Hawai'i investigates first detection of H5 avian flu at O'ahu wastewater site

Government
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Kenneth S. Fink, MD, MGA, MPH Director | Hawaii Department of Health

The Hawaiʻi Department of Health (DOH) is investigating potential sources of H5 avian influenza after it was detected at a wastewater sampling site on Oʻahu. The specimen, collected on November 7, 2024, marked the first detection of its kind in the area. DOH received the test result today.

Routine wastewater sampling is conducted across Hawaiʻi as part of ongoing surveillance for infectious diseases like avian influenza. H5N1, also known as Highly Pathogenic Avian Influenza (HPAI), is one type of H5 avian influenza. However, whether this detection involves HPAI cannot be determined from wastewater testing alone. This method provides a signal for further investigation to determine if the detection is related to H5N1 and offers an opportunity to reinforce prevention measures, especially among those at increased risk of exposure.

H5N1 has been spreading among birds and mammals, causing a nationwide outbreak. Human cases have been reported among individuals working closely with infected animals. Currently, there is no evidence of sustained human-to-human transmission of H5N1 in the United States. Until now, Hawaiʻi had been the only state without any detections of H5N1 avian influenza in birds or animals. There are no reports of human or animal cases in Hawaiʻi, and the overall risk to Oʻahu and state residents remains low.

The DOH will continue to collaborate with federal agriculture and wildlife partners to support further investigation, prevention efforts, and public health surveillance.

Despite the low current risk of transmission to Hawaiʻi residents, DOH advises following these best practices when around animals or consuming animal products:

- Avoid touching sick or dead birds, livestock, or wild animals without personal protective equipment.

- Report sick pets to veterinarians and contact the Animal Industry Division at Hawaiʻi Department of Agriculture at 808-483-7106 during business hours or 808-837-8092 during non-business hours for multiple or unusual illnesses or deaths in poultry, livestock, or wild birds.

- Do not consume raw milk or raw milk products from animals with confirmed or suspected avian influenza infection; pasteurized milk products are safe.

If symptoms such as fever, cough, sore throat, and conjunctivitis develop after close contact with sick or dead animals, contact the Department of Health immediately at 808-586-4586. Antiviral flu treatment is available and recommended for suspected or confirmed infections.

Further information can be found through resources such as Avian Influenza | Disease Outbreak Control Division and Prevention and Antiviral Treatment of Avian Influenza A Viruses in People | Bird Flu | CDC.