Information for Health Care Providers
Screening patients for H5N1
Influenza A H5N1 is causing widespread outbreaks among
wild and domestic birds in Asia and Eastern Europe. At this
time, person-to-person transmission appears to be rare, but
travelers from affected areas with serious respiratory
illness could be infected with H5N1.
To rapidly detect and control imported Influenza A H5N1,
we are asking healthcare providers to immediately notify
their local health department of any patient who has:
- Traveled to areas reporting avian or human H5N1
within 10 days of onset, AND
- Has severe respiratory disease, including
pneumonia or acute respiratory distress syndrome (ARDS),
for which no alternative cause is established, OR
- Milder illness with fever (>100.4°F [38°C]) and
respiratory symptoms (cough, sore throat or shortness of
breath) following contact with live birds or persons
with suspected or confirmed influenza A H5N1 during
Infection control for patients with suspected or
confirmed H5N1 should include standard and droplet
precautions. Airborne precautions should be used for
procedures that may aerosolize respiratory secretions.
We encourage providers to obtain travel histories from
patients with severe respiratory illness. Avian H5N1 has
been reported in Cambodia, China, Croatia, Indonesia,
Kazakhstan, Kuwait, Mongolia, Russia, Thailand, Turkey and
Vietnam and in birds smuggled to Taiwan, Belgium and the
United Kingdom. Updated information on H5N1 activity is
available on the WHO and Centers for Disease Control and
Prevention (CDC) websites:
Laboratory diagnosis of suspected H5N1 Influenza
Your local health department will facilitate diagnostic
testing at the Washington State Department of Health Public
Health Laboratories (PHL). Please do not submit specimens to
a commercial laboratory, which may cause a delay in
confirming the diagnosis. The PHL performs H antigen
subtyping of influenza by polymerase chain reaction assay.
H5N1 is considered to have pandemic potential and specimens
identified as influenza A H5 or another novel subtype will
go to CDC for further identification and viral isolation
under enhanced biosafety level 3 conditions.
To maximize the detection of influenza, specimens should
be collected within three days of symptom onset. Collect
serum for antibody testing and at least one of the
- Oropharyngeal swab, nasopharyngeal swab or aspirate
- Bronchoalveolar lavage, tracheal aspirate or pleural
fluid as appropriate
- All testing should be performed using appropriate
infection control precautions.
- No specimens will be accepted at the Washington
State Public Health Laboratories (PHL) without
notification and approval of your local health
- For Thurston and Mason Counties, contact Dr.
Diana T. Yu at 360-867-2501.
For detailed instructions
for collecting each specimen, see