DOH Issues Advisory Regarding Influenza Testing of Patients with Severe Respiratory Illness

(July 30, 2024) The NYS Department of Health (DOH) Wadsworth Center and Division of Epidemiology, Bureau of Communicable Disease Control (BCDC), recently issued a health advisory regarding influenza testing among individuals with severe respiratory illness during periods of low influenza virus circulation.

From the advisory:

The purpose of this advisory is to provide guidance regarding surveillance for influenza (including highly pathogenic avian influenza A(H5N1)) in patients with severe respiratory illness and the submission of specimens to Wadsworth Center.

Summary

In response to the ongoing and extensive global outbreak of highly pathogenic avian influenza (HPAI) A(H5N1) in wild birds, poultry, and dairy cattle, the Centers for Disease Control and Prevention (CDC) is encouraging year-round testing for influenza among persons with severe respiratory illness.
NYSDOH and the CDC request that respiratory samples from persons hospitalized with laboratory confirmed influenza, particularly patients receiving intensive care unit (ICU) level care, be promptly forwarded to the Wadsworth Center Virology Laboratory for additional testing, including subtyping, whole genome sequencing, and antiviral resistance testing.
Laboratories, hospitals, and clinical providers should recognize that adherence to recommendations for influenza testing and sample submission are important steps for human HPAI A(H5N1) surveillance in the United States (U.S.), especially during the summer when influenza testing may not be routine and exposure to poultry, cattle, and swine may increase during agricultural fair season.
If you suspect a patient has a novel influenza A virus infection based on an influenza A positive laboratory result in combination with clinical history and exposures, immediately contact the NYSDOH at 518-473-4439 or 1-866-881-2809 after hours and the local health department (LHD) where the patient resides.

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Recommended actions:

Submit to Wadsworth Center year-round all positive influenza samples from hospitalized patients requiring ICU care.
Conduct enhanced influenza surveillance during months when seasonal influenza incidence is typically low (May through September).

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Submit to Wadsworth Center all influenza positive samples detected in hospitalized persons NOT requiring ICU care until December 31, 2024, for subtyping, sequencing, and other specialized analyses, as well as potentially forwarding to CDC for their repository.

In the event of an outbreak, please contact the NYSDOH at 518-473-4439 for guidance.

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Infection Prevention Considerations

Standard, Contact, and Airborne precautions, including the use of eye protection, are recommended for the collection of respiratory and other specimens and medical evaluation.

Patients with suspected HPAI A(H5N1) infection who present to a healthcare facility should be placed in an airborne infection isolation room (AIIR).
If a patient presents to a healthcare facility at which an AIIR is not available, the patient should be instructed to wear a facemask and should be placed in an examination room with the door closed until discharge or transfer to a facility with an AIIR.
Additional infection prevention and control guidance for healthcare facilities with or without an AIIR, including additional patient placement information and cleaning and disinfection steps, is available [from the CDC here].

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Resources and Questions

Questions regarding submission of specimens to Wadsworth Center can be directed to wcid@health.ny.gov.

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Additional NYSDOH guidance for clinicians regarding Highly Pathogenic Avian Influenza A(H5N1) is available [here].

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