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H5N1 Information for Clinicians
Clinicians should consider the possibility of avian influenza A (H5N1) in persons showing signs or symptoms of acute respiratory illness or conjunctivitis who have relevant exposure history. Exposure history may include but is not limited to:
- Any exposure to animals or people with confirmed H1N1 (bird flu)
- Direct contact with sick or dead birds, farm animals (such as chickens or cows), cats, or other wild animals
- Exposure may include direct contact with potentially infected sick or dead birds, livestock, or other animals (e.g., handling, slaughtering, defeathering, butchering, culling); direct contact with water or surfaces contaminated with feces or parts (carcasses, internal organs, etc.) of potentially infected animals; or prolonged proximity to potentially infected birds or other animals in a confined space
- Consumption of raw (unpasteurized) milk or raw dairy products
Clinicians can use the following algorithm to determine the need for additional action and testing for avian influenza A (H5N1) in patients:
Specimen Collection and Shipment
Specimens suspected of avian influenza A (H5N1) should be tested at the Illinois Department of Public Health (IDPH) laboratories. Most commercial laboratories are unable to detect novel influenza A subtypes, including H5N1. Specimens sent to the IDPH labs must include an authorization number, which can be obtained by contacting the local health department where the suspected case lives.
The following respiratory specimens should be collected as soon as possible after illness onset:
- A nasopharyngeal swab
- A nasal swab combined with an oropharyngeal swab (e.g., two swabs collected separately and combined into one viral transport media vial)
If the person has conjunctivitis (with or without respiratory symptoms), both a conjunctival swab and a nasopharyngeal swab should be collected.
Human respiratory specimens to be tested within 72 hours post-collection should be transported refrigerated at 2-8°C to an IDPH laboratory. Alternatively, clinical specimens can be frozen at ≤-70°C and transported promptly. Avoid freezing and thawing specimens.
