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October 22, 2024

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

Current situation

On October 20, 2024, the Washington State Department of Health and Benton-Franklin Health District reported four agricultural workers have tested presumptive positive for avian influenza A(H5) virus after working with infected poultry at a commercial egg farm in Franklin County. The individuals experienced mild symptoms and have been provided with antiviral medication. Testing of additional individuals on the farm is currently pending and the number of cases under investigation may change.

These cases are the first potential human cases of avian influenza identified in Washington State. Washington is the sixth state to identify a human infection of H5N1. H5N1 highly pathogenic avian influenza (HPAI) has caused ongoing multistate outbreaks in poultry, dairy cattle, and wildlife.

The CDC currently considers the risk to the public from this H5N1 avian influenza to be low; however, people with job-related or recreational exposures to infected birds, cattle, or other potentially impacted domestic or wild animals are at higher risk and should take precautions, including wearing personal protective equipment.

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

  • 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.

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