DOH Issues New Flu Health Advisory for Hospitalized Patients

(Feb. 4, 2025) The Department of Health (DOH) issued a health advisory on Feb. 3, 2025 with updated recommendations for all health care facilities that perform influenza testing. This advisory is regarding accelerated subtyping for influenza A specimens among hospitalized individuals testing positive for influenza.

Although the ongoing global outbreak of highly pathogenic avian influenza A(H5N1) virus has primarily affected dairy cows, poultry, and other animals, 66 human cases (including one death) have been identified in the U.S. since 2024.

The Centers for Disease Control and Prevention (CDC) is now recommending ordering subtyping for all influenza A-positive specimens collected from hospitalized individuals within 24 hours of hospital admission to help rapidly detect any human cases of avian influenza A(H5N1).

The CDC is asking NY clinicians to follow certain steps described below when treating patients with suspected or confirmed influenza.

Ask people about potential exposures to wild and domestic animals, animal products, or symptomatic people with probable or confirmed avian influenza A(H5).
Implement appropriate infection control measures when influenza is suspected. This includes:

If avian influenza A(H5) is suspected, place the individual in an airborne infection isolation room (AIIR) with negative pressure, with standard, contact, and airborne precautions.
If none is available, place a facemask on the individual and isolate in an examination room with the door closed. The individual should not be placed in any room where room exhaust is recirculated without high-efficiency particulate air (HEPA) filtration.

Test for influenza A in all hospitalized people with suspected seasonal influenza or avian influenza A(H5) virus infection, using whatever diagnostic test is most readily available for initial diagnosis.

If the initial diagnostic test cannot subtype, order a seasonal influenza A subtyping diagnostic test within 24 hours of hospital admission for those who tested positive for influenza A.
If preliminary seasonal influenza subtyping yields an unsubtypeable result, samples should be promptly submitted to a public health laboratory for further characterization and potential H5 testing.
If exposure history or symptoms strongly suggest H5 infection, submit specimens to a public health laboratory for characterization in lieu of seasonal subtyping, in line with previous guidance.

The CDC has provided the following information on how to submit a specimen to a public health laboratory both within and outside of NYC.

For people residing in NYC:

Send specimens to the NYC Public Health Laboratory for testing. Call the NYC Health Department’s Public Health Laboratory at 212-671-5890 to coordinate specimen submission.

For people residing outside of NYC:

Send specimens to NYS Wadsworth for testing. Specifics regarding influenza specimen collection and shipping to Wadsworth Center can be found here.
A shipping manifest from an electronically submitted Remote Order OR an Infectious Disease Requisition (IDR) form requesting influenza testing with subtyping should accompany all specimens sent to Wadsworth.
For questions about shipping on holidays or weekends, please call 518-474-4177.
Please ship specimens to: David Axelrod Institute, Virology Laboratory, Wadsworth Center, NYS Department of Health, 120 New Scotland Ave., Albany, NY 12208.

Start anyone hospitalized, especially those in an intensive care unit (ICU), with suspected seasonal influenza or avian influenza A(H5) on antiviral treatment with oseltamivir without waiting for the results of influenza testing, unless contraindicated.
Notify the appropriate health department promptly if avian influenza A(H5) virus infection is suspected, probable, or confirmed.

People residing in NYC: Call the NYC Health Department’s Provider Access Line (PAL) at 866-692-3641.
People residing outside of NYC: Call the NYS Department of Health at 518-473-4439 or 866-881-2809 after hours and the local health department where the individual resides.

The health advisory is available here. More information is also linked below:

Contact: Carrie Mosley, cmosley@leadingageny.org, 518-867-8383 ext. 147