This morning [4 May 2021] Hong Kong's CHP reported mainland China's 12th H9N2 infection of 2021, involving a 30 year old woman from Guangdong province with onset on 20 Apr 2021. Also, Cambodia reported a case -- also in April -- involving a 3 year old boy. While most H9N2 infections are mild, their reported incidence has risen sharply in 2021. Whether this rise is more to do with better surveillance and reporting or is propelled by increased transmission of the virus to humans, is unknown. The following update comes from the WHO Western Pacific Regional Office (WPRO): "Between 23 and 29 Apr 2021, there was one new case of human infection with avian influenza A(H9N2) reported from the National Health Commission of the People's Republic of China to WHO in the Western Pacific Region. The case is a 30 year old female from Huizhou, Guangdong Province. The case had onset of mild symptoms on 20 Apr 2021. "To date, 12 cases of avian influenza A(H9N2) have been reported from China in 2021, and a total of 54 cases of human infection with avian influenza A(H9N2) have been reported in the Western Pacific Region since December 2015." Admittedly, the numbers we have -- as elevated as they may be of late -- are believed to be significant undercounts. Most people in China (or elsewhere) who get minor-to-moderate flu-like symptoms never bother to see a doctor or get tested.