Surveillance of avian influenza through bird guano in remote regions of the global south to uncover transmission dynamics.

Abstract

Avian influenza viruses (AIVs) pose a growing global health threat, particularly in low- and middle-income countries (LMICs), where limited surveillance capacity and under-resourced healthcare systems hinder timely detection and response. Migratory birds play a significant role in the transboundary spread of AIVs, yet data from key regions along migratory flyways remain sparse. To address these surveillance gaps, we conducted a study between December 2021 and February 2023 using fresh bird guano collected across 10 countries in the Global South. Here, we show that remote, uninhabited regions in previously unsampled areas harbor a high diversity of AIV strains, with H5N1 emerging as the most prevalent. Some of these H5N1 samples also carry mutations that may make them less responsive to the antiviral drug oseltamivir. Our findings documented the presence of AIVs in several underrepresented regions and highlighted critical transmission hotspots where viral evolution may be accelerating. These results underscore the urgent need for geographically targeted surveillance to detect emerging variants, inform public health interventions, and reduce the risk of zoonotic spillover.