    <jats:xref>Zucca et\u00a0al., 2021<\/jats:xref>\n                    ). This mini review synthesizes current literature on the molecular basis of influenza cross-species transmission, the Norwegian epidemiological and One Health governance context, and established child- and family-oriented risk-communication frameworks, to argue that Norway\u2019s community-based public health nurses (helsesykepleiere) \u2014 who deliver near-universal, statutorily mandated contact with children and families through the helsestasjon- and skolehelsetjeneste \u2014 occupy a distinctive but underused position as One Health communication nodes (\n                    <jats:xref>Helsedirektoratet, 2021<\/jats:xref>\n                    ). I outline a practical three-tier framework for translating zoonotic-influenza science into age-appropriate household guidance, critically appraise the feasibility, workload, training, and governance implications of this role, and identify priority gaps for future empirical and implementation research.\n                  <\/jats:p>","DOI":"10.3389\/fcimb.2026.1965045","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:38:44Z","timestamp":1790077124000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["From molecular evolution to the school health room: the role of community-based public health nurses (helsesykepleiere) in one health communication on cross-species influenza transmission in Norway"],"prefix":"10.3389","volume":"16","author":[{"given":"J\u00f6rn","family":"Klein","sequence":"first","affiliation":[{"name":"Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway","place":["Porsgrunn, Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1093\/pch\/pxab101","article-title":"COVID-19 and the importance of effective risk communication with children","volume":"27","author":"Abrams","year":"2022","journal-title":"Paediatr. Child Health"},{"key":"B2","unstructured":"Selective genome packaging mechanisms of influenza A viruses\n          \n          \n          2021"},{"key":"B3","unstructured":"Key Considerations: Child Engagement in the Context of Disease Outbreaks. Social Science in Action\n          \n          2025"},{"key":"B4","unstructured":"Country Profile: Norway\n          \n          2025"},{"key":"B5","unstructured":"Access and Functional Needs Toolkit: Integrating a Community Partner Network to Inform Risk Communication Strategies"},{"key":"B6","unstructured":"Health Literacy Action Plan\n          \n          2024"},{"key":"B7","unstructured":"Bird Flu in Pets and Other Animals\n          \n          2025"},{"key":"B8","unstructured":"Current Situation: Bird Flu in Dairy Cows\n          \n          2025"},{"key":"B9","first-page":"5","article-title":"Highly pathogenic avian influenza A(H5N1) clade 2.3.4.4b virus infection in poultry farm workers, Washington, USA, 2024","volume":"31","year":"2025","journal-title":"Emerg. Infect. 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Rep."},{"key":"B19","unstructured":"Om Helsesykepleiere Og Helsestasjons- Og Skolehelsetjenesten\n          \n          2021"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.1007\/s10096-025-05147-z","article-title":"The emergence of highly pathogenic avian influenza H5N1 in dairy cattle: implications for public health, animal health, and pandemic preparedness","volume":"44","author":"Kamel","year":"2025","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/ggn2.202500051","article-title":"Evolution of H5N1 cross-species transmission: adaptive mutations driving avian-to-human infection","author":"Man","year":"2026","journal-title":"Adv. Genet"},{"key":"B22","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1038\/nrmicro.2016.46","article-title":"Reassortment in segmented RNA viruses: mechanisms and outcomes","volume":"14","author":"McDonald","year":"2016","journal-title":"Nat. Rev. Microbiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1038\/s43247-025-03153-9","article-title":"An outbreak of highly pathogenic avian influenza H5N1 could impact the dairy cattle sector and the broader economy in the United States","volume":"7","author":"Morel","year":"2026","journal-title":"Commun. Earth Environ."},{"key":"B24","unstructured":"One Health\n          \n          2020"},{"key":"B25","unstructured":"National One Health Strategy Against Antimicrobial Resistance 2024\u20132033"},{"key":"B26","doi-asserted-by":"publisher","first-page":"3889","DOI":"10.1038\/s41591-025-03905-2","article-title":"Human infections with highly pathogenic avian influenza A(H5N1) viruses in the United States, March 2024-May 2025","volume":"31","author":"Rolfes","year":"2025","journal-title":"Nat. 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Assoc."},{"key":"B30","doi-asserted-by":"publisher","first-page":"215","DOI":"10.15585\/mmwr.mm7517a1","article-title":"Serologic evidence of highly pathogenic avian influenza A(H5N1) virus infection in a veterinary professional exposed to an infected domestic cat - Los Angeles County, California, December 2024-January 2025","volume":"75","author":"Vaughan","year":"2026","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"B31","unstructured":"WHO Strategic Communications Framework for Effective Communications"},{"key":"B32","unstructured":"Health Literacy Development for the Prevention and Control of Noncommunicable Diseases\n          \n          2022"},{"key":"B33","unstructured":"Influenza at the Human-Animal Interface: Monthly Risk Assessment Summary"},{"key":"B34","article-title":"Surveillance programme for avian influenza in Norwegian wildlife 2025","volume-title":"Norwegian Veterinary Institute Report 35\/2026","author":"Ytrehus","year":""},{"key":"B35","doi-asserted-by":"publisher","first-page":"127","DOI":"10.15585\/mmwr.mm7408a1","article-title":"Human cases of highly pathogenic avian influenza A(H5N1) - California, September-December 2024","volume":"74","author":"Zhu","year":"2025","journal-title":"MMWR"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.658876","article-title":"What do adolescents know about One-Health and zoonotic risks? A school-based survey in Italy, Austria, Germany, Slovenia, Mauritius, and Japan","volume":"9","author":"Zucca","year":"2021","journal-title":"Front. Public Health"}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1965045\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:38:49Z","timestamp":1790077129000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1965045\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":36,"alternative-id":["10.3389\/fcimb.2026.1965045"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2026.1965045","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"1965045"}}