Avian influenza differential diagnosis

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For more information about seasonal human influenza virus that is not associated with animal exposure, see Influenza

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.

Overview

Avian influenza should be differentiated from the following diseases or pathogens that cause upper or lower respiratory tract infection or flu-like illness, such as other influenza viruses, such as human or swine influenza, other viral, bacterial, fungal, and parasitic agents that are typically associated with nasopharyngeal and respiratory tract infections, and non-infectious causes, such as asthma, chronic obstructive pulmonary disease (COPD), drug adverse effects, and cardiac causes.

Differential Diagnosis

Influenza should be differentiated from the following diseases or pathogens that cause upper or lower respiratory disease or flu-like symptoms:

Infectious Diseases

• Other influenza viruses, such as human influenza or swine influenza
• Other infectious agents, including viruses, bacteria, fungi, and parasites, that are typically responsible for respiratory illness
  • Adenoviruses
  • Anthrax (caused by B. anthracis)
  • Arenaviruses
  • Cytomegalovirus (CMV)
  • Chlamydia pneumoniae
  • Coronaviruses (responsible for SARS and MERS)
  • Dengue fever
  • Echoviruses
  • Ebola virus infection
  • Hantavirus pulmonary syndrome
  • Herpes viruses
  • HIV disease
  • Histoplasmosis and other fungal causes of respiratory disease
  • Human metapneumovirus
  • Malaria
  • Measles
  • Parainfluenza virus
  • Poliovirus infection
  • Q fever
  • Rhinovirus
  • Respiratory syncytial virus
  • Other bacterial causes of nasopharyngeal and respiratory infection, such as S. pneumoniae, S. aureus, H. influenzae, M. pneumoniae, M. tuberculosis, L. pneumophila.

Non-infectious Diseases

• Asthma
• Bronchiectasis
• Chronic obstructive pulmonary disease and emphysema
• Drugs, such as interferons, monoclonal antibodies, bisphosphonates, and chemotherapeutic agents
• Hematologic malignancies (leukemias and lymphomas)
• Myocarditis
• Metal fume fever
• Pericarditis
• Pulmonary embolism
• Vaccinations (typically transient and mild flu-like illness)

Differentiating Influenza and Common Cold

Symptoms	Influenza	Common Cold
Fever	High fever (100-102° F)	Uncommon
Headache	Common	Uncommon
Cough	Common, moderate to severe	Mild to moderate
Body aches	Common, may be severe	Slight
Fatigue	Common, can last up to 2-3 weeks	Sometimes
Nasal congestion	Sometimes	Common
Sneezing	Sometimes	Common
Sore throat	Sometimes	Common
Adapted from the National Institute of Allergy and Infectious Diseases (NIAID)