Although recently detected in dairy cattle in some states, the risk of H5N1 avian influenza A to the general public is still considered low. It is primarily an occupational risk and limited to people with direct contact with infected or potentially infected animals, such as sick birds and dairy cattle and their environments, or to unpasteurized (raw) milk or dairy products. We are not aware of H5N1 positive dairy herds in Washington state, however, clinicians should remain up to date on the situation. Consider the possibility of H5N1 infection in people with respiratory illness or conjunctivitis and relevant exposure history within 10 days before symptom onset.
Requested Actions:
- Review information on H5N1, please refer to https://doh.wa.gov/avian-influenza
- Educate patients on the risks of raw milk and dairy product consumption (https://www.fda.gov/food/resources-you-food/raw-milk )
- Take a comprehensive patient history for patients presenting with respiratory illness and/or conjunctivitis including asking about their occupation, animal exposure and raw milk consumption
- When symptoms are present, isolate patient and use appropriate PPE. Standard, contact, use of eye protection, and airborne precautions are recommended for management of patients with suspected or laboratory-confirmed novel influenza A virus infection; this includes collection of respiratory specimens.
- Collect respiratory specimens (instructions for collection)
- Contact WCHCS at 360-778-6150 to arrange for testing for influenza A(H5N1) virus
- Initiate empiric antiviral treatment with oseltamivir twice daily for 5 days
- Encourage patients to isolate at home away from household members until test results are available
- 360-778-6100 Main Call Line – available M-F 8:30am to 4:30pm.
- Afterhours Answering Service – available after 4:30pm and weekends, call 360-778-6100 and press 2 to be connected to the on-call manager or health officer.
- 360-778-6150 Communicable Disease Report Line – 24 hours a day 7 days a week
- 360-778-6103 Confidential Communicable Disease Fax – 24 hours a day 7 days a week
- 509 Girard Street, Bellingham WA 98225