Bird Flu Outbreak: How Valley is Responding

The U.S. is experiencing an ongoing outbreak of avian influenza H5 (commonly known as Bird Flu), as is much of the world. The disease is widespread in wild birds and has infected commercial poultry and dairy cattle in the U.S., including Washington. The infection has been spread to humans, especially those in contact with wild birds, dairy, cattle, and commercial poultry. Although one person recently died from a strain of avian influenza H5, most human infections have been mild and conjunctivitis has been the most common symptom. 11 total cases were confirmed in Washington in the last year. 

This virus is felt to have a high potential for developing variations which may be more pathogenic over time, and federal and state officials are recommending an aggressive search and containment strategy to avoid potentially catastrophic spread of novel lethal variants. Valley Medical Center’s patient base is extremely diverse. We could easily see patients who have been exposed to avian influenza H5, though our area is not at high risk due to the lack of large commercial animal industries nearby. We are requesting our providers be vigilant for avian influenza H5 with the following actions. 

Hospitalized patients: 

• Test all patients for influenza who present with flu-like symptoms, including patients with severe conjunctivitis (rapid antigen test can suffice).
• Have all hospitalized influenza A positive patients subtyped for H antigen. This can be done with a respiratory viral panel performed either at Valley or at Labcorp.
• Notify infection prevention or Dr.Mike Hori if the specimen does not type as H1 or H3 (non-typeable). These specimens need to be forwarded to the state lab for more advanced typing.
• Until typing is complete, place any patient with a positive influenza A test and a) conjunctivitis or b) exposure to sick or deceased animals, raw animal products (particularly unpasteurized milk), or other patients with suspected or confirmed avian influenza H5 in airborne and contact isolation.
• Patients with influenza A that types as H1 or H3 do not need airborne/contact isolation precautions but should remain in droplet isolation.

Ambulatory patients: 

• Consider influenza testing (rapid antigen can suffice) for patients with severe conjunctivitis.
• Question patients with positive influenza A testing for exposure to sick or deceased animals, raw animal products (particularly unpasteurized milk), or other patients with suspected or confirmed avian influenza H5.
• Obtain respiratory viral panel (from our hospital lab or Labcorp) for patients with influenza A for subtyping who have symptoms or exposures as noted above.
• Notify infection prevention or the Dr.Mike Hori for influenza A patients whose virus does not type as H1 or H3 (non-typeable).  Virus will need to be forwarded to state health lab for advanced typing.

If you have any questions, please reach out to Amelia Hanron, MPH, Infection Preventionist or Mike Hori, MD, Medical Director of Infectious Disease & Infection Prevention.