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Avian Influenza

Case definitions for notification to/within public health

Person under investigation (PUI)

An individual with onset of clinical signs/symptoms [1] within 10 days of last exposure to a potential source[2] of avian influenza virus, not otherwise attributed to other known etiology.

Probable

An individual that meets the criteria of a PUI case and has a lab confirmed influenza A infection with subtyping pending.

Confirmed

An individual that has a lab confirmed influenza A H5 infection. The specimen must be confirmed by at least one of the following tests:

1)            H5 RT-PCR
2)            Whole genome sequencing

[1] Clinical signs/symptoms:  conjunctivitis (red eye, discharge from eye) or acute respiratory or influenza-like illness with one or more of cough, sore throat, fever or feverishness, rhinorrhea, fatigue, myalgia, arthralgia, headache. May include mild, moderate (e.g. shortness of breath, difficulty breathing, altered mental status, seizures) or severe manifestations (e.g. pneumonia, respiratory failure, acute respiratory distress syndrome, multi-organ failure, meningo-encephalitis). Gastro-intestinal symptoms may also be present.

2 Exposures of concern: Close exposure (within 2 meters) to a bird, animal or other human with confirmed avian influenza A virus infection. Exposures can include, but are not limited to: being in the same close airspace, touching or handling infected animals; OR consuming under- or uncooked poultry or egg products; OR direct contact with contaminated surfaces; OR being exposed to manure or litter containing high concentration of virus or being in a contaminated air space or environment; OR visiting a live poultry market with confirmed bird infections or associated with a case of human infection. Where avian influenza test results are not available but there is a high index of suspicion and other exposure criteria are met, also consider testing. If during on-site depopulation of birds, last exposure includes when birds are depopulated and all carcasses are disposed. Unprotected laboratory exposure also qualifies as testing indication.

SOURCE: Avian Influenza ( )
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