#18,944
Late yesterday the Washington State Department of Health emailed out the following announcement on their first presumed H5N1 case of 2025. It was just over a year ago (Oct 21st, 2024) that WA announced their first (4) cases, among poultry cullers.
By the end of 2024, WA State had recorded 11 confirmed and 3 probable (mostly mild) human infections among agricultural workers, all exposed to infected poultry.
Today's human case (which requires confirmation by the state lab) appears to be more severe, and the route of exposure has yet to be determined. Beyond that, we know this is an older adult with comorbidities, who has been hospitalized for more than a week.
There is no word yet on the genotype of this virus. In fact, we've seen very little data on any of the poultry and wild bird outbreaks this fall.Last year, the B3.13 (aka `Bovine') genotype was associated with milder human infections (mostly conjunctivitis), while the D1.1 and D1.3 genotypes tended to produce more severe symptoms (including 1 death).
The full press release follows. I'll have a bit more, after the break.
Grays Harbor County resident tests preliminarily positive for avian influenza
For immediate release: November 13, 2025 (25-136)
Contact: DOH Communications
If confirmed, this would be the first human case of avian influenza reported in Washington in 2025
OLYMPIA – A Grays Harbor County resident has tested preliminarily positive for avian influenza, also known as bird flu. Confirmatory testing through the Washington State Public Health Laboratories is pending.
Health officials are working to determine the potential sources of the infection, including contact with wild or domestic birds. The person, who is an older adult with underlying health conditions, developed a high fever, confusion, and respiratory distress and was hospitalized in early November. They are currently receiving treatment in King County after previously being treated in Thurston and Grays Harbor counties.
Public health disease experts have not identified any risk to the public. The Washington State Department of Health is working with the local health departments and healthcare facilities to support the investigation.
About Avian Influenza
Avian influenza is a disease caused by influenza type A viruses, which naturally occur in wild aquatic birds around the world. These viruses can infect other bird species, and, occasionally mammals, and can be deadly to domestic birds such as chickens and turkeys. On rare occasions, avian influenza viruses can infect people and make them sick. Most cases have occurred in people who were exposed to sick or infected animals. Reported human cases of avian influenza in the United States have typically been mild, with symptoms such as conjunctivitis (red eyes), fever, and respiratory symptoms.
The risk of avian influenza increases in the fall and winter because migratory birds can carry the virus and spread it to domestic animals including commercial poultry farms and backyard flocks.
Transmission of avian influenza between humans is extremely rare and has never been documented in the United States. To ensure that human-to-human spread is not occurring, public health officials are contacting anyone who has been in close contact with the patient to monitor for symptoms and provide testing and treatment as needed.
Public Health Guidance
The Centers for Disease Control and Prevention (CDC) currently considers the risk to the public from avian influenza to be low. However, people who work with or have recreational contact with infected birds, cattle, or other potentially infected domestic or wild animals, are at higher risk and should take precautions, including wearing personal protective equipment (PPE) such as gloves, masks, eye protection, and fluid-resistant coveralls or other outerwear.
People with backyard poultry should avoid contact with sick or dead birds and report illness to the Washington State Department of Agriculture (WSDA) by calling 1-800-606-3056 or reporting online. Veterinarians should report sick or dead domestic animals or livestock suspected of having avian influenza to WSDA. Avoid contact with sick or dead wildlife and report sick or dead wild birds or other animals to the Washington State Department of Fish & Wildlife. Never handle or allow pets near dead birds or other wildlife.
Avoid eating raw or undercooked food products, such as unpasteurized (raw) milk or raw cheeses, and don’t feed these products to pets.
It is especially important that people who may have exposure to sick birds get a seasonal flu vaccine. While the seasonal flu vaccine will not prevent bird flu infection, it reduces the risk of becoming sick with both human and avian influenza viruses at the same time. Seasonal flu vaccine is recommended for everyone six months and older.
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Although the steep decline in human infections with HPAI H5N1 in the United States over the past 10 months has been somewhat reassuring, the reality is it requires a combination of both diligence and luck to detect community cases of novel influenza infection.
It has been estimated previously that fewer than 1-in-100 novel swine flu infections are picked up by passive surveillance (see CID Journal: Estimates Of Human Infection From H3N2v (Jul 2011-Apr 2012).
Many with mild or moderate symptoms will not seek a doctor's advice, and among those who do, most will not be tested for novel influenza. And of course, asymptomatic cases are almost certain to be missed.
In January of 2025, the CDC issued guidance (see CDC HAN: Accelerated Subtyping of Influenza A in Hospitalized Patients) calling for more robust inpatient testing - and while some progress appears to have been made - it is unclear what the level of compliance is to these guidelines across the nation.Obviously, these steps are only likely to capture hospitalized patients. Those attending clinics or private physicians are less likely to be tested for novel flu.
While one human infection does tell us much, it does confirm that the threat of human infection has not gone away.
Stay tuned.
