H5N1 Avian Influenza (Bird Flu) Update for Nurses and Other Health Providers

Influenza is a clever virus and one that deserves respect. Current concerns with the H5N1 avian influenza virus strain demonstrate why public health around the world continues to watch and monitor for impact on human health. Although the situation is not one that currently affects us on a day-to-day basis, it is important that we have a basic understanding of why this remains newsworthy.

Spread and evolution of H5N1.

Since its emergence, H5N1 has spread across multiple continents, affecting wild birds, poultry, and mammals. In late 2023, the virus was detected in Antarctica for the first time, raising concerns about its impact on native wildlife. By 2024, H5N1 had been reported in various regions, including Europe, Asia, and the Americas, leading to significant poultry losses and economic challenges.

In the United States, H5N1 has been detected in wild birds, poultry, and mammals across all 50 states. As of early 2025, nearly 70 human cases have been confirmed, primarily among individuals with direct exposure to infected animals. In December 2024, the Centers for Disease Control and Prevention (CDC) confirmed the first severe human case of H5N1 in Louisiana, involving a patient hospitalized with severe illness.

We have seen H5N1 move across nonhuman animal species, to situations where humans have become mildly ill after contact with animals, and now to situations where animal contact has resulted in severe human illness.

Since this particular strain of influenza has been detected in a variety of animals, but rarely in humans, what is the concern? The concern […]

Dengue Fever: What Nurses Need to Know Now

This summer the Centers for Disease Control and Prevention (CDC) has issued a health advisory as countries in the Americas report 9.7 million cases of dengue, the highest number in any year. The United States and Puerto Rico have reported 2,559 cases of dengue since January. The CDC expects the numbers to continue to rise as the environment warms.

Nurses in every specialty, but especially those who prepare individuals and families for international travel, will want to know about this latest dengue surge. All U.S. nurses will want to know how to triage, manage, and follow-up these patients to prevent local outbreaks and life-threatening complications.

Dengue (“den-gay”) fever is an age-old viral illness rapidly expanding its global impact beyond the tropics. According to the Rockefeller Foundation, “dengue fever is the most rapidly spreading mosquito-borne viral infection in the world.”

Also known as “breakbone fever” because of the painful arthralgias and myalgias associated with the infection, dengue is a common disease in the Americas, Africa, the Middle East, Asia, and the Pacific Islands, where it is a health risk for travelers and locals alike.

Currently 3.9 billion people are at risk in 129 countries, including certain areas of the United States. The WHO estimates […]

The Monkeypox Vaccine: What Nurses Need to Know

Colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell, cultured in the laboratory. Credit: NIAID. (Wikimedia Commons)

In the current monkeypox outbreak, the pandemic-strained U.S. public health system is once again faced with a major threat. This time, a vaccine is already available, but only in limited quantities. Here’s what nurses need to know. It will remain important to keep up with new developments as they occur.

The Jynneos vaccine

Jynneos is a live but nonreplicating vaccine for the prevention of both monkeypox and smallpox. It is made from vaccinia virus, a less virulent relative of these two viruses. The vaccine is given subcutaneously in two separate doses administered at least 28 days apart, and a person is considered fully vaccinated two weeks after the second dose.

The most common vaccine side effects are pain, redness, induration, swelling, or itching at the vaccination site. (People with HIV infection or atopic dermatitis do not seem to experience additional or more severe side […]

Monkeypox Update: As Knowledge Increases, More to Be Learned

Colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell (blue), cultured in the laboratory. Credit: NIAID. (Wikimedia Commons)

It seems impossible that we have to confront the rapid spread of a new virus when we’re still dealing with the effects of COVID-19. But for monkeypox, we didn’t have to respond “from scratch.” After decades of research and clinical work on smallpox, a related but considerably more lethal virus, testing protocols and vaccines were already available for use in monkeypox.

Nearly 20,000 cases of monkeypox have been reported around the world since May, with more than 5,000 infections reported in the U.S. There are probably many more undiagnosed and unreported cases.

Variations in presentation.

In New York City, where more than 1,000 cases of monkeypox have been reported, clinicians are seeing variations from “classic” presentations of monkeypox. The NYC Department of Health and Mental Hygiene reports that many people with monkeypox are not experiencing prodromal symptoms […]

States Seek to Limit Health Officials’ Powers to Act

Since the COVID-19 pandemic began, public health measures to control the spread of the virus have provoked fierce debate. In recent months, at least 15 state legislatures have passed or are considering bills to limit the legal authority of public health agencies, according to the Network for Public Health Law, which has partnered with the National Association of County and City Health Officials to document the situation. In addition, lawmakers in at least 46 states have introduced bills to rein in the power of governors to take action in public health and other emergencies.

The anger fueling these actions stems from the perceived overreach by health officials, resulting in a backlash of legislative attempts to limit their authority. These include measures to prevent the closure of businesses or allow lawmakers to rescind mask mandates.

In addition, some state courts have limited the emergency and regulatory powers that governors used to respond to the pandemic. Demands for “individual freedom” spurred some of these state actions, though their consequences are likely to be more far reaching. […]

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