Influenza season, avian spillover, neurologic complications, and antiviral preparedness

U.S. Week 38 surveillance shows influenza A dominance, H1N1 prevalence, and positivity at 3.4%; Australia, Japan, Ontario, Oregon, California, and Washington report early or unusual activity. A Taiwan H7N7 preprint found PB2 E627K but no detected onward transmission, highlighting surveillance needs rather than an established outbreak. Modest strain-dependent vaccine effectiveness, resistance-associated variants, rare complications, and vaccine-confidence and delivery barriers reinforce integrated clinical, genomic, and animal surveillance.