A client comes to the outpatient clinic where you work complaining of abdominal pain, diarrhea, shortness of breath, and epistaxis. Which of the following actions would you take first?
A. Screening clients for upper respiratory tract symptoms
B. Call an ambulance to take the client immediately to the hospital
C. Ask the client about any recent travel to Asia or the Middle East
D. Determine whether the client has had recommended immunizations
Correct Answer: C. Ask the client about any recent travel to Asia or the Middle East.
The client’s clinical manifestation suggests possible avian influenza (bird flu). If the client has traveled recently in Asia or the Middle East, where outbreaks of bird flu have occurred, you will need to institute airborne and contact precautions immediately. The other actions may also be appropriate but are not the initial action to take for this client, who may transmit the infection to other clients or staff members
Option A: Most patients present with symptoms consistent with a flu-like viral illness. In these patients, especially during a known avian influenza outbreak, a thorough history is necessary to evaluate for clues that the illness is due to avian influenza.
Option B: Whenever there is a possible outbreak of avian influenza, the essential way to reduce the severity and population impact is to reduce the spread of the virus. Since the human-to-human transmission is uncommon, the focus should be on reinforcing appropriate sanitation habits in the population, especially those that work around birds or that are involved in food preparation.
Option D: There is currently an FDA-licensed vaccine for the H5N1 strain of avian influenza in the United States. In the case of an H5N1 outbreak in the United States, the CDC and public health officials may decide to vaccinate at-risk populations to reduce spread.