Presumptive positive human cases of Avian Influenza A (H5N1) under investigation in Washington state

Actions requested

• Identify

  • Consider HPAI A (H5N1) virus infection in people showing signs or symptoms of acute respiratory illness, influenza-like-illness (ILI) or conjunctivitis and who have recently been around birds (including poultry), cattle, or other animals that might be infected with HPAI A(H5N1) viruses.
  • Specifically, ask patients presenting for care with the clinical syndromes above about:
    • Exposure to poultry (e.g., chickens, turkeys, ducks)
    • Exposure to sick or dead wildlife
    • Exposure to cattle or pigs
    • Attendance at agricultural fairs or other livestock exhibitions
    • Consumption of unpasteurized dairy products
    • Contact with other animals with known or suspected avian influenza virus infection or their environments (e.g., worked at a poultry farm with known or suspected infections)
    • Contact with another person suspected or confirmed to be infected with HPAI, or symptomatic after exposure to animals infected with HPAI
• Manage

  • Begin empiric antiviral treatment as soon as possible in patients with suspected avian influenza, as the infection has potential to cause severe disease in humans.
    
    • Antiviral treatment should not be delayed while waiting for laboratory results.
      
  • Standard, contact and airborne precautions, including the use of eye protection, are recommended when evaluating patients for infection with avian influenza.
• Test

  If avian influenza is suspected, contact Public Health immediately to arrange specimen collection and submission to the Washington State Public Health Laboratory. Collect the following specimens:

  • A nasopharyngeal swab collected in viral transport medium and
  • A conjunctival swab collected in viral transport medium for patients presenting with conjunctivitis
• Educate

  • If novel influenza is suspected, the patient should isolate at home away from their household members and not go to work or school until it is determined they do not have avian influenza A virus infection.
  • Educate patients, especially those in livestock and poultry occupations, about how to prevent avian influenza.
    • The seasonal flu vaccine will not protect against avian influenza, however it is important that people who may have frequent exposure to infected or potentially infected birds or other animals get a seasonal flu vaccine to reduce the risk of seasonal influenza and to reduce the risk of co-infection and possible reassortment between seasonal influenza and HPAI.
• Notify

  Immediately report suspected cases of avian flu and novel influenza to Public Health at 206-296-4774.