Saturday, January 31, 2015

The CDC is Watching for Human Avian Influenza Infections

So far, North America has been lucky. Community acquired infections of avian  influenza have not yet occurred, although an imported case of H5N1 was identified in Alberta Canada in 2013 and two imported cases of H7N9, a husband and wife, were reported from British Columbia in just this past week.

Because of recent outbreak of highly pathogenic avian influenza (H5 subtypes) in wild birds and domestic flocks in North America, the Center for Disease Control has issues guidance for health care workers for identifying and testing patients with potential avian influenza infections. As of January 31, 2015, no H5 subtype human avian influenza infections have been recorded from these outbreaks which have been reported from six western states along the Pacific Flyway (Washington, Oregon, Idaho, Nevada, Utah, and California ). (link)

The CDC guidance will help health care workers to assess patients with influenza symptoms that might be at infected with an H5 subtype of avian influenza.   The CDC identifies the following  items as risk factors for potential avian influenza infections. Individuals
who have had recent contact (<10 days prior to illness onset) with sick or dead birds in any of the following categories:
Domestic poultry (e.g., chickens, turkeys, ducks)
Wild aquatic birds (e.g., ducks, geese, swans)
Captive birds of prey (e.g., falcons) that have had contact with wild aquatic bird
Contact may include: direct contact with birds (e.g., handling, slaughtering, defeathering, butchering, preparation for consumption); or direct contact with surfaces contaminated with feces or bird parts (carcasses, internal organs, etc.); or prolonged exposure to birds in a confined space.

The CDC also states that exposures that occur in geographic regions in the United States where newly detected avian influenza A H5 viruses have been identified are of most concern ( e.g. Washington, Oregon, Idaho, Nevada, Utah, and California).

Health care workers need to be familiar with this CDC guidance in order to adequately assess patients who might be infected with avian influenza. Last year a suspected Ebola patient was not correctly diagnosed and was sent home causing an Ebola scare in Texas. The patient later died.  Human infections from H5 subtypes are virulent often resulting death. There is some evidence that H5 subtypes can be transmitted from human-to-human, so early detection is important.

If you experience influenza symptoms and meet any of the risk factors for avian influenza be sure to mention it to your doctor or health care professional at the time of your visit.

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