India has reported an H9N2 avian flu case involving a 4-year-old child in West Bengal who was exposed to poultry, marking the country’s second such case since 2019, the World Health Organization (WHO) said on Wednesday.

The child, who had a history of upper-airway disease, was first hospitalised in February for complications from respiratory virus infections, which included influenza B and adenovirus. In early March, the child was hospitalised again with severe respiratory symptoms, which were positive for unsubtyped influenza A and rhinovirus, said the WHO, noting that the child had direct exposure to poultry at home and in the surrounding environment.

No other individuals, including family members and close contacts, reported any symptoms of respiratory illness.

Although the H9N2 virus generally causes mild illness in humans, the global health agency has warned that sporadic human cases could continue to emerge.

H9N2 circulates as a low-pathogenic virus in poultry in many parts of the world.

Though there have been two deaths reported from across the world due to the infection so far, the WHO said that the overall risk is low, given that H9N2 hasn’t shown a capacity to transmit easily among people. According to reports, neighboring China’s mainland has reported five infections involving the virus this year.

In its risk assessment, the WHO said: “Most human cases of infection with H9N2 viruses are exposed through contact with infected poultry or contaminated environment… Given the continued detection of the virus in poultry populations, sporadic human cases can be expected.”

Human infection with H9N2 tends to be mild, but there have been some cases where hospitalisation was required like the one from West Bengal. With most cases of bird flu being reported by people who handle poultry, it is important that animals and poultry are handled with care.

“People need to minimise contact with animals and poultry and areas contaminated with their faeces. Contact should be avoided with dead animals. Everyone should wash their hands thoroughly with soap and water as often as possible, especially before and after handling animals,” said the WHO.