Last reviewed: 23 May 2021
Last updated: 24 Nov 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • cough
  • influenza-like illness
  • dyspnoea
  • fever
  • rales, rhonchi
  • wheeze
  • decreased breath sounds
  • tachypnoea

Other diagnostic factors

  • abdominal pain, vomiting, diarrhoea
  • altered mental status
  • seizures

Risk factors

  • close contact with infected birds
  • recent travel to an HPAI-H5N1 virus infected country
  • environmental exposure to H5N1 virus
  • close contact with infected humans
  • laboratory work with H5N1 virus

Diagnostic investigations

1st investigations to order

  • FBC with differential
  • LFTs
  • chest x-ray
  • pulse oximetry
  • sputum Gram stain
  • sputum and blood bacterial culture
  • reverse transcription polymerase chain reaction (RT-PCR) of respiratory specimens

Investigations to consider

  • viral culture of respiratory specimens

Emerging tests

  • serological testing for H5N1-specific antibody for retrospective diagnosis

Treatment algorithm

Contributors

Affiliate Assistant Professor of Medicine & Global Health

University of Washington

Seattle

WA

Disclosures

JRO received honorarium from Pfizer for speaking on adult immunisation policies at the 2019 Immunisation for All Ages Summit and participation on the Immunisation for All Ages Steering Group. JRO has participated on the Global Influenza Hospital Surveillance Network for Sanofi and has received honorarium from the International Federation on Aging for speaking about adult immunisation policies at the 2019 United Nations International Day of Older Persons side event “End Immunisation Inequality Toward Healthy Aging”. JRO receives research grants and contracts to evaluate influenza vaccines from the National Institutes of Health and has served as a medical monitor for a cholera vaccine study for Pharmaron.

Chief Medical Officer

Influenza Division

National Center for Immunization and Respiratory Diseases

Centers for Disease Control and Prevention

Atlanta

GA

Disclosures

TMU declares that he has no competing interests.

Peer reviewersVIEW ALL

Associate Professor

Medical Director of Infection Control

Infectious Disease

Department of Medicine

SUNY Upstate Medical University

Syracuse

NY

Disclosures

WJ declares that he has no competing interests.

Associate Professor

Department of General Practice and Primary Health Care

Ghent University

Belgium

Disclosures

ADS declares that she has no competing interests.

Assistant Professor

Pulmonary & Critical Care Medicine

Associate

Center for Health Policy/Center for Primary Care & Outcomes Research

Stanford University School of Medicine

Stanford

CA

Disclosures

NK declares that she has no competing interests.

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