Testing for avian influenza A (H5N1) virus infection is recommended for:

A patient who has an illness that:

• requires hospitalization or is fatal; AND
• has or had a documented temperature greater than 38 C (100.4 F); AND
• has radiographically confirmed pneumonia, acute respiratory distress syndrome (ARDS), or other severe respiratory illness for which an alternate diagnosis has not been established; AND
• has at least one of the following potential exposures within 10 days of symptom onset:

A)  History of travel to a country with influenza H5N1 documented in poultry, wild birds, and/or humans, AND had at least one of the following potential exposures during travel:

• direct contact with (e.g., touching) sick or dead domestic poultry;
• direct contact with surfaces contaminated with poultry feces;
• consumption of raw or incompletely cooked poultry or poultry products;
• direct contact with sick or dead wild birds suspected or confirmed to have influenza H5N1;
• close contact (approach within 1 meter [approx. 3 feet]) of a person who was hospitalized or died due to a severe unexplained respiratory illness

B)  Close contact (approach within 1 meter [approx. 3 feet]) of an ill patient who was confirmed or suspected to have H5N1;

 

C) Worked with live influenza H5N1 virus in a laboratory.

Testing for avian influenza A (H5N1) virus infection can be considered on a case-by-case basis, in consultation with local and state health departments, for:

• A patient with mild or atypical disease (hospitalized or ambulatory) who has one of the exposures listed above (criteria A, B, or C); OR
• A patient with severe or fatal respiratory disease whose epidemiological information is uncertain, unavailable, or otherwise suspicious but does not meet the criteria above (examples include: a returned traveler from an influenza H5N1-affected country whose exposures are unclear or suspicious, a person who had contact with sick or well-appearing poultry, etc.)

Algorithm for Suspected Cases of Novel Influenza