The Hawaiʻi Department of Health (DOH) is investigating possible sources of H5 avian influenza, which has been detected for the first time at a wastewater sampling site on Oʻahu.

Wastewater sampling is routinely performed across Hawaiʻi as part of ongoing surveillance for infectious diseases including avian influenza. H5N1, also called Highly Pathogenic Avian Influenza (HPAI), is one type of H5 avian influenza. Whether this detection is HPAI is unable to be determined from wastewater testing. The wastewater testing provides a signal for further investigation to determine whether this detection is H5N1-related, and an opportunity to reinforce prevention measures, particularly among persons at increased risk of exposure.

H5N1 has been spreading among birds and mammals, leading to a nationwide outbreak. Human cases have been reported among those working closely with infected animals. There is no evidence of sustained human-to-human transmission of H5N1 in the United States. To date, Hawaiʻi has been the only state without H5N1 avian influenza detected in birds or animals. There are no reports of human or animal H5N1 cases in Hawaiʻi and the overall risk of H5N1 to Oʻahu and state residents remains low.

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

While the current risk of transmission to Hawaiʻi residents is low, DOH encourages residents to follow these best practices when around animals or when consuming animal products:

• In general, do not touch birds, livestock, or wild animals that are sick or dead without personal protective equipment.
• Residents are encouraged to report sick pets to their veterinarian. In addition, please contact the Animal Industry Division at Hawaiʻi Department of Agriculture at 808-483-7106, Monday to Friday from 7:45 a.m. to 4:30 p.m., or 808-837-8092 during non-business hours and holidays to report multiple or unusual illnesses or deaths in poultry, livestock, or wild birds or animals.
• Do not touch or consume raw milk or raw milk products, especially from animals with confirmed or suspected avian influenza infection.

Symptoms of avian influenza may include fever, cough, sore throat and conjunctivitis. Antiviral flu treatment is available and recommended as soon as possible for people with suspected or confirmed avian influenza infection.