Revised Avian Influenza Guidance and Algorithms

This supercedes all previous guidance

WHO Pandemic Alert Phase 3 - HPA Algorithms and Guidance

H5N1 is the currently perceived threat and the algorithms have been developed to reflect this. However, they are flexible enough to be used should another event capable of causing human disease be identified.

The revised algorithms aim to assist in the management of:

• suspected or confirmed human cases of avian influenza
• contacts of confirmed human cases
• people exposed to birds where avian influenza is suspected or confirmed.

Occupational guidance is also provided for those involved in the response to an avian influenza incident.

Please contact your local Health Protection Unit  for advice and support, particularly in situations which do not fit any of the algorithms.

Case management of suspected or confirmed human cases of avian influenza A/H5N1

• The investigation and management of possible human cases of avian influenza A/H5N1 (including returning travellers) algorithm 1, Phase 3, aims to help with the management of the initial assessment of suspected human cases of avian influenza whether an individual has returned from travel abroad or not. Advice is provided on the infection control measures to be introduced, and the testing protocol and the reporting mechanisms to be used.
• Travel advice is available at Travel Advice Page. 
• The management of contacts of confirmed human case(s) of avian influenza A/H5N1 algorithm 2, Phase 3, aims to help with the assessment and prophylaxis of human contacts of confirmed human cases of avian influenza. Definitions of close and casual contact are provided as are the actions that should be taken.

Management of people exposed to birds where avian influenza is suspected or confirmed

• The management of people exposed to birds where avian influenza is suspected/confirmed and who have not used PPE at time of exposure  algorithm 3, Phase 3, aims to help with the assessment and prophylaxis of people who have been exposed to suspected or confirmed avian influenza in birds (both wild birds and poultry) and where personal protective equipment was not worn at the time of their exposure or antiviral prophylaxis was taken.

Avian Influenza Standard Operating Procedure

Guidance for Health Protection Units on dealing with human health implications of avian influenza in poultry and wild birds (PDF, 367 KB)

Occupational guidance for those responding to a suspected or confirmed avian influenza incident

• The occupational guidance for those responding to a suspected or confirmed avian influenza incident aims to help with the occupational health issues to be addressed during an avian influenza incident.

Case Reporting

Health Protection Units investigating respiratory illness in individuals meeting the avian influenza case definition should use the avian influenza management system (AIMS), a secure, password-protected clinical database developed by the HPA, at http://10.195.173.5/avianflu. 

All required login and password details are on file in each HPU.

A case report form that may be helpful for gathering the appropriate data items is attached -   Case Report Form - Influenza A/H5 (Avian) (Word Document, 248 KB).

Laboratory Guidance

• Microbiological guidance for taking and handling specimens for avian influenza testing  
• Advisory Committee on Dangerous Pathogens (ACDP) laboratory advice (ACDP website)

Last reviewed: 21 January 2009