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Avian Flu

Avian Flu is a topic covered in the 5-Minute Clinical Consult.

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  • Human infection due to avian influenza type A viruses (subtypes H5N1 and H7N9 to date). H5N1 is highly pathogenic; H7N9 has low pathogenicity.
  • Presents with influenza-like illness and primarily lower respiratory tract symptoms
  • High mortality rate in elderly and very young (particularly H5N1)
  • Synonym(s): bird flu, H5N1, H7N9


  • >860 confirmed human cases A(H5N1) (53% fatality rate); most cases from Egypt and Indonesia
  • 1,564 cases and 610 deaths A(H7N9) (mostly from China) since February 2013
  • Predominant age: affects all age groups


Etiology and Pathophysiology

  • Infected poultry (domesticated ducks, turkeys, chickens) reservoir
  • Low incidence of human-to-human transmission, typically household clusters and health care workers
  • Incubation period: 7 days (range 2 to 17 days)

Risk Factors

  • Known direct contact with H5N1 or H7N9 virus or infected individual
  • Contact with infected poultry
  • Recent travel to endemic country (within 10 days of symptom onset)

General Prevention

  • Consider isolating any patient with influenza-like symptoms who has had close contact with H5N1, H7N9, or ill poultry.
  • Respiratory droplet precautions and N-95 masks
  • Vaccine (H5N1) for adults 18 to 65 years of age has been approved.
  • Consider antiviral chemoprophylaxis if H5N1 is circulating in the community; no postexposure chemoprophylaxis recommended for H7N9 if the individual meets travel exposure criteria

Commonly Associated Conditions

Severe respiratory distress (common in severe cases)

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Stephens, Mark B., et al., editors. "Avian Flu." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816195/all/Avian_Flu.
Avian Flu. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816195/all/Avian_Flu. Accessed April 25, 2019.
Avian Flu. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816195/all/Avian_Flu
Avian Flu [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 25]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816195/all/Avian_Flu.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Avian Flu ID - 816195 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816195/all/Avian_Flu PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -