Summary
Definition
History and exam
Key diagnostic factors
- cough
- influenza-like illness
- dyspnea
- fever
- rales, rhonchi
- wheeze
- decreased breath sounds
- tachypnea
Other diagnostic factors
- abdominal pain, vomiting, diarrhea
- 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
- CBC 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
Emerging tests
- serologic testing for H5N1-specific antibody for retrospective diagnosis
Treatment algorithm
Contributors
Authors
Affiliate Assistant Professor of Medicine & Global Health
University of Washington
Seattle
WA
Disclosures
JRO received honorarium from Pfizer for speaking on adult immunization 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 immunization 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 reviewers
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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