Current Situation
An ongoing global outbreak of highly pathogenic avian influenza (HPAI) in wild birds, with transmission to poultry and certain mammals, including dairy cattle, has resulted in four confirmed cases of HPAI in humans in the United States in 2024.
To date, there have been no human cases of HPAI confirmed in Washington; however, clincians should remain vigilant for patients presenting with potential symptoms of HPAI.
Clinicians in Washington state are encouraged to consider HPAI infection in patients who present with influenza-like illness (ILI), and to assess patients presenting with ILI for animal exposures, including raw milk consumption, exposures to sick or dead wild birds or other wild animals, as well as exposure to cattle or pigs, or attendance at agricultural fairs this summer.
Actions Requested
- Clinicians should consider HPAI and other novel influenza virus infections in patients who present with influenza-like illness, including isolated conjunctivitis or symptoms of acute respiratory infection.
- Specifically, ask patients seeking care for influenza-like illness about:
- Exposure to cattle or pigs
- Attendance at agricultural fairs or other livestock exhibitions
- Consumption of unpasteurized dairy products
- Exposure to sick or dead wildlife
- Contact with birds or other animals with known or suspected avian influenza virus infection
- Clinicians should consider testing for novel influenza for patients with ILI who endorse any of the above exposures in the past ten days and have no alternative diagnosis.
- If novel influenza infection is suspected contact Jefferson County Public Health immediately to help arrange sample collection and testing at the Washington State Public Health Laboratories (WA PHL). We can can provide guidance on collecting the below samples:
- A nasopharyngeal swab collected in viral transport medium for testing at WA PHL
- Patients with conjunctivitis should also have a conjunctival swab collected in viral transport medium for testing at WA PHL
- Empiric antiviral treatment should be started as soon as possible for patients suspected to be infected with novel influenza A viruses as they have the potential to cause severe disease in humans. For more information, see the Centers for Disease Control and Prevention‘s (CDC) interim guidance on the use of antiviral medications for treatment of human infections with novel influenza A viruses associated with severe human disease.
Resources
- CDC: Clinical Overview of Evaluating and Managing Patients Exposed to Birds Infected with Avian Influenza A Viruses of Public Health Concern | Bird Flu | CDC
- CDC: H5N1 Bird Flu: Current Situation | Bird Flu | CDC
- WA DOH: Avian Influenza | Washington State Department of Health
Please don’t hesitate to call us at Jefferson County Public Health for support with testing and treatment decisions! (360) 385-9400