Avian influenza is a viral infection that mainly affects birds and can sometimes infect humans. People with avian influenza often develop sudden fever, cough, sore throat, muscle aches, and trouble breathing. Illness can progress quickly over days, and severe cases may lead to pneumonia and organ failure. Risk is higher for people who have close contact with infected birds or contaminated environments, and outbreaks vary by region and strain. Treatment usually includes supportive hospital care and antiviral medicines such as oseltamivir, but severe avian influenza can be life‑threatening.
Overview
Avian influenzaSymptoms
Avian influenza symptoms often start suddenly with fever, chills, cough, sore throat, and severe muscle aches. Many also have headache, watery eyes, or diarrhea. Breathing can worsen quickly, with chest pain or shortness of breath needing urgent care.
Outlook and prognosis
Most people with avian influenza feel very unwell early, and the illness can progress quickly. With prompt hospital care—flu antivirals, oxygen, and supportive treatment—recovery is possible, though complications like pneumonia or organ stress can be life‑threatening. Outcomes vary by virus strain and overall health.
Causes and risk factors
Avian influenza usually follows close contact with infected birds or contaminated settings—live markets, backyard flocks, or poultry work—especially without protective gear. Risk rises with pregnancy, older adults, chronic illness, weak immunity; inherited differences may shape early symptoms of avian influenza.
Genetic influences
Genetics matters for avian influenza, but exposure is the main driver. Variations in immune genes can influence who gets severely ill, how quickly symptoms escalate, and response to vaccines or antivirals. Viral genetic changes also shape transmissibility, tissue targeting, and drug resistance.
Diagnosis
Doctors suspect avian influenza when severe flu-like illness follows bird or poultry exposure. Diagnosis is confirmed with RT‑PCR testing of nose or throat swabs; chest imaging may support findings. Rapid diagnosis of avian influenza guides isolation and antiviral treatment.
Treatment and drugs
Treatment for avian influenza focuses on early antiviral medication, careful monitoring for breathing problems, and supportive care like fluids, fever control, and oxygen if needed. Doctors often consider oseltamivir or zanamivir, ideally started within 48 hours. Close contacts may receive preventive antivirals and vaccination against seasonal flu to reduce co‑infection risk.
Symptoms
Avian influenza often starts suddenly and can feel like a severe flu. The early symptoms of avian influenza often resemble seasonal flu—fever, cough, sore throat, and feeling very tired. Symptoms vary from person to person and can change over time. Breathing problems, chest pain, or confusion can develop quickly and need urgent care, especially if symptoms worsen over 24–48 hours.
Temperatures often rise quickly to 38–40°C (100.4–104°F) with chills and sweats. Fever can come with shaking chills and feeling weak.
Profound tiredness can make routine tasks hard to finish. Rest may not restore energy at first.
A dry or wet cough is common, often with throat pain. Talking or swallowing may worsen the discomfort.
You may feel winded after minimal activity or even at rest. Breathing can feel fast or shallow.
How people usually first notice Avian influenza?
Many people first notice avian influenza (bird flu) after a clear exposure to sick or dead birds or contaminated environments, followed a few days later by sudden flu-like symptoms such as fever, cough, sore throat, fatigue, and body aches. Eye redness (conjunctivitis) and shortness of breath can appear early, and symptoms often feel more severe than a typical seasonal flu; gastrointestinal issues like diarrhea may also occur. If you’ve had recent contact with poultry or wild birds and develop these symptoms, especially within about 2–8 days, that timing is one of the first signs of avian influenza and is a reason to seek prompt medical care.
Types of Avian influenza
Avian influenza can look very different from one person to the next. Some feel like they have a seasonal flu that passes, while others develop fast-rising breathing trouble that needs urgent care. People may notice different sets of symptoms depending on their situation. Broadly, symptoms are grouped into patterns based on how the illness shows up and how severe it becomes; you can think of these as types of avian influenza presentations rather than different viruses.
Mild flu-like
Fever, cough, sore throat, and body aches are the main features. Many also feel tired and may have headache or runny nose. Symptoms often improve with rest and fluids.
Gastrointestinal-predominant
Nausea, vomiting, or diarrhea come to the forefront, sometimes before any cough. Belly cramps and poor appetite are common. Dehydration can develop if fluids are not kept up.
Eye-involved (conjunctivitis)
Red, watery, or painful eyes appear with or without mild respiratory symptoms. Light sensitivity and gritty eye sensation are common. Vision usually returns to baseline as the eye irritation settles.
Lower-respiratory dominant
Shortness of breath, chest tightness, and a persistent cough point to the lungs being more affected. Oxygen levels can drop, and pneumonia may develop. This pattern needs prompt medical attention.
Severe systemic
High fever with rapid breathing, confusion, or dizzy spells signals whole‑body involvement. For many, certain types stand out more than others. This can lead to complications like acute respiratory distress and requires emergency care.
Neurologic features
Severe headache, confusion, or seizures can occur in rare cases. These signs suggest the nervous system is affected. Urgent evaluation is important if neurologic symptoms appear.
Children’s presentation
Kids may show more stomach symptoms and higher fevers than adults. Irritability, low energy, and poor drinking are common clues. Not everyone will experience every type.
Older adults pattern
Fatigue, breathlessness, and fast breathing may be more prominent than fever. Appetite often drops, and weakness can be marked. Early symptoms of avian influenza can be subtle in this group.
What genetics can tell you about symptoms
Certain avian influenza strains carry changes in the hemagglutinin (HA) gene that let the virus bind deeper in the lungs, leading to high fever, severe cough, chest pain, and breathing trouble. Variants in polymerase genes (like PB2 E627K) are linked to rapid worsening, confusion, and higher risk of pneumonia.
Causes and risk factors
Avian influenza is caused by bird flu viruses that sometimes jump from birds to people and rarely spread between people. Risk is highest with close contact with sick or dead birds, live bird markets, or contaminated cages and droppings, especially without protective gear. Doctors distinguish between risk factors you can change and those you can’t. Higher exposure comes from handling or slaughtering poultry, cleaning cages, traveling to affected areas, and poor hand hygiene. Severe avian influenza is more likely in very young children, older adults, people who are pregnant, those with chronic illness or weak immunity, and in some with inherited differences in immune response.
Environmental and biological risk factors
Avian influenza spreads to people mostly through close contact with infected birds or contaminated environments. Risks come both from exposures in daily settings and from health factors that affect how your body responds. Some risks are carried inside the body, others come from the world around us.
Crowded markets with chickens, ducks, or geese can carry high levels of virus in cages, dust, and droppings. Spending time in these settings raises the chance of avian influenza exposure. Risk increases if birds are being slaughtered on-site.
Handling or preparing ill or dead poultry can bring your hands, eyes, or nose into contact with virus. Avian influenza can spread when fluids or feathers contaminate skin or clothing.
Jobs in farming, culling, transporting, or processing birds raise exposure to infected flocks. Daily tasks can aerosolize virus, making avian influenza more likely without strong safeguards.
Keeping small flocks at home brings repeated close contact with birds, coops, and litter. Cleaning coops or home slaughter without protection increases exposure risk.
Genetic risk factors
Both the virus’s genes and our own inherited traits influence who gets sick from Avian influenza and how severe it becomes. Some viral lineages carry changes that help them latch onto human airway cells, copy themselves efficiently, and evade medicines; this can also shape how quickly early symptoms of Avian influenza appear. Carrying a genetic change doesn’t guarantee the condition will appear. Research also points to human gene variants that can raise the odds of severe illness, though their effects differ between people and populations.
Viral subtype: Strains such as H5N1, H5N6, and H7N9 have gene patterns linked to higher risk of severe disease in people. These viral blueprints can increase how firmly the virus establishes infection from Avian influenza. Differences between subgroups (clades) also affect severity.
Binding shifts: Small genetic changes in the virus’s surface proteins can switch its preference toward receptors common in the human nose and throat. This can make Avian influenza infection more likely. It may also influence how easily the virus spreads in the airways.
Polymerase changes: Alterations in viral replication genes help the virus multiply efficiently at human airway temperatures. This can increase virus levels and raise the risk of severe lung disease from Avian influenza. Such changes have been documented in some human cases.
Drug resistance genes: Certain viral mutations reduce the benefit of antiviral medicines. When present, they can limit treatment options for Avian influenza and allow virus levels to stay higher. Labs may check for these changes during outbreaks.
Gene mixing: When two flu viruses infect the same host, they can swap gene segments and create a new combination. This reassortment can generate avian strains better adapted to human infection with Avian influenza. It also complicates vaccine planning.
IFITM3 variant: A common change in this immune gene has been linked to worse outcomes from flu in some groups. For Avian influenza, findings are mixed, but the variant may increase the risk of severe illness. Effects appear to vary by ancestry and study.
Early antiviral defenses: Inherited differences in genes that drive the body’s first-line response can alter how quickly the virus is controlled. Some variants are tied to higher virus levels and stronger inflammation in Avian influenza. This can contribute to severe pneumonia.
HLA types: Differences in HLA genes shape how well T cells recognize flu proteins. Certain types may provide better protection against Avian influenza, while others may be less effective. Patterns vary by population.
Family clustering: Rare clusters of severe illness within families suggest a shared genetic susceptibility. When multiple relatives become very ill with Avian influenza, inherited immune differences may be part of the explanation. This has been noted in several outbreaks.
Lifestyle risk factors
Your behaviors around birds and poultry products are the main lifestyle risk factors for avian influenza. Everyday choices in food preparation, market visits, and hygiene can raise or lower exposure. Understanding how lifestyle affects avian influenza helps you target the riskiest habits and replace them with safer routines.
Eating undercooked chicken, duck, or eggs can transmit virus present in meat or fluids. Cook poultry to safe internal temperatures and avoid runny eggs or raw dishes.
Regular visits to live bird markets increase exposure to respiratory droplets and contaminated surfaces. Limiting visits and practicing strict hand hygiene lowers risk.
Handling raw poultry without separate boards and thorough handwashing spreads virus to hands and kitchen surfaces. Clean and disinfect prep areas and utensils after use.
Keeping chickens or ducks without basic biosecurity raises close contact with potentially sick birds. Use dedicated footwear, gloves, and keep birds out of living spaces.
Risk prevention
Most prevention focuses on limiting contact with infected birds and their environments, and reducing the chance the virus reaches your eyes, nose, or mouth. Some prevention is universal, others are tailored to people with specific risks. People who work with birds need extra layers of protection, while travelers and backyard flock owners can lower risk with careful hygiene and food safety. Simple steps add up to meaningful protection for you and your family.
Stay away from sick or dead birds and their droppings. Do not handle or feed wild birds, and keep pets from pecking at carcasses. If you must move a dead bird, use gloves and a shovel, then wash hands well.
Skip live bird markets and backyard slaughter when possible, especially in areas with avian influenza reports. If you must visit, wear a well-fitted mask, avoid touching cages and rails, and wash hands before eating or drinking.
Wash hands often with soap and water for 20 seconds, especially after contact with birds or their housing. Use an alcohol-based hand rub when soap and water are not available. Avoid touching your eyes, nose, and mouth until hands are clean.
Cook poultry and eggs thoroughly to at least 74°C/165°F. Avoid raw or runny eggs and undercooked poultry dishes. Keep raw poultry separate from other foods and disinfect cutting boards and knives.
Transmission
Avian influenza (bird flu) spreads mainly from infected birds to people through close contact with sick or dead poultry and their fluids or droppings, or by breathing in contaminated dust in barns, coops, or live bird markets. People can be exposed by touching birds, feathers, or soiled surfaces and then touching their eyes, nose, or mouth; eating well-cooked poultry and eggs does not spread Avian influenza. Avian influenza is not easily spread from person to person; rare, limited spread has happened among close contacts after prolonged, unprotected exposure, with no sustained community transmission. Some strains can also infect other animals, such as pigs, cats, or cattle, so close contact with sick mammals linked to infected birds can occasionally pass the virus to people. Overall, the risk to the general public is low; how Avian influenza spreads depends on direct, close exposure to infected animals or their environments.
When to test your genes
Avian influenza is usually diagnosed with standard viral tests, not routine genetic testing. Consider genetic testing only if your care team suspects a rare immune or clotting disorder, or if you have repeated severe infections that seem out of proportion. Otherwise, focus on timely vaccination guidance, exposure prevention, and prompt medical evaluation.
Diagnosis
Many people first notice sudden fever, cough, or feeling very unwell after contact with sick birds or visiting live poultry markets. Doctors usually begin by asking about recent travel, work around birds, and close contact exposures, then checking vital signs and lungs. Understanding how avian influenza is diagnosed can make the next steps clearer.
Your provider will ask about recent travel, work with poultry, live bird market visits, or contact with sick or dead birds. These details help estimate risk and guide which tests to order.
Clinicians check temperature, breathing rate, oxygen levels, and listen to the lungs. Findings such as fast breathing or crackles can point toward a serious lung infection.
A nose or throat swab is tested by RT‑PCR to detect influenza A and specific avian strains. This is the main test because it is highly sensitive when done early in illness.
If influenza A is detected, the sample is checked for H5 or H7 and related markers. Subtyping helps confirm avian influenza and informs treatment and public health actions.
Stages of Avian influenza
Avian influenza does not have defined progression stages. It’s an acute infection that can range from mild, flu‑like illness to sudden, severe breathing problems, so it doesn’t follow set steps over time. Doctors look at early symptoms of avian influenza together with any recent contact with birds or affected environments, and they use a nose or throat swab to check for the virus. Different tests may be suggested to help confirm the infection and monitor lung health and oxygen levels through blood work and chest imaging.
Outlook and prognosis
Looking ahead can feel daunting, but many people want to understand the likely course of avian influenza after a diagnosis. The outlook is not the same for everyone, but it depends a lot on the virus strain, how severe the illness is at the start, and how quickly antiviral treatment begins. People with avian influenza who are treated early and have milder infection often recover fully within weeks, though fatigue and cough can linger. Severe cases can lead to pneumonia, breathing failure, or complications affecting the heart or brain, which can extend recovery or lead to lasting effects.
Doctors call this the prognosis—a medical word for likely outcomes. Reported mortality has varied by outbreak and strain; some H5N1 and H7N9 infections have had high fatality rates, especially when care was delayed or when people had underlying conditions. Risk is generally higher for older adults, those who are pregnant, and people with chronic illnesses or weakened immunity. Early symptoms of avian influenza can look like seasonal flu—fever, cough, sore throat, aches—so getting tested and starting antivirals promptly can make a real difference.
With ongoing care, many people maintain good long‑term health once they recover from avian influenza, especially if lungs were not severely affected. If hospitalization was required, follow‑up may include breathing tests, heart checks, and gradual return to activity to rebuild stamina. Talk with your doctor about what your personal outlook might look like, including warning signs to watch for and what supports—rehab, vaccines, or prevention steps—fit your situation.
Long-term effects
People who recover from avian influenza can feel its effects long after the infection clears, especially after severe pneumonia or time in intensive care. Long-term effects vary widely, from lingering breathlessness to changes in thinking and mood. People who had severe illness beyond the early symptoms of avian influenza are more likely to notice ongoing issues, though many improve gradually over months.
Some people develop areas of lung scarring after severe pneumonia. This can make deep breaths uncomfortable and limit airflow. Breathing tests may show reduced capacity.
Shortness of breath can persist during routine activities like climbing stairs or carrying groceries. This is more common after avian influenza that caused acute respiratory distress. Symptoms may slowly ease over months.
Stamina can drop, making walks feel harder and recovery after exertion slower. People with avian influenza–related lung injury notice this most after colds or air pollution exposure.
A dry or productive cough can linger after the infection resolves. Airways may stay sensitive and react to dust, smoke, or cold air.
How is it to live with Avian influenza?
Living with avian influenza is usually short-term but can feel intense, with sudden high fever, severe cough, body aches, and profound fatigue that can make even basic tasks exhausting. Many need strict isolation while recovering, which disrupts work or school and can feel lonely, and in severe cases hospitalization and oxygen support are required. People around you may worry and need to monitor their own symptoms, adjust schedules, and follow careful infection-control steps like masking, hand hygiene, and cleaning shared surfaces. Most recover with rest and medical care, but it can take weeks to regain energy, so pacing, hydration, and follow-up with a clinician help you and those close to you ease back into routine safely.
Treatment and drugs
Treatment for avian influenza focuses first on supportive care to keep you stable: rest, fluids, fever control, and oxygen if breathing is hard. Antiviral medicines, such as oseltamivir or zanamivir, are often started as soon as possible, ideally within 48 hours of symptoms, to help shorten illness and lower the risk of complications; a doctor may adjust your dose to balance benefits and side effects. People with severe avian influenza may need hospital care, including oxygen therapy, breathing support (like ventilators), and treatment for complications such as pneumonia or dehydration. Antibiotics don’t treat the virus itself, but doctors may use them if there’s a bacterial lung infection on top of the flu. Vaccines against avian influenza are not routinely given to the public, but specific vaccines may be offered to high-risk groups or during outbreaks, and close contacts might receive preventive antivirals if recommended by public health teams.
Non-drug treatment
Avian influenza can make daily tasks hard—breathing feels heavier, energy drops, and rest becomes essential. Non-drug treatments often lay the foundation for comfort and safety while your clinical team decides on other care. Spotting early symptoms of avian influenza and acting quickly—resting, isolating, and monitoring breathing—can reduce complications and protect others. These approaches focus on easing symptoms, supporting the lungs, and preventing spread at home and in clinics.
Plenty of sleep and quiet time helps your body fight the infection. Regular sips of water, oral rehydration drinks, or broths can prevent dehydration.
Stay in a separate, well‑ventilated room and avoid close contact until cleared by a clinician. Wear a high‑quality mask when around others to reduce spread.
Frequent handwashing and cleaning high‑touch surfaces lower the risk to family and caregivers. Use tissues or your elbow to cover coughs and sneezes.
Sitting upright, slow deep breathing, and gentle pacing can ease breathlessness. A clinician may provide oxygen or high‑flow support in hospital if levels drop.
Your genes may have an impact on how drugs work for you
Think of treatment like choosing the right key for a lock: small genetic differences in people can change how well antiviral drugs work, how fast they’re cleared, and who is more likely to get side effects. Viral genetics also matter, because certain avian influenza strains carry mutations that reduce susceptibility to medications like oseltamivir.
Pharmacological treatments
For people with avian influenza, treatment focuses on starting antiviral medicine as early as possible to lower the chance of severe illness. First-line medications are those doctors usually try first, based on strong evidence and safety in flu. Supportive drugs can ease fever and treat bacterial complications that sometimes follow. If you’re unsure when to seek care, getting help at the first early symptoms of avian influenza—such as sudden fever, cough, or shortness of breath—can make treatment more effective.
This neuraminidase inhibitor is the first choice and should be started as soon as avian influenza is suspected, ideally within 48 hours. It can still help if started later in severe or hospitalized cases.
Another neuraminidase inhibitor that can be used when oseltamivir isn’t suitable. It’s inhaled powder and generally avoided in people with asthma or COPD due to bronchospasm risk.
An intravenous neuraminidase inhibitor for people who can’t take pills or are critically ill. It’s often used in hospital settings, including intensive care.
A single-dose antiviral that blocks a different step of the flu virus life cycle. It may be considered by specialists in select situations, but neuraminidase inhibitors remain the mainstay for avian influenza.
Genetic influences
Avian influenza isn’t inherited; it’s caught from infected birds or contaminated environments, so family history doesn’t raise your risk. The main genetic influence lies in the virus itself: changes in its genes can shift which parts of our airways it latches onto and how quickly it multiplies. Genetics is only one piece of the puzzle, but certain viral changes may make this infection more severe in people or, rarely, easier to spread from person to person. Scientists track these changes by sequencing virus samples, which helps public health teams spot strains with higher risk and guide vaccines or treatments. On the human side, research suggests that natural differences in our immune system genes may partly explain why some people with avian influenza become much sicker than others, though this is still being studied. Overall, when you hear about “genetic factors in avian influenza,” it usually refers to the virus’s mutations and how they affect severity and spread, not to something you inherit.
Is Avian influenza genetic?
Genetics matters for avian influenza, but exposure is the main driver. Variations in immune genes can influence who gets severely ill, how quickly symptoms escalate, and response to vaccines or antivirals. Viral genetic changes also shape transmissibility, tissue targeting, and drug resistance.
Pharmacogenetics—how genetics influence drug effects
Genetic differences can shape how antiviral medicines work for avian influenza, both in the virus and in the person being treated. Changes in the virus’s own genes can make certain drugs less effective—most famously, neuraminidase changes that reduce oseltamivir’s benefit—so when it’s available, doctors may use resistance testing to steer choices toward another option, such as inhaled zanamivir, intravenous peramivir, or baloxavir. On the human side, some antivirals are prodrugs that need to be activated in the liver, and natural differences in these enzymes can slightly raise or lower drug levels; others, like inhaled zanamivir, have very little body-wide metabolism, so genetics matters less. Not every difference in response is genetic, but timing of treatment, illness severity, kidney function, and other medications also play major roles. In practice, this means your team may start antiviral treatment for avian influenza early, adjust the drug or dose if needed, and rely more on viral resistance testing than on pharmacogenetic tests, which aren’t routinely used here. If a medicine isn’t helping or side effects build, your doctor may switch to a different antiviral or route based on how the virus—and your body—are handling the drug.
Interactions with other conditions
When avian influenza occurs in someone with ongoing lung or heart disease, it can hit harder and may trigger flare-ups of asthma, COPD, or heart failure. Doctors call it a “comorbidity” when two conditions occur together, and with avian influenza this often means a higher chance of pneumonia, breathing trouble, or the need for hospital care. Coinfections can happen too—seasonal flu, COVID-19, or other respiratory viruses may overlap with avian influenza and make symptoms worse or harder to tell apart. Bacterial pneumonia can follow avian influenza, so some people need antibiotics in addition to antiviral treatment and breathing support. People with weakened immunity, those who are pregnant, very young children, and older adults may face more severe illness, and early symptoms of avian influenza can look like many other infections, which is why testing matters. Clinicians also consider other health issues and medicines when choosing antivirals, especially if kidney or liver problems are present, to reduce side effects and prevent complications from avian influenza.
How genes can cause diseases
Humans have more than 20,000 genes, each carrying out one or a few specific functions in the body. One gene instructs the body to digest lactose from milk, another tells the body how to build strong bones and another prevents the body's cells from beginning to multiply uncontrollably and developing into cancer. As all of these genes combined are the building instructions for our body, a defect in one of these genes can have severe health consequences.
Through decades of genetic research, we know the genetic code of any healthy/functional human gene. We have also identified that in certain positions on a gene, some individuals may have a different genetic letter from the one you have. We call these hotspots "Genetic Variations" or "Variants" in short. In many cases, studies have been able to show that having the genetic letter "G" in the position makes you healthy, but having the letter "A" in the same position disrupts the gene function and causes a disease. Genopedia allows you to view these variants in genes and summarizes all that we know from scientific research, which genetic letters (Genotype) have good or bad consequences on your health or on your traits.
History
Throughout history, people have described sudden bird die-offs followed by waves of fever and cough in nearby towns. Market sellers noticed that when chickens in crowded stalls fell ill, families who handled them often became sick days later. Farmers recalled winters when geese or ducks died in clusters, and some caretakers developed severe chest symptoms soon after. These community stories often described the condition long before lab tests or strain names existed.
From early theories to modern research, the story of avian influenza has been one of watching birds closely to understand human risk. In the late 19th and early 20th centuries, veterinarians documented “fowl plague” in Europe, recognizing a contagious illness that moved quickly through flocks. As medical science evolved, researchers learned that a virus carried by birds—especially waterfowl—could sometimes change enough to infect people, mainly those working with poultry. Over time, descriptions became more precise as scientists linked outbreaks in live-bird markets and farms with human cases marked by high fever, muscle aches, and serious lung infections.
The late 20th century brought better tools to tell one strain from another, showing that avian influenza isn’t a single virus but a family with many versions. In 1997, a cluster of severe human illness in Hong Kong tied directly to infected chickens showed how quickly a bird virus could jump to people in close contact. Culling flocks and changing market practices helped break chains of spread, shaping modern outbreak control. With each decade, global surveillance improved, and countries began sharing samples to track changes that might raise pandemic risk.
In recent decades, awareness has grown that wild bird migration can carry avian influenza across continents. Satellite tracking and genetic testing linked patterns seen by birdwatchers with spikes in poultry outbreaks, guiding vaccination and biosecurity on farms. At the same time, doctors recognized that most people with avian influenza had direct, prolonged exposure to sick birds, and that sustained person-to-person spread remained uncommon.
Current studies build on a long tradition of observation, combining farm reports, wildlife monitoring, and hospital data to spot early symptoms of avian influenza and respond faster. Historical differences highlight why today’s definitions focus on both animal health and human health. Looking back helps explain why measures like protective gear, careful handling of raw poultry, and rapid testing are emphasized after bird die-offs. This shared history—from barnyards to clinics—continues to shape how communities and health systems prepare for and manage avian influenza.