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Reassortment of Highly Pathogenic Avian Influenza as a Driver for Zoonotic Spillover, Asia
Alexander M.P. Byrne
1, Lorcan Carnegie
1, Nicola S. Lewis, Ian G. Barr, Erik A. Karlsson, and Michelle Wille
Author affiliation: Worldwide Influenza Centre, The Francis Crick Institute, London, UK (A.M.P. Byrne, N.S. Lewis); Food and Agriculture Organization of the United Nations, Rome, Italy (L. Carnegie); World Health Organization Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia (I.G. Barr, M. Wille); Institut Pasteur du Cambodge, Phnom Penh, Cambodia (E.A. Karlsson); Environment and Infectious Risks Unit, Laboratory for Urgent Response to Biological Threats, Institut Pasteur, Paris, France (E.A. Karlsson)
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Figure 1

Figure 1. Emergence and human case trends of highly pathogenic avian influenza (HPAI) H5N1 clade 2.3.2.1 viruses in study of reassortment of HPAI as a driver for zoonotic spillover, Asia. A, B) Case notification data of HPAI H5N1 in Cambodia (A) and India and Bangladesh (B), demonstrating the clear resurgence of zoonotic spillover occurring in 2023, driven by reassortant clade 2.3.2.1c/e and 2.3.2.1a viruses. C) Time-scaled phylogeny of the H5 hemagglutinin gene for clade 2.3.2.1 viruses, highlighting the divergence of clade 2.3.2.1a and clade 2.3.2.1c/e.
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