The following guidance to health care providers has been issued by Norton Healthcare’s infection prevention and employee health department.

Current situation in Kentucky

On Jan. 16, 2025, the Centers for Disease Control and Prevention (CDC) issued a health advisory to encourage rapid subtyping for patients hospitalized with influenza A. The Kentucky Department for Public Health (KDPH) disseminated this communication to acute care facilities and health departments on Jan. 21, 2025. KDPH continues to work with health care facilities to conduct enhanced surveillance of influenza A.

The latest detections of avian influenza A (H5N1), commonly known as bird flu, in wild birds in Kentucky include waterfowl in Franklin County (January 2025), Rowan County (December 2024), and Henderson County (December 2024).

There are currently no detections of bird flu in poultry, dairy cattle, or cats in Kentucky. There have not been any human cases of avian influenza A (H5N1) in Kentucky.

Current situation in the United States

Bird flu is widespread in wild birds worldwide and causing outbreaks in poultry and U.S. dairy cows.

As of Feb. 12, 2025, 68 human cases of avian influenza A (H5N1) have been reported in the United States, including one death. Nearly all identified cases had known exposure to infected animals. There is no evidence of human-to-human transmission of avian influenza A (H5N1).

The CDC considers the current public health risk to be low.

What is avian influenza?

Avian influenza, or bird flu, is a type of influenza A virus that primarily affects birds but occasionally can infect humans and other animals. The virus is highly contagious among birds and can lead to severe illness and death in poultry and wild birds.

Recently, bird flu has been detected in an increasing number of mammal species, including dairy cattle and domestic cats.

How does bird flu spread?

Avian influenza virus spreads through direct contact with infected animals, their feces, saliva, or mucus, or contaminated surfaces and materials such as feed, water and equipment.

Humans can become infected through close contact with infected animals or their contaminated environments. Human-to-human transmission is extremely rare.

Risk to the public

The current risk for the general public remains low. However, people with direct exposure to infected animals or their environments, such as people who work with birds, poultry or cows, or who have recreational exposure to them, are at higher risk.

Poultry, egg, and other animal products cooked to proper temperatures and pasteurized dairy products are safe for consumption.

What are the symptoms of avian influenza in humans?

If a person is infected, symptoms may range from mild flu-like illness (conjunctivitis, fever, cough) to severe (difficulty breathing, pneumonia, death). Individuals should notify public health officials and seek medical attention if they experience flu-like symptoms after exposure to birds, animals or their environments.

Laboratory testing is required to confirm diagnosis and differentiate between avian and seasonal influenza. Antiviral treatment (oseltamivir) for avian influenza is recommended as soon as possible and should not be delayed while awaiting laboratory results.

How patients can avoid exposure

The best way for patients to protect themselves and their families from bird flu is to avoid sources of exposure. Avoid direct contact with wild birds and other animals infected with or suspected to be infected with avian influenza viruses. Additional advice for patients:

• Do not handle sick or dead animals or birds. Contact local wildlife or agriculture authorities for assistance. Keep pets away from sick or dead animals and their feces.
• Wash hands thoroughly after handling animals, birds, their waste, food, water, bedding, or equipment.
• Fully cook animal and poultry products to the correct internal temperature before consuming. Avoid consuming unpasteurized raw milk or cheese from animals with suspected or confirmed infection.
• Notify the Kentucky Department of Fish & Wildlife Resources (KDFWR) of unusual illness or deaths in wild animals or birds. Report sick, injured or dead birds to KDFWR. Owners concerned about pets exposed to avian influenza should seek veterinary care.

What is being done in Kentucky?

KDPH is working closely with agriculture, wildlife and federal partners to monitor the current avian influenza situation. KDPH is monitoring persons exposed to infected birds or animals for symptoms of avian influenza for 10 days after their last exposure.

KDPH is working with health care facilities to provide subtyping of influenza A samples from hospitalized patients.

KDPH, University of Kentucky and Breathitt Veterinary Diagnostic Labs have been conducting H5N1 testing in cats that test negative for rabies submission, since May 2024.

The U.S. Department of Agriculture (USDA), Kentucky Department of Agriculture and KDPH are collaborating on efforts in support of the USDA National Milk Testing Strategy and anticipate raw milk testing efforts in Kentucky in the near future.

The CDC is monitoring for changes in the virus that may suggest that it can spread easier to and among humans, cause more severe disease, or be less responsive to antiviral medications or candidate vaccine viruses.