The Hong Kong Department of Health said it was notified about the case in Guilin, a city in the Guangxi Zhuang Autonomous Region in mainland China, on Wednesday. There was no immediate word from local officials.

The health department said the 26-year-old woman had contact with live domestic poultry before she developed symptoms on August 14. She was admitted to hospital five days later and has since died.

It’s unknown why the case was not reported to the public until Wednesday. A spokesperson for the World Health Organization (WHO) did not immediately respond to request for comment.

Only 46 human cases of H5N6 bird flu have been confirmed since the first case in 2014, but nearly a quarter of them have been reported during the last 2.5 months. At least 22 cases, all but one of them in China, were reported during the last year.

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