One Flu Over the Cuckoo's Nest: Is Concern for Avian Flu Warranted in a Busy Clinic?

At present H5N1 is mainly a disease of birds. However, with ongoing mutation, the virus may develop the ability to bind to human upper airway receptors and be easily passed between human beings by coughing and sneezing. Care providers must be prepared to recognize isolated cases, clusters of cases, or possibly sudden, overwhelming numbers of cases. Most importantly, guidelines for recognition and testing suspected cases should be available for reference in each clinic. This article provides background in the biology, epidemiology, and natural history of H5N1 infection, along with guidelines for prevention, diagnosis, and advice for treatment.