Testing Recommendations for Persons with possible infection with Avian Influenza A (H7N9) virus in the United States
Patients who meet both the clinical and exposure criteria described below should be tested for avian influenza A (H7N9) virus infection by reverse-transcription polymerase chain reaction (RT-PCR) assay using H7-specific primers and probes.
Decisions on diagnostic testing for influenza using RT-PCR should be made using available clinical and epidemiologic information, and additional persons in whom clinicians suspect avian influenza A (H7N9) virus infection also should be tested.
For more information on laboratory testing of persons under investigation for avian influenza A (H7N9) virus infection, please see Information for Health Professionals and Laboratorians.
Guidance on testing, treatment, and infection control will be updated by CDC as more information becomes available.
Clinical Illness Criteria
- Patients with new-onset severe acute respiratory illness requiring hospitalization (i.e., illness of suspected infectious etiology that is severe enough to require inpatient medical care in the judgment of the treating clinician).
- AND
- Patients for whom no alternative infectious etiology is identified.
Exposure Criteria
- Patients with recent travel (within 10 days of illness onset) to areas where human cases of avian influenza A (H7N9) virus infection have recently become infected<SUP>1</SUP> or where avian influenza A (H7N9) viruses are known to be circulating in animals<SUP>2</SUP>.
- OR
- Patients who have had recent close contact (within 10 days of illness onset) with suspected<SUP>3</SUP> or confirmed cases of human infection with avian influenza A (H7N9) virus.
- Close contact may be regarded as coming within about 6 feet (2 meters) or within the room or care area of a person with a suspected or confirmed case while the person was ill (beginning 1 day prior to illness onset and continuing until resolution of illness).
- Close contacts include healthcare personnel providing care for a person with a suspected or confirmed case, family members of a person with a suspected or confirmed case, persons who lived with or stayed overnight with a person with a suspected or confirmed case, and others who have had similar close physical contact, especially without the use of respiratory protection.
- OR
- Persons with an unprotected exposure to avian influenza A (H7N9) virus in a laboratory setting.
________
<SUP></SUP>
<SUP>1</SUP>As of January 23, 2014, mainland China is the only country where human cases of avian influenza A (H7N9) virus infection have recently (within the past 24 months) become infected.
<SUP>2</SUP>As of January 23, 2014, mainland China is the only country where avian influenza A (H7N9) viruses are known to be circulating in animals.
<SUP>3</SUP>Patients suspected of having infection with avian influenza A (H7N9) virus can include probable cases, cases under investigation for infection with avian influenza A (H7N9) virus, and other patients for whom available clinical and epidemiologic information support a diagnosis of infection with avian influenza A (H7N9) virus.
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State health departments are encouraged to investigate potential human cases of avian influenza A (H5N1) virus infection and should notify CDC within 24 hours of identifying a probable or confirmed case of novel influenza A virus infection, including avian influenza A (H5N1) virus infection, and avian influenza A (H7N9) virus.
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