Human Infection with Highly Pathogenic Avian Influenza A(H5N5) Virus

Extract from the report: 

"This case highlights several diagnostic and clinical challenges. First, multiple upper-respiratory-tract specimens were negative for influenza A virus despite high-burden lower respiratory tract infection, a finding that emphasizes the importance of obtaining bronchoalveolar-lavage or tracheal specimens in patients with severe pneumonia and relevant zoonotic exposures. Because of the delayed diagnosis of HPAI A(H5N5) virus infection, antiviral treatments were not initiated until late in the clinical course. Second, the identification of an HPAI A(H5N5) virus with a transient, low-frequency mammalian-associated change underscores the fact that fully avian influenza A viruses remain capable of zoonotic spillover. Finally, severe acute respiratory distress syndrome in the context of underlying hematologic cancer arouses concern that such patients may be particularly vulnerable to adverse outcomes from novel influenza A virus infections.

This report shows the importance of considering avian influenza A virus infection in patients with pneumonia and direct bird exposure, even when testing for influenza virus in upper-respiratory-tract specimens is negative."

Lite, T.-L., Goya, S., Davis, M.L., Morris, A.E., Bryson-Cahn, C., Vengerovsky, A., Corpuz, C.G., Nunley, B.E., Maenza, J.R., Hawn, T.R., Luks, A.M., Lynch, J.B., Uyeki, T.M., Chu, H.Y., Greninger, A.L. and Sung, C.C. (2026). Human Infection with Highly Pathogenic Avian Influenza A(H5N5) Virus. New England Journal of Medicine. doi:https://doi.org/10.1056/nejmc2518178