Avian influenza A(H5N1): Prevention and risks

On this page

• Where avian influenza A(H5N1) is found
• How avian influenza A(H5N1) spreads
• Preventing avian influenza A(H5N1) infections
• Risks of getting avian influenza A(H5N1)
• Who is most at risk
• What to do if you have been exposed
• Recommendations for travellers

Where avian influenza A(H5N1) is found

The avian influenza A(H5N1) virus is commonly found in birds in several countries in Africa and Asia, and more recently has spread to Europe, North America (Canada, the United States, and Mexico), Central and South America, and Antarctica.

Wild birds in Canada and throughout the world are natural carriers of avian influenza viruses. Although some wild birds may get sick and die, others can be infected and still appear healthy. All bird species are thought to be susceptible to infection, however domestic poultry, such as chickens and turkeys, are more likely to become severely ill and die.

While avian influenza is primarily a disease of birds, it can also infect mammals, especially those who:

• hunt, scavenge or otherwise consume infected birds
• are exposed to heavily contaminated environments

In addition to birds, some mammals that have been infected include:

• bears
• cats
• foxes
• livestock (including cattle and goats)
• marine mammals
• mink and other farmed fur animals
• otters
• raccoons
• skunks

How avian influenza A(H5N1) spreads

Avian influenza viruses can spread through animal feces and secretions (such as mucus and saliva). Human infections can happen when the virus gets into a person's mouth, nose or eyes, or is inhaled. This can happen when the virus is in the air in droplets, or possibly through dust or feathers, and a person breathes it in. It can also happen when a person touches something that has virus on it and then touches their mouth, nose or eyes.

Human infections with avian influenza viruses have occurred most often after close contact with infected birds or potentially highly contaminated environments, such as animal farms or live animal markets.

Although the virus spreads easily between birds, it is not well adapted to mammals, including humans. There have been some reports of possible limited human-to-human transmission in other parts of the world, but there has been no evidence of ongoing transmission between people. However, there have been increasing reports of instances where mammal-to-mammal transmission may have occurred. This includes situations involving farmed fur animals, marine mammals and cattle.

You cannot get infected with avian influenza virus by eating thoroughly cooked poultry, eggs and meat. Milk and milk products that have been pasteurized are also safe to consume. Milk must be pasteurized in order to be sold in Canada. Drinking raw or unpasteurized milk comes with an increased risk of serious illness because it hasn't been pasteurized to eliminate harmful microorganisms.

Preventing avian influenza A(H5N1) infections

Minimizing contact with secretions (mucus, saliva), blood, or feces from infected birds and mammals is key to preventing avian influenza A(H5N1) infections.

The risk of infection is low for the general public, however basic precautions are always recommended to prevent transmission of zoonotic diseases (diseases that transmit from animals to people), including avian influenza:

• Keep a distance from wild birds and other wild animals, and don't touch, feed, or handle them
• Avoid contact with animals, including livestock (like cattle and goats) that may be sick or infected
• If contact is unavoidable, wear gloves or use a doubled plastic bag and avoid contact with blood, body fluids and feces. Remove gloves if worn, and wash your hands thoroughly with soap and water. If soap and water aren't available, use a hand sanitizer containing at least 60% alcohol
• Always wash your hands after being in an area where birds and other wildlife are living or nesting, such as in parks or zoos
  • Children should be monitored to ensure proper handwashing
  • Pets should be kept away from birds and wildlife and their feces

People who work with animals or in higher-risk environments

Some jobs may require you to handle certain animals or work in an environment heavily contaminated with animal feces or other secretions.
People who have close contact with the following animals or work in environments that have been contaminated by them should take additional precautions:

• poultry
• livestock (including cattle, goats and pigs)
• wild birds and wildlife
• other animals that are suspected or confirmed to be infected with avian influenza A(H5N1)

If you do have close contact with any of the listed animals or exposure to heavily contaminated environments, take the following precautions.

• Wear masks and eye protection to protect your eyes, nose and mouth from contaminated dust, feathers, secretions and feces.
• Wear other protective clothing, such as gloves, boots and coveralls.
• Prior to cleaning up contaminated areas, mist dry areas with low pressure water to prevent fecal matter, dust and feathers from being stirred up into the air.
• Change clothing and footwear, and wash hands thoroughly with soap and water before moving onto other activities.
• Follow any additional occupational health guidelines, as directed by your occupational health provider.

There is no evidence to suggest that fully cooked wild game meat, organs or wild bird eggs are a source of avian influenza infection for people. However, because exposure to avian influenza can occur when handling wild birds and some wild mammals, it is recommended that hunters and trappers take precautions when de-feathering, cleaning and preparing wild game, along with following other safe food handling procedures.

Thoroughly cooking meat, organs and eggs harvested from wildlife will kill avian influenza virus and other potential pathogens, such as Salmonella.

The annual seasonal influenza vaccine ("flu shot") does not provide protection against avian influenza. However, if you are involved in the food production system or agricultural settings, getting a seasonal flu shot each year can help reduce the spread of human influenza viruses between people and between people and animals.

Risks of getting avian influenza A(H5N1)

The risk of infection is low for the general public who have limited contact with infected animals; those with close contact to infected animals are at increased risk, and should take appropriate precautions.

Human infection with avian influenza A(H5N1) is rare.

Since 1997, there have been over 900 human cases of avian influenza A(H5N1) reported worldwide, mostly occurring in Africa and Asia. The number of human cases has decreased substantially since 2015. This decrease may be attributed to the use of poultry vaccinations, prevention and control initiatives, and potentially changes in the virus.

The predominant avian influenza A(H5N1) viruses now circulating globally among birds and other animals are different from earlier A(H5N1) viruses. Avian influenza viruses continually change, which can affect how easily the virus spreads from birds to other animals, including humans, and also how severe illness is.

While historically, the risk of infection was highest for those travelling to areas in Asia and Africa, avian influenza A(H5N1) has recently spread throughout Europe and North America and has been detected in Central and South America, and Antarctica. In 2022, the virus became widespread across Canada through the migration of wild birds, and has affected many poultry farms and many different species of wild birds and other wildlife. Most recently, A(H5N1) has also been detected in livestock, such as dairy cattle and goats.

Few human cases associated with the 2021-2024 avian influenza A(H5N1) outbreak have been detected. The number of A(H5N1) human cases reported worldwide is tracked and reported in the Human Emerging Respiratory Pathogen Bulletin.

There has only been one human case of A(H5N1) ever reported in Canada. A Canadian resident died of avian influenza A(H5N1) in early 2014 after returning from a trip to China, where they were likely infected.

Avian influenza is not known to be a food safety concern. There is no evidence that eating fully cooked commercial poultry, eggs and meat could transmit avian influenza to humans. Milk and milk products that are pasteurized are also safe to consume.

• Safe food handling practices should be followed.
  • Such practices include handwashing and keeping poultry, meat, eggs and egg products separate from other food products to avoid cross contamination.
• Pasteurization of milk is a requirement for sale of cow's milk in Canada.
  • Pasteurization ensures the milk we drink is safe by killing harmful bacteria and viruses while retaining the nutritional properties of milk.

Who is most at risk

Some examples of activities that may increase your risk of exposure and infection include:

• Working with infected poultry (like chickens, turkeys and ducks) or livestock (like cattle and goats) such as on a commercial farm or with small farms or backyard flocks
• Hunting, de-feathering, field dressing and butchering infected wild birds and wild mammals
• Working with wild birds for activities such as research, conservation, or rehabilitation
• Working with wild mammals, especially those that commonly eat wild birds (like foxes, skunks, raccoons, mink and other farmed fur animals and some marine mammals)
• Visiting animal farms or live animal markets

What to do if you have been exposed

Early recognition of exposure to an animal infected with avian influenza and initiation of treatment, if deemed necessary, are important steps to provide protection against infection.

Antiviral medications may be considered after exposure to animals infected with avian influenza, as antivirals may help prevent infection or reduce symptoms often associated with an infection. Speak with your health care provider or local public health authority for assessment of your exposure risk, instructions to follow, and further information about antiviral treatment options.

Recommendations for travellers

Avian influenza A(H5N1) is a concern in many countries, including Canada. If you plan to travel to another country where avian influenza A(H5N1) is a concern, see your health care provider or visit a travel health clinic at least 6 weeks before you leave.

When travelling to an affected area:

• Avoid high-risk areas (such as animal farms and live animal markets)
• Avoid close contact with birds and other animals, including:
  • chickens
  • ducks and other waterfowl
  • livestock (like cattle and goats)
  • farmed fur animals
  • wild birds
  • wild mammals that commonly ingest wild birds, like:
    • foxes
    • skunks
    • raccoons
    • mink
    • some marine mammals
• Avoid surfaces that may have animal droppings or secretions on them
• Make sure that all foods made with poultry, meat and eggs, are cooked well, and that your milk and milk products are pasteurized
• Wash your hands immediately after touching potentially contaminated environments and/or animals:
  • use soap and water for at least 20 seconds
  • if soap and water aren't available, use an alcohol-based hand sanitizer with at least 60% alcohol content
• If you develop flu-like symptoms after travelling or living in an area where avian influenza is a concern:
  • Upon arrival in Canada, tell a border services officer
  • Contact a health care professional immediately and tell them about your symptoms and where you have been travelling or living, and follow their instructions

Related links

• Guidance on human health issues related to avian influenza in Canada (HHAI)
• Wildlife and avian influenza – Handling guidelines to protect your health
• Safe cooking temperatures
• Travel health notices
• Human Emerging Respiratory Pathogen Bulletin
• Hand washing and staying healthy
• Facts about Avian Influenza Animals susceptible to H5N1 highly pathogenic avian influenza (HPAI)
• Highly pathogenic avian influenza (HPAI) in livestock
• Avian influenza A(H5N1) or bird flu
• How to protect yourself from avian influenza A(H5N1) at work