First Things First (assess & treat for the following)

• This chapter will deal primarily with human infection with avian influenza A (H5N1) virus.
• Classic presentation of avian influenza (AI): teenager with severe pneumonia that progresses rapidly to acute respiratory distress syndrome (ARDS)
• Risk factor for AI is handling of sick poultry within a week of illness onset, although AI has been reported in areas without a known population of affected poultry.
• Human-to-human transmission of AI is rare.
  • Use full barrier precautions (standard, contact, airborne, and eye protection) for patients with suspected or confirmed AI (H5N1).

• N95 mask has a tight fit.

• Consider higher level of respiratory protection, such as powered air-purifying respirator, for procedures with significant aerosol generation such as tracheal intubation.

• Contact local public health officials if you suspect the diagnosis.