Tweet
November 24, 2025
Situation:
Identify
Avian influenza is a disease caused by influenza type A viruses, which naturally occur in wild aquatic birds around the world. On rare occasions, avian influenza can infect people and make them sick. Most cases have occurred among people who have been exposed to sick or infected animals.
As noted above, a Washington resident was recently diagnosed with HPAI. To ensure that human-to-human spread is not occurring, public health officials are contacting anyone who was in close contact with the patient to monitor for symptoms and provide testing, post-exposure prophylaxis, and treatment as needed.
As seasonal influenza activity begins to increase in Washington and across the United States, the greatest risk to the public is seasonal influenza. DOH publishes a Weekly Influenza Update for seasonal influenza on our Influenza Surveillance Data webpage.
Resources
For more information about H5 Influenza, please visit:
CDC:
For questions and to report all suspected or confirmed cases of novel influenza and all influenza a specimens that result as “unsubtypeable” call (253) 649-1412.
Situation:
- On Nov. 13, 2025, a Washington resident who was hospitalized with respiratory illness symptoms since early November tested positive for influenza A H5.
- More testing confirmed the patient was infected with H5N5 influenza virus.
- This is the first known case of H5N5 in humans.
- The patient has since died.
- The patient had a mixed backyard flock of domestic poultry at home. The flock had exposure to wild birds.
- Centers for Disease Control and Prevention (CDC) and Washington State Department of Health (DOH) currently consider the risk from highly pathogenic avian influenza (HPAI) to be low for the general public.
Identify
- Be alert for patients with symptoms of influenza.
- Symptoms of avian influenza infection in humans can range from mild (e.g., conjunctivitis or nonspecific upper respiratory symptoms) to severe.
- Getting an accurate exposure history from symptomatic patients is important to rapidly identify potential patients with HPAI.
- Assess exposure history for all patients with suspected or confirmed influenza.
- Assess these patients for the following exposures:
- Wild, captive, and livestock animals, including poultry and cattle.
- Any sick or dead animals or their environment, including pets.
- Consuming or handling raw animal products (e.g., raw cow milk, products made with raw cow milk, and raw meat-based pet food).
- OR recent close contact (within 6 feet) with a symptomatic person who is suspected or confirmed to have avian influenza.
- DOH recommends adding the above screening questions to the electronic medical record (EMR).
- Assess these patients for the following exposures:
- A negative influenza test result does not rule out avian influenza in symptomatic patients with exposure to sources of HPAI.
- Clinicians who suspect HPAI in a patient should immediately notify Tacoma-Pierce County Health Department by calling (253) 649-1412.
- HPAI should remain on the differential diagnosis with maintenance of contact, droplet, and airborne isolation.
- Clinicians and facilities in all healthcare settings are required to IMMEDIATELY report the following to Tacoma-Pierce County Health Department by calling (253) 649-1412:
- All influenza A specimens that result as “unsubtypeable” (when the subtype of influenza cannot be determined by available tests).
- All suspected or confirmed cases of novel influenza, including HPAI (H3 or H5), regardless of initial influenza test results.
- Collect specimens for influenza testing as soon as possible after illness onset, ideally within 7 days of first symptoms. Acceptable specimens include:
- Nasopharyngeal (NP) swab, or
- A nasal swab combined with an oropharyngeal (OP) swab (e.g., two swabs collected separately and combined into one viral transport media vial).
- If the patient has conjunctivitis: conjunctival swab.
- If the patient is severely ill: lower respiratory tract specimens (e.g., an endotracheal aspirate or bronchoalveolar lavage (BAL) fluid from intubated patients, or induced sputum).
- Test all hospitalized patients with compatible influenza symptoms AND exposure history (when HPAI is suspected) within 24 hours of presentation to the hospital.
- A negative influenza result does not rule out avian influenza; HPAI should remain on the differential for hospitalized patients with a compatible exposure. Repeat influenza testing on at least two consecutive days for hospitalized patients.
- If the patient has severe respiratory disease, consider collecting lower respiratory tract specimens.
- A negative influenza result does not rule out avian influenza; HPAI should remain on the differential for hospitalized patients with a compatible exposure. Repeat influenza testing on at least two consecutive days for hospitalized patients.
- Positive influenza A specimens should be subtyped (tested to determine the subtype of influenza A, i.e., H1, H3, etc.)
- Specimens should be submitted for subtyping to your facility’s clinical or commercial laboratory, if possible.
- If subtyping is not available, specimens should be submitted to DOH’s Public Health Laboratories (WAPHL) for subtyping.
- Advise patients not to handle sick or dead birds or other wildlife.
- People can report sick or dead wild birds or other wild animals to the Washington State Department of Fish & Wildlife.
- People can report sick or dead domestic animals, including backyard flocks or livestock suspected of having avian influenza to the Washington State Department of Agriculture.
- DOH and CDC continue to recommend seasonal influenza vaccine for patients 6 months of age and older.
- Getting a yearly flu vaccination is the best way to reduce the risk from seasonal influenza and its potentially serious complications.
- The 2025-26 seasonal influenza vaccine is a trivalent vaccine covering influenza A(H1N1) virus, an A(H3N2) virus, and a B/Victoria lineage virus.
- While the seasonal influenza vaccine will not protect against avian influenza, it helps prevent patients from getting infected with seasonal influenza and HPAI at the same time.
Avian influenza is a disease caused by influenza type A viruses, which naturally occur in wild aquatic birds around the world. On rare occasions, avian influenza can infect people and make them sick. Most cases have occurred among people who have been exposed to sick or infected animals.
As noted above, a Washington resident was recently diagnosed with HPAI. To ensure that human-to-human spread is not occurring, public health officials are contacting anyone who was in close contact with the patient to monitor for symptoms and provide testing, post-exposure prophylaxis, and treatment as needed.
As seasonal influenza activity begins to increase in Washington and across the United States, the greatest risk to the public is seasonal influenza. DOH publishes a Weekly Influenza Update for seasonal influenza on our Influenza Surveillance Data webpage.
Resources
For more information about H5 Influenza, please visit:
- Avian Influenza.
- Influenza Surveillance Data.
- Influenza Virus Testing at the Washington Public Health Laboratories (WAPHL).
- Avian Influenza in Livestock and Pets, Washington State Department of Agriculture.
- Avian Influenza in Wild Animals, Washington State Department of Fish & Wildlife.
CDC:
- H5 Bird Flu: Current Situation.
- Signs and Symptoms of Bird Flu in People.
- Interim Guidance on the Use of Antiviral Medications for Treatment of Human Infections with Novel Influenza A Viruses Associated with Severe Human Disease.
For questions and to report all suspected or confirmed cases of novel influenza and all influenza a specimens that result as “unsubtypeable” call (253) 649-1412.