Health Advisory

Summary

• Avian influenza A (H5) has recently been detected in Virginia in wild birds, commercial poultry, and in birds housed in a zoo collection. Detections also have occurred in bordering states. These detections are not unexpected as avian influenza A(H5) virus is currently widely circulating in the United States. The risk from avian influenza viruses to the public remains low. To date, avian influenza has not been detected in people or dairy cattle in Virginia.
• A Virginia Department of Health Clinician Letter issued on January 31, 2025 and a Centers for Disease Control and Prevention (CDC) Health Alert issued on January 16, 2025 provide guidance on testing for influenza in individuals with relevant clinical findings and exposure history, and for rapidly subtyping influenza A viruses for all hospitalized patients.

Suggested Actions

• Avian influenza virus infection should be suspected in any patient with symptoms of acute respiratory illness or conjunctivitis who have a relevant exposure history within the last 10 days. Relevant exposure history includes:
  • Direct contact with infected/sick birds, poultry, and dairy cattle.
  • Contact with raw animal products, such as raw cow milk and raw cow milk products, or raw meat-based pet food.
  • Recent close contact with a symptomatic person with probable or confirmed avian influenza A(H5) infection.
• If a provider suspects avian influenza in a patient, the following steps should be taken immediately:
  • Isolate the patient and follow appropriate infection control recommendations, including the use of personal protective equipment.
  • Initiate antiviral treatment with oseltamivir as soon as possible without waiting for the results of influenza testing.
  • Report all suspected cases immediately to the Fairfax County Health Department by calling 703-409-8449. Health Department staff can coordinate public health testing and provide isolation guidance and infection control recommendations.
• Per CDC’s Health Alert, hospitals and commercial labs should ensure expedited subtyping of influenza A positive respiratory specimens from all hospitalized patients to enhance surveillance in the U.S. during high levels of seasonal influenza activity.
  • Specimens from patients positive for influenza A but negative for seasonal influenza A virus subtypes [i.e., negative for A(H1) and A(H3)], should be forwarded to the Division of Consolidated Laboratory Services (DCLS) within 24 hours of obtaining the results.
  • DCLS’s submission guidance for hospitals and clinical laboratories can be found here: https://dgs.virginia.gov/globalassets/business-units/dcls/documents/hot-topic-and-updates/dcls-accelerated-flu-a-subtype-guidance_2025-59799-1.pdf.

Additional Information

• The Virginia Department of Wildlife Resources (DWR) is the agency responsible for guidance and public queries related to sick or dead birds found outside. Their recent press release provides guidance to individuals on when to report instances of sick or dead birds and the proper method to ensure safe removal of dead birds from individual’s property. The press release can be found here: https://dwr.virginia.gov/media/press-release/dwr-avian-influenza-update-and-guidance/.
• Virginia Department of Health guidance and updates related to avian influenza can be found here: https://www.vdh.virginia.gov/epidemiology/influenza-flu-in-virginia/avian-flu/ while CDC guidance and updates related to avian influenza can be found here: https://www.cdc.gov/bird-flu/index.html.