Evolving dynamics of H5Nx avian influenza in China revealed by long-term wild bird surveillance

H5Nx highly pathogenic avian influenza viruses pose persistent threats to poultry, wildlife, and public health. Over the past two decades, their geographic and host ranges have expanded across migratory networks whose epidemiological connectivity has become increasingly apparent through recent surveillance and genomic analyses. To elucidate these dynamics, we conduct long-term nationwide wild-bird surveillance in China, integrating active and passive monitoring. Our analyses reveal the maintenance, reassortment, and transmission of H5Nx viruses in wild birds, highlighting the value of sustained surveillance in capturing viral evolution. We identify distinct ecological patterns among major clades, with 2.3.4.4b showing the widest distribution and acting as the main lineage mediating intercontinental spread. Since 2020, most 2.3.4.4b viruses detected in wild birds in China have clustered with lineages originating outside China, consistent with repeated reintroduction rather than sustained local circulation. This shift underscores the growing role of migratory connectivity in shaping global viral exchange and the need for coordinated international active surveillance. Long-term surveillance of wild birds in China shows that H5Nx avian influenza viruses persist, evolve and spread along migratory flyways, leading to repeated cross-border introductions of clade 2.3.4.4b viruses.