Avian Influenza (Bird Flu) Information for Clinicians and Veterinarians

  • Clinicians should consider the possibility of avian influenza in persons with conjunctivitis and/or other respiratory symptoms who have had recent contact with sick cattle, poultry, or wildlife.
  • If avian influenza is suspected in a patient, clinicians should immediately isolate the patient and contact their local health department.
  • Please do not submit specimens for H5 influenza testing to Wadsworth Center or a commercial laboratory before consulting with the patient's local health department.

Information for clinicians:

Clinicians should remain vigilant for potential human cases of avian influenza in New York State, particularly among populations working with or handling poultry, dairy cattle, wildlife, and unpasteurized milk.

Situational updates about avian influenza from the Centers for Disease Control and Prevention can be found here.

Clinicians should consider the possibility of avian influenza in persons showing signs or symptoms of conjunctivitis and/or acute respiratory illness who have had any of the following relevant exposures within 10 days prior to symptom onset:

  • Direct contact with known or potentially infected sick or dead animals, particularly wild birds, domestic poultry, or dairy cattle. High-risk activities include handling, milking, slaughtering, defeathering, butchering, culling, and preparing for consumption.
  • Direct contact with unpasteurized (raw) milk or unpasteurized dairy products from sick or potentially infected animals.
  • Direct contact with water or surfaces contaminated with feces, unpasteurized (raw) milk, or parts (e.g., carcasses, internal organs) from sick or potentially infected animals.
  • Prolonged exposure to potentially infected birds and other animals in a confined space.

If avian influenza is suspected:

  • Isolate the patient and provide them with a face mask.
    • Place the patient in a single-patient, airborne infection isolation room (or, if unavailable, an examination room with the door closed, pending transfer).
    • Follow infection control recommendations, including standard, contact, and airborne precautions, plus the use of eye protection. Recommended PPE includes gown, gloves, N95 respirator, and goggles or face mask.
    • Complete infection control guidelines for novel influenza can be found here.
  • Report any suspected human avian influenza virus infection immediately to the local health department where the patient resides.
  • If unable to reach the local health department, contact the Department of Health Bureau of Communicable Disease Control at 518-473-4439 during business hours or at 866-881-2809 after hours.
    • For New York City residents, report to the New York City Department of Health and Mental Hygiene Provider Access Line at 866-692-3641.
  • Collect respiratory specimens for avian influenza virus testing, if indicated, after discussion with the local health department. Testing should be conducted at the NYSDOH Wadsworth Center or the NYC Public Health Laboratory.
  • Initiate empiric antiviral treatment.
    • Administer oseltamivir, either orally or enterically, at the standard dose of 75 mg twice daily for 5 days, is recommended for symptomatic patients with confirmed, probable, or suspected avian influenza.
    • Treatment should be initiated as early as possible, regardless of time since symptom onset.
    • Additional information on treatment of suspect novel influenza cases can be found here.

Resources for clinicians:

Information for Veterinarians:

Veterinarians should take precautions when working with animals suspected or known to be infected with avian influenza A H5N1 virus. These could include dairy cattle, poultry, wild birds, wild mammals, and small domestic animals, particularly cats.

Resources for Veterinarians: