Preparedness for HPAI A(H5N1) virus varies across jurisdictions

Variation is seen in preparedness and response to highly pathogenic avian influenza (HPAI) A(H5N1) viruses, according to a research letter published online May 21 in the Journal of the American Medical Association.

Noting that HPAI A(H5N1) clade 2.3.4.4b viruses pose pandemic potential, Noah Kojima, M.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues examined components of public health preparedness and response to HPAI A(H5N1) viruses. State and territorial epidemiologists in 55 jurisdictions were surveyed.

The researchers found that 91 percent of jurisdictions (50 jurisdictions) reported persons exposed to A(H5N1) virus-infected animals and monitored for symptoms. Of these, human exposures were reported in backyard flocks, commercial poultry, wild birds, and sick or dead mammals in 88, 82, 54, and 18 percent of jurisdictions, respectively.

Overall, 59 percent of 49 jurisdictions with A(H5) virus testing capacity reported testing respiratory specimens from symptomatic persons since January 2022.

Public health authorities reported difficulties in monitoring A(H5N1) virus-exposed persons due to personnel shortages or lack of funding in 66 percent of 50 jurisdictions.

Overall, 19 of 50 respondents (38 percent) reported recommending empirical antiviral treatment before performing influenza testing for persons monitored after exposure to A(H5N1) virus who developed symptoms. One-third of the jurisdictions would recommend postexposure prophylaxis for close contacts of those with laboratory-confirmed A(H5N1).

“Challenges reported in monitoring exposed persons and differences in antiviral recommendations highlight the need to strengthen and standardize public health preparedness and response to HPAI A(H5N1) viruses in the U.S., particularly if additional animal-to-human A(H5N1) virus transmission events are reported,” the authors write.

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