Which patient characteristics should prompt evaluation for avian H5N1 influenza?

Updated: Apr 23, 2019
  • Author: Hien H Nguyen, MD, MS; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

According to CDC recommendations, [35] clinicians should attempt to specifically identify avian H5N1 influenza in patients with all of the following characteristics:

  • Severe illness that necessitates hospitalization or is fatal

  • Documented temperature of 38°C (100.4°F) or higher in the past 24 hours or a history of feverishness during that time

  • Radiographically confirmed pneumonia, acute respiratory distress syndrome (ARDS), or other severe respiratory illness for which an alternative diagnosis has not been established

  • At least 1 potential exposure within 7 days of symptom onset

Testing may be considered in discussion with public health authorities in patients who have only some of these characteristics; all testing should be discussed with local public health departments.

The CDC defines potential exposure as follows:

  • History of travel to a country where highly pathogenic avian influenza (HPAI) H5N1 virus has been documented in poultry, wild birds, or humans, with potential exposure to the virus during the visit

  • Close contact (approach within ~6 ft) with an ill person who was under investigation for possible HPAI H5N1 virus infection

  • Working with live HPAI H5N1 virus in a laboratory


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