State and situation of avian influenza in the Eastern Mediterranean Region.

Avian influenza viruses have had a significant burden of disease on animal and public health in countries of the Eastern Mediterranean Region. In this review, we aimed at describing the state of avian influenza in the region from 2011 to 2021. We gathered information available through the peer-reviewed scientific literature, public gene sequence depositories, OIE World Animal Health Information System platform, World Health Organization FluNet, Joint External Evaluation reports, and governmental, Food and Agriculture Organization of the United Nations, and World Organization for Animal Health websites. We used an interdisciplinary perspective consistent with the One Health approach to perform a qualitative synthesis and making recommendations. Analysis showed that although avian influenza research in the Eastern Mediterranean Region has gained more attention during the last decade, it was limited to only few countries and to basic science research. Data highlighted the weakness in surveillance systems and reporting platforms causing underestimation of the actual burden of disease among humans and animals. Inter-sectoral communication and collaboration for avian influenza prevention, detection, and response remain weak. Influenza surveillance at the human-animal interface and the application of the One Health paradigm are lacking. Countries' animal health and public health sectors rarely publish their surveillance data and findings. This review suggested that surveillance at the human-animal interface, research, and reporting capacities should be enhanced to improve understanding and control of avian influenza in the region. Implementing a rapid and comprehensive One Health approach for zoonotic influenza in the Eastern Mediterranean Region is recommended.