Clinician Alert- H5 avian influenza (H5 bird flu) in humans

Australia has confirmed its first detections of high pathogenicity avian influenza (HPAI) H5N1 clade 2.3.4.4b, otherwise called “H5 bird flu”, in wild birds. There have been 17 cases confirmed or presumed: 10 in Western Australia, 5 in South Australia and 2 in New South Wales. H5 bird flu is linked to global mass mortality in poultry, wild birds and sea mammals. So far in Australia, the virus has only been found in seabirds with no detections in poultry or other species, and no evidence of animal deaths.  No human infection with this strain has been reported in Australia.

Human infection is rare but can occur after close contact with infected birds, other animals, contaminated environments or contaminated objects. The Queensland Government is closely monitoring the situation in other Australian states and has measures in place to respond quickly if there is a detection in Queensland. The virus is not a food safety concern in Australia; properly cooked poultry products and eggs remain safe for consumption. 

Discuss with the Metro North Public Health Unit (PHU) if you suspect a patient has been exposed to bird flu. 

Clinical presentations - who to notify to PHU

Human infection with H5 bird flu is rare. Most people will experience mild symptoms, or no symptoms at all. Symptoms are similar to those of seasonal influenza and typically start about 1 to 10 days after being infected. People who work with, care for or volunteer with birds, especially poultry workers and outbreak responders are at increased of infection.

Consider H5 bird flu in people who present with influenza-like illness AND who have had contact with unwell migratory or seabirds in the 10 days prior to onset of symptoms.

If managing a suspected case of H5 bird flu, place patient in a single room and encourage patient to wear a surgical mask.  Staff should wear an apron, protective eye wear and P2/N95 mask, particularly for testing or face to face care.

Laboratory testing

Requests for an avian influenza test should occur after consultation with the Metro North Public Health Unit (PHU).

Prevention

There is currently no vaccine available for avian influenza. All Queenslanders are encouraged to stay up to date with seasonal influenza vaccine.

While uncommon, co-infection of H5 and seasonal strains can create opportunities for influenza viruses to combine and potentially result in the emergence of a new influenza strain.
 

Advice for general public 

If you find a sick or dead bird or animals:

• AVOID the area. Do not touch or collect sick or dead wild birds or wildlife.
• RECORD what you see. If safe to do so, record information on the number of dead birds/animals, species, location, date and time.

• REPORT sick or dead wild birds to the Emergency Animal Disease Hotline on 1800 675 888 (24/7)  

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Further information

• Australian Centre for Disease Control - Bird flu (avian influenza)
• Queensland Health - Avian influenza in humans (bird flu) 
• Biosecurity Queensland - Avian influenza
• Department of Agriculture, Fisheries and Forestry - Avian influenza (bird flu)
• H5 bird flu resource centre – Wildlife Health Australia
• Working with bird and bat droppings - Workplace Health and Safety Queensland
• Understanding avian influenza in the workplace - Workplace Health and Safety Queensland