Main menu


Should I worry about H5N1 bird flu? | BY HEIDI


Avian flu, or bird flu, refers to a group of diseases that result from infections with specific influenza viruses. These viruses infect birds and — rarely — spread among humans. One virus that causes bird flu is called H5N1.

The H5N1 virus can cause severe flu with a high mortality rate.

However, according to the Centers for Disease Control and Prevention (CDC)Trusted Source, transmission among humans is rare.

So far, the virus has shown no signs of changing genetically to spread more efficiently among humans. However, due to the severity of the illness that the virus can cause, authorities continue to monitor for these genetic changes. H5N1 bird flu is fatal in 60%Trusted Source of cases.

The first outbreakTrusted Source of H5N1 avian flu in humans occurred in 1997 in Hong Kong. Overall, authorities have reported more than 700Trusted Source instances of human H5N1 infection — in Africa, Asia, and Europe. Indonesia, Vietnam, and Egypt have had the highest numbers of cases.

Below, we investigate whether the H5N1 virus poses a global threat to health. We also describe the symptoms, causes, and treatments of H5N1 bird flu.

Will there be a pandemic?

The transmission of H5N1 from animals to humans is rare.

Image credit: BAY ISMOYO/AFP via Getty Images.

It is not easy for the H5N1 virus to transmit from animals to humans. It is even harder for the virus to pass from person to person.

However, if a person with seasonal flu then develops this bird flu, the H5N1 virus may be able to exchange genetic information with the seasonal flu virus. If this happens, the H5N1 virus could gain further abilityTrusted Source to spread among people.

A strain of avian flu virus that develops greater ability to spread among humans could have serious consequences.

At present, controlling outbreaks of bird flu in animals and humans can help keep the virus from developing this capacity and prevent further spread that could lead to a pandemic.

Find out more about pandemics here.

What is H5N1?

Type A strains of the influenza virus, including H5N1, cause avian flu, or bird flu.

The H5N1 virus can infect several types of birds. Authorities have mostly reported the disease in farmed poultry, such as chickens, geese, turkeys, and ducks.

However, in January 2015Trusted Source, healthcare professionals found a wild duck in the United States that had H5N1 avian flu. Virologists — scientists who focus on viral diseases — have also found the virus in pigs, cats, dogs, and beech martens, as well as leopards and tigers in captivity.

The virus spreads easily among birds through their saliva, nasal secretions, feces, and feed. They can acquire the virusTrusted Source from contaminated surfaces, such as cages and other farming equipment.

Most peopleTrusted Source with the infection have had direct contact with infected poultry or objects that have touched contaminated bird feces or secretions, according to the CDC.

Until now, very few cases of human-to-human transmission have occurred.

The most recent reported incidence of H5N1 bird flu occurred in Malaysia in March 2017. The outbreak killed a number of chickens, but the authorities reported no human infections.

Here, learn more about H1N1, more commonly known as swine flu.


The “incubation period” of a virus is the amount of time between the infection and the host developing symptoms. The virus may be contagious during this time.

A 2019 reviewTrusted Source estimates the incubation period of H5N1 in humans to be at most 7 days, but more commonly 2–5 days.

H5N1 bird flu can cause severe symptoms in humansTrusted Source. A person may experience more serious typical flu symptoms, including:

a fever of above 100.4ºF (38ºC)

a cough

muscle aches

The following signs and symptomsTrusted Source of the illness can range from mild to severe:

a hoarse voice

a sore throat



an upset stomach, sometimes involving diarrhea



abdominal pain

chest pain

an altered mental state


Some people with H5N1 bird flu develop severe respiratory problems, including pneumonia and breathlessness.

According to a World Health Organization (WHO) report from 2005, shortness of breath occurs around 5 days after the first symptoms appear.

The condition of a person with H5N1 avian flu can deteriorate rapidly. They may experience respiratory failure and multiple organ failure, leading to death.


Humans can acquire the infection and develop the illness after coming into unprotected contact with birds who are carrying the virus. Human-to-human transmission is rare.

According to the Food and Agriculture Organization of the U. S., the following activities may lead to the illness in humans:

touching infected birds

touching or breathing in feces or other secretions of infected birds

preparing infected poultry for cooking

slaughtering or butchering infected poultry

handling birds for sale

attending markets that sell live birds

The infection can transmit to humansTrusted Source through a person’s eyes, nose, or mouth. However, some people develop the infection even without exposure to birds with the virus.

Eating cooked poultry or eggs does not cause infection. However, it is important to cook poultry until its internal temperature is at least 165º F (74º C) and eggs until both the whites and yolks are firm.

Bird droppings may contain the virus and can contaminate feed, equipment, vehicles, shoes, clothing, soil, dust, and water. The bodies, and particularly the feet, of animals can also carry the H5N1 virus.


Receiving a diagnosis of H5N1 avian flu early can lead to a better outlook.

Before arriving at a diagnosis, the doctor will:

consider the person’s symptoms

look for signs of bird flu

ask about recent travel

ask about any contact with birds

collect a respiratory specimen and send it to a lab for analysis

If a person gives this respiratory sample in the first few daysTrusted Source of the illness, the results of the analysis are likely to be more accurate.

In 2009, the FDA approved the AVantage A/H5N1 flu test, which can detect the presence of the virus in nose or throat swabs.

The test can identify a specific protein, called NS1, which indicates the presence of the virus.

Because H5N1 avian flu is rare, a physician would not expect to make this diagnosis, unless the person has been in contact with birds or recently stayed in a place where H5N1 infection is likely.


According to the WHO, antiviral medications can slow the speedTrusted Source at which the virus copies itself and improve outcomes for patients. Antivirals can prevent some cases from becoming fatal.

Doctors should administer oseltamivir (Tamiflu) within 48 hoursTrusted Source of symptoms developing. However, as mortality rates are high, doctors may also administer the medication after 48 hours to improve the individual’s outlook.

Tamiflu has a standard dosage of 75 milligrams for people aged 13 years or older. Children under this age will need a smaller dosage, as will people with kidney problems or end stage renal disease.

A standard course of Tamiflu is 5 days, though a doctor may recommend a longer course for a person who is severely ill or who has a weakened immune system.

People for whom H5N1 bird flu causes gastrointestinal problems may not be able to absorb the drug as effectively as people who do not experience abdominal pain, diarrhea, or vomiting.

Also, studiessuggest that some cases of H5N1 avian flu may be resistant to this treatment.

Anyone who has diagnosed or suspected avian flu should remain isolated, at home or in a hospital.

Apart from taking Tamiflu, healthcare professionals advise people to:


drink plenty of fluids

eat a balanced and healthful diet

take other medications to help manage the pain and fever

Complications, such as bacterial pneumonia, are common in people with H5N1 avian flu. Anyone with bacterial pneumonia will need to take antibiotics, and some people may need supplemental oxygen.

Read more about how doctors treat low oxygen levels.


Knowledge is power. Get our free daily newsletter.

Dig deeper into the health topics you care about most. Subscribe to our facts-first newsletter today.

Enter your email

Your privacy is important to us


It is not possible to prevent bird flu from spreading. However, authorities can help communities prepare for possible infections by monitoring bird migration patterns.

Vaccination is available for seasonal flu but not bird flu.

According to the WHOTrusted Source, vaccines for H5N1 infection have been developed but are not yet ready for widespread use.

Individuals can minimize the spread of bird flu by taking precautions. These include:

Hand hygiene: Wash the hands regularly with warm water and soap before and after using the bathroom, handling food, or coughing.

Coughing: It is best to cough into an elbow or tissue and carefully dispose of used tissues — also, touching a surface after coughing into the hands can leave the virus on the surface, allowing it to spread.

Isolation: Those who have symptoms should stay away from public places and avoid contact with people, whenever possible.

The WHOTrusted Source explain that the seasonal flu vaccine does not protect people from H5N1 avian flu.

Precautions around birds

When preparing meals, do not use the same utensils for cooked and raw meats. Before and after handling raw poultry, it is essential to wash the hands with soap and water.

Avoid dead or sick birds. To remove dead birds, call the relevant local authority. People who work with domestic birds should follow local and national guidelines.

Anyone traveling to an area in which avian flu may be active should avoid:

bird feces

live animal markets

poultry farms