​​Recommendations​

In response to the global outbreak in birds of highly pathogenic avian influenza (HPAI)​ A(H5N1), the Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CPDH) are encouraging continued testing for influenza this summer among persons with severe respiratory illness or who are exposed to poultry or swine. 

• ​Healthcare providers should always consider influenza testing, including subtyping, for patients with respiratory illness who are at higher risk for contracting novel or variant ​influenza, such as those exposed to wild birds, poultry, or swine, which may occur more often during agricultural fair season.

• Throughout the year, any samples that are influenza A positive and for which subtyping was attempted but did not identify a seasonal influenza subtype should be reported to your local health department and urgently directed to a local public health laboratory for additional testing.

• In addition, during June through September 2023, influenza A positive samples from patients in the intensive care unit (ICU) not subtyped in clinical laboratories are requested to be submitted to local public health laboratories for influenza A subtyping. This is an important step for continued surveillance of A(H5N1), as well as for enhanced detection of novel or variant influenza cases.​

Background

The ongoing global outbreak of HPAI A(H5N1) has caused the worst domestic poultry outbreak on record, with more than 58 million poultry affected in the U.S. to date. Thirteen human cases have been reported globally, including one in the U.S. Of the globally reported cases, six were hospitalized and two have died.​

Currently, A(H5N1) is believed to pose a low risk to the health of the general public. In addition, the spread of avian influenza viruses from one infected person to a close contact is very rare, and when it has happened, it has only spread to a few people. However, because of the possibility that avian influenzas viruses could change and gain the ability to spread easily between people, monitoring for human infection and person-to-person spread is extremely important for the public health.

We believe these steps are important for continued surveillance of novel influenza in the U.S., including avian, variant, and other novel influenza A cases, if they occur. As a reminder, human infection with any novel influenza A virus should be reported to your local health department immediately upon suspicion. ​

Novel Influenza Resourc​es

• CDC COCA Call, Tuesday June 20: What Providers Need to Know about Zoonotic Influenza

• Information on Bird Flu | Avian Influenza (Flu) (cdc.gov)

• Variant Influenza Viruses in Humans | CDC

• CDFA - AHFSS - AHB - Avian Influenza (ca.gov)

• USDA APHIS | 2022-2023 Detections of Highly Pathogenic Avian Influenza
  

• Viruses of Special Concern | Pandemic Influenza (Flu) | CDC​