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Background Zoonotic influenza surveillance in Myanmar is sparse, despite the risks of introduction of such viruses from neighboring countries that could impact the poultry industry and lead to spillover to humans. Methods In July and August 2019, our multi‐institutional partnership conducted a One Health‐oriented, cross‐sectional surveillance (weekly for 3 weeks) for influenza A and influenza D viruses at the three largest live bird markets in Yangon, Myanmar. Results The 27 bioaerosols, 90 bird cage swabs, 90 bird oropharyngeals, and 90 human nasopharyngeal samples yielded molecular influenza A detections in 8 bioaerosols (30.0%), 16 bird cages (17.8%), 15 bird oropharyngeals (16.7%), and 1 human nasopharyngeal (1.1%) samples. No influenza D was detected. Seven of the influenza A virus detections were found to be subtype A/H9N2, and one human nasopharyngeal sample was found to be subtype A/H1pdm. Among all IAV‐positive samples, three of the A/H9N2‐positive samples yielded live viruses from egg culture and their whole genome sequences revealing they belonged to the G9/Y280 lineage of A/H9N2 viruses. Phylogenetic analyses showed that these A/H9N2 sequences clustered separately from A/H9N2 viruses that were previously detected in Myanmar, supporting the notion that A/H9N2 viruses similar to those seen in wider Southeast Asia may have been introduced to Myanmar on multiple occasions. Conclusions These findings call for increased surveillance efforts in Myanmar to monitor for the introduction of novel influenza viruses in poultry, as well as possible reassortment and zoonotic virus transmission.

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Myanmar profileMyanmar is a country in Southeast Asia with a population of 52 million. Of those, ;14 million are younger than age 14 years. 1 Hematologic malignancies are now the second most common among pediatric malignancies worldwide after central nervous system tumors, but they are still the most common malignancies in Myanmar. The World Health Organization (WHO) estimated that Myanmar has a total of about 2000 childhood hematologic malignancies per year, according to statistics for our country, but only 594 cases were detected in 2018. Among those, 372 cases were from Yangon Children's Hospital (YCH). 2 That gap between estimation and diagnosis indicates the need to improve outreach diagnosis activities.