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Human Infection with Avian Influenza A (H5N1) Virus: Advice for Travelers

NOTE: This document is provided for historical purposes only and may not provide our most accurate and up-to-date information. The most current travel health information can be found on the Travelers' Health homepage.

Current Situation

Highly pathogenic avian influenza A (H5N1) virus (also called “bird flu”) has caused outbreaks of serious disease in poultry and wild birds with high rates of death on multiple continents. Since 1997, human infections with H5N1 virus have been reported in different countries. Since 2003, more than 560 people in 15 countries in parts of Asia, Africa, Eastern Europe, and the Middle East with H5N1 virus infection have been reported, and about 60% of these people have developed severe pneumonia and died. These human infections have been linked to H5N1 virus outbreaks among poultry. You can find the most up-to-date information by using the links below:

The World Organization for Animal Health (OIE) lists the countries reporting H5N1 outbreaks among poultry and/or wild birds.
Confirmed human H5N1 cases are listed, by country, on the World Health Organization (WHO) Avian Influenza website.
The Centers for Disease Control and Prevention (CDC) Avian Influenza website also gives information.

Most people who have become infected with H5N1 virus have had direct or close contact with H5N1 virus-infected poultry (sick or dead) during the week before they became sick. Direct contact involves touching infected birds or surfaces contaminated by infected birds and could happen during activities such as:

Slaughtering or cleaning poultry for cooking
Raising and handling poultry, cleaning poultry cages
Disposing of poultry that were sick and died

Some people are thought to have gotten H5N1 virus infection by having contact with live poultry or breathing in aerosolized material with H5N1 virus while visiting a live poultry market. Consuming uncooked duck blood may have caused a rare case of H5N1 virus infection.

Some people have gotten H5N1 virus infection after close, prolonged contact with another family member who was very sick with H5N1, but this is rare. The H5N1 virus is not spreading among people. CDC expects that outbreaks of H5N1 among poultry will continue in Asia and the Middle East. Because of this, people who have direct contact with infected birds may occasionally get H5N1 virus infection.

Advice for Travelers

No traveler has ever gotten sick with H5N1 virus infection. At this time, CDC is not recommending that the general public avoid travel to any of the countries where there are H5N1 outbreaks. However, if you are planning travel to one of these areas, follow these steps to reduce your risk of getting sick:

Before Your Trip

Visit CDC's Travelers’ Health website to learn about any disease risks and health recommendations for areas you plan to visit.
See a travel medicine specialist or a doctor familiar with travel medicine at least 4 to 6 weeks before you leave to answer your questions and make specific recommendations for you.
Be sure you are up-to-date with all your routine vaccinations, including a seasonal flu vaccine. Although seasonal flu vaccine will not protect you from H5N1 or other kinds of avian influenza, it will protect you from seasonal flu, which is much more common worldwide than H5N1. In addition, get any travel-related vaccines that your doctor recommends for you.
Pack a travel health kit that contains basic first aid and medical supplies. See the Pack Smart page for suggested items.
Before you leave, know where health care resources are located in your destination. For more information, visit Doctors/Hospitals Abroad from the US Department of State.
Learn more about preparing for your trip at Your Survival Guide to Safe and Healthy Travel.

During your visit to an area affected by avian influenza A (H5N1) virus

Be careful with birds:

Avoid all direct contact with birds, especially sick or dead birds, including poultry (such as chickens and ducks) and wild birds.
Avoid touching surfaces that have bird droppings (feces) on them.
Avoid places such as poultry farms and bird markets where live birds are raised or kept.
Eat only poultry meat or products that have been thoroughly cooked.
- Egg yolks should not be runny or liquid.
- Do not eat dishes that contain uncooked (raw) or undercooked bird meat or products (such as eggs and poultry blood).
- Because flu viruses are destroyed by heat, the cooking temperature for bird meat should be 165°F (74°C).

Practice healthy habits to help stop the spread of germs:

Wash your hands often with soap and clean water. This removes germs from your skin and helps prevent diseases from spreading.
- Use waterless alcohol-based hand gels (containing at least 60% alcohol) when soap and clean water are not available and hands are not visibly dirty.
Cover your mouth and nose with a tissue when you cough or sneeze, and put your used tissue in a waste basket.
If you don’t have a tissue, cough or sneeze into your upper sleeve, not your hands.
Wash your hands after coughing or sneezing.
Follow all local health recommendations. For example, you may be asked to put on a surgical mask to protect others.
Avoid people who are sick with fever and respiratory symptoms such as coughing.

Seek medical care if you feel sick:

If you become sick with a fever plus a cough and sore throat or have trouble breathing, seek medical care right away. Tell the doctor if you have had direct or close contact with sick or dead birds.
If you need to find local medical care, a US consular officer can help you locate medical services and will inform your family or friends in the United States of your illness. To contact the US embassy or consulate in the country where you are visiting:
- Dial: 1-888-407-4747 if calling from the United States or Canada,
- Dial: 00 1 202-501-4444 if calling from overseas, or
- Find your local US embassy at Websites of US Embassies, Consulates, and Diplomatic Missions.
See the information on the page “Know What To Do if You Become Sick or Injured on Your Trip” to help you. You should avoid further travel until you are free of symptoms, unless you are traveling locally for medical care.

A note about health screening:

Some countries monitor the health of people arriving from areas affected by bird flu, usually in airports. You may be asked to fill out a questionnaire or have your temperature taken.

After your return from an area affected by avian influenza A (H5N1) virus

Closely monitor your health for 7 days.
If you become sick with a fever plus a cough, sore throat, or have trouble breathing during this 7-day period, see a doctor. When you make the appointment, tell the doctor the following:
1. your symptoms,
2. where you traveled, and
3. if you have had direct contact with birds or close contact with a very sick person.
Do not travel when you are sick, unless you are traveling locally to get medical care. By limiting contact with others as much as possible, you can help prevent others from getting sick.
Seasonal influenza and other human respiratory illnesses (e.g., the “common cold”) are much more common. Antiviral treatment of influenza is available.