|
What is H5N1 Bird Flu?
H5N1 bird flu is a specific strain or type of influenza virus. H5N1 bird flu is also called highly pathogenic avian influenza (HPAI). H5N1 bird flu can infect wild birds, poultry, and mammals such as cows. Human infections with H5N1 bird flu are rare, but spread of the virus may lead to changes that make it more likely to infect humans.
Public Health Recommendations
CDC has indicated that the current risk to the general public from H5N1 bird flu is low. People should:
- Wash your hands regularly, especially before eating and after interacting with animals.
- Avoid unprotected exposures to sick or dead animals including wild birds, poultry, and other domesticated birds. Handling sick or dead animals safely requires personal protective equipment and training.
- Do not drink or eat unpasteurized (raw) milk or raw cheese. Raw milk and cheese have not gone through a process called pasteurization that kills disease-causing germs. The milk of cows infected with H5N1 carries live virus. For more information about how raw milk can make you sick, visit the CDC’s Raw Milk web page.
Recommendations for Agricultural Workers and Animal Care Providers
People who have job-related or recreational exposure to infected animals, including wild birds, poultry, and dairy cows, are at greater risk of being exposed to H5N1 bird flu. People at higher risk should:
- Follow all CDC recommendations for worker protection to reduce the risk of infection
- Call your health care provider if you feel sick. Symptoms of H5N1 bird flu can include red or watery eyes, cough, sore throat, and fever.
The California Department of Public Health has also created educational fliers for agricultural workers and animal care providers about H5N1 bird flu. Please access the PDF here:
Additional Resources
- Avian Influenza (Bird Flu) Fact Sheet (California Department of Food and Agriculture)
- Avian Influenzas Updates (California Department of Food and Agriculture)
- Poultry Products Transportation (California Department of Food and Agriculture)
- Updates on Highly Pathogenic Avian Influenza (HPAI) (Food and Drug Administration)
Status Update
Last Reviewed: July 13, 2025
There are currently no active infections of Highly Pathogenic Avian Influenza (HPAI) in California poultry flocks. However, California dairy cattle herds are still affected by the H5N1 virus. In California, there have been 38 confirmed cases of bird flu in humans. In most cases, people who got sick worked with cows or poultry. The last human case reported in California was on January 14, 2025.
In Marin County, H5N1 has been found in wild birds, poultry, and wastewater—but not in local livestock or farm workers. In November 2024, a child in Marin got sick after drinking raw milk. The child tested positive for the Flu, but the tests couldn’t confirm whether it was bird flu or regular flu. This case was suspected to be a possible bird flu infection.
What is H5N1 Bird Flu?
H5N1 bird flu is a specific strain or type of influenza virus. H5N1 bird flu is also called highly pathogenic avian influenza (HPAI). H5N1 bird flu can infect wild birds, poultry, and mammals such as cows. Human infections with H5N1 bird flu are rare; however, the spread of the virus may lead to mutations that increase its likelihood of infecting humans.
Public Health Recommendations
CDC has indicated that the current risk to the general public from H5N1 bird flu is low. People should:
- Wash your hands regularly, especially before eating and after interacting with animals.
- Avoid unprotected exposures to sick or dead animals, including wild birds, poultry, and other domesticated birds. Handling sick or dead animals safely requires the use of personal protective equipment and proper training.
- Do not drink or eat unpasteurized (raw) milk or raw cheese. Raw milk and cheese have not undergone a process called pasteurization, which kills disease-causing germs. The milk of cows infected with H5N1 carries live virus. For more information about how raw milk can make you sick, visit the CDPH Raw Milk web page.
Recommendations for Schools and Childcare
The current risk to the schools and childcare settings from H5N1 bird flu remains low.
- Schools or Childcare facilities with backyard poultry should monitor for signs and symptoms of H5N1 in poultry. Please see the California Department of Public Health CDPH Bird Flu Webpage for information on symptoms of H5N1 in poultry and what to do if you identify a sick bird.
- Supervise children around healthy birds (including chickens) and remind them not to kiss, snuggle, rub their eyes, or touch their nose or mouth while handling birds or bird feces.
- Tell children not to touch or handle a sick or dead bird. They should let an adult know, so that it can be reported.
- In general, birds carry a lot of diseases besides bird flu. The best way to avoid getting sick is to ensure that children wash their hands with soap and water before and after being around any birds or bird droppings.
Recommendations for Agricultural Workers and Animal Care Providers
People who have job-related or recreational exposure to infected animals, including wild birds, poultry, and dairy cows, are at greater risk of being exposed to H5N1 bird flu. People at higher risk should:
- Follow all CalOSHA recommendations for worker protection to reduce the risk of infection
- Call your healthcare provider if you experience any symptoms of illness. Symptoms of H5N1 bird flu can include red or watery eyes, cough, sore throat, and fever.
The California Department of Public Health has also created educational fliers for agricultural workers and animal care providers about H5N1 bird flu:
Reporting Sick Animals
- Community members with backyard poultry flocks should report an unusual number of sick or dead birds to the California Department of Food and Agriculture (CDFA) at 1-866-922-BIRD (2473).
- Members of the public encountering dead or sick wildlife and birds in public, like at a park, should report that to the California Department of Fish and Wildlife (CDFW), not CDFA. Reporting form
- CDFW’s FAQ includes how to dispose of dead wildlife safely.
Additional Resources
- Avian Influenza (Bird Flu) Fact Sheet (California Department of Food and Agriculture)
- Avian Influenzas Updates (California Department of Food and Agriculture)
- Poultry Products Transportation (California Department of Food and Agriculture)
- Updates on Highly Pathogenic Avian Influenza (HPAI) (Food and Drug Administration)
Mosquitoes and West Nile virus
Marin Health and Human Services and the Marin/Sonoma Mosquito and Vector Control District (MSMVCD) remind residents to do their part in preventing mosquito breeding and mosquito-borne disease.
Protect Yourself: Follow the Four D’s
To keep families and neighbors safe from diseases such as West Nile Virus, practice the four D’s of mosquito protection (Dawn, Dusk, DEET and Drain):
►DAWN and DUSK are when some mosquitoes are most active. Avoid going out at those times during mosquito season or prepare accordingly. If outdoors during these times, dress in long sleeves, long pants and light-colored, loose-fitting clothing.
►DEET is an effective repellent. Always use Environmental Protection Agency (EPA)-registered insect repellents with one of the active ingredients such as DEET, picaridin, IR3535, or oil of lemon eucalyptus (OLE). When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women.
►DRAIN water from containers—tires, buckets, planters, toys, kid pools, birdbaths, flowerpots, animal water bowls or trash cans—at least twice per week. It only takes as little as one bottle cap of water for mosquitoes to breed and multiply.
Eliminate Mosquito Breeding Areas Around your Home:
- Stock permanent water features with mosquitofish (available for free from MSMVCD)
- Be sure to properly screen and/or secure lids on rain barrels or water storage containers
- Do not over-water lawns
- Clean out bird baths and animal waterboow
- Keep swimming pools and hot tubs properly chlorinated
- Make sure that septic tank lids are properly sealed and vent pipes are screened
- Report mosquito problems at 707-285-2200 or online at www.msmosquito.org
Mosquito Borne-Disease
- West Nile virus (WNV) is the leading cause of mosquito-borne disease in the continental United States. It is most spread to people by the bite of an infected mosquito. Cases of WNV occur during mosquito season, which starts in the summer and continues through fall. There are no vaccines to prevent or medications to treat WNV in people. Fortunately, most people infected with WNV do not feel sick. About 1 in 5 people who are infected develop a fever and other symptoms. About 1 out of 150 infected people develop a serious, sometimes fatal, illness. [learn more]
- Saint Louis encephalitis (SLE) is spread to people by the bite of an infected mosquito. Most people infected with SLE virus have no apparent illness. Initial symptoms of those who become ill include fever, headache, nausea, vomiting, and tiredness. Severe neuroinvasive disease (often involving encephalitis, an inflammation of the brain) occurs more commonly in older adults. In rare cases, long-term disability or death can result. There are no vaccines to prevent nor medications to treat SLE. While SLE reemerged in California in 2015, it has not been detected in Marin County.
- Zika virus is transmitted through mosquito bites, sexual transmission, or from a pregnant woman to her fetus. Many people infected with Zika virus wont’ have symptoms or will only have mild symptoms. Symptoms include fever, rash, headache, joint pain, read eyes, and muscle pain. Symptoms can last for several days to a week. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. Once a person has been infected with Zika, they are likely to be protected from future infections. Zika poses the greatest risk for pregnant women. Zika infection during pregnancy can cause a birth defect of the brain called microcephaly and other severe brain defects. It is also linked to other problems, such as miscarriage, stillbirth, and other birth defects. There have also been increased reports of Guillain-Barré syndrome, an uncommon sickness of the nervous system, in areas affected by Zika. If you must travel to an area with risk of Zika, take steps to protect yourself. Pregnant women should avoid traveling to areas of Zika outbreaks. While Zika has been found in areas around the United States, they have not been detected in Marin County.
More Information:
- Centers for Disease Control: West Nile Virus
- Centers for Disease Control: Saint Louis Encephalitis
- Centers for Disease Control: Zika virus
- Mairn/Sonoma Mosquito and Vector Control District: West Nile virus
- Marin/Sonoma Mosquito and Vector Control District: Saint Louis encephalitis
- Marin/Sonoma Mosquito and Vector Control District: Zika virus
Health Conditions
Many Marin County residents take medications that need refrigeration (e.g., insulin) or use home medical devices that require electricity or batteries, including breathing machines (e.g., CPAP, BiPAP), oxygen concentrators, power wheelchairs, scooters, and electric beds, among others.
Emergency Medical Contact Information
Keep a contact list handy of local family members, health care provider and other support agencies.
For medical supplies, call your health care provider.
In a life-threatening emergency, call 911.
Prepare for home medical needs and devices during power outages
Along with emergency supplies, such as water and dried or nonperishable food, we encourage you to organize a plan to meet your medical needs during a power outage.
Refrigerated Medications
Medications that require refrigerator should be kept cold during a power outage. In the event of a power outage:
- A closed refrigerator will maintain a cool temperature for 2-3 hours.
- To prepare for longer periods without power, remove the refrigerated medications from the refrigerator as soon as possible.
- Place medications into an ice chest or small cooler packed with ice, cooling bricks or cold packs.
- Use a thermometer to monitor medication temperatures to ensure they’re safe to use.
- Avoid freezing the medication by making sure it does not directly touch the ice.
INSULIN
For up to 4 weeks, you can use insulin in opened or unopened vials that have been stored at room temperature (between 59°F and 86°F). Learn more about managing insulin in an emergency at https://Centers for Disease Control and Prevention.
Medication and Medical Supplies
- Have easy access to an updated list of medications
- Keep at least a one-week supply of essential medications
- Call your health care provider if you need more medication or other supplies
- Spare pair of eyeglasses
- Extra medical insurance cards
- Extra batteries for hearing aids
Medical Devices
- Notify authorities of your needs before an emergency: Call non-emergency lines of local police and fire departments, ambulance services and/or paramedics.
- You may wish to sign up for PG&E’s Medical Baseline Program, which offers extra notifications in advance of planned power shut offs.
- Inventory medical devices that rely on electricity. Read your user instructions or call your distributor or device manufacturer to find out if your device can be used with batteries or a generator.
- Stock extra back-up batteries for each device.
- Have a week’s worth of supplies for use and cleaning of devices.
- See the Food and Drug Administration’s (FDA) publication, which includes a form to help you collect information needed in an emergency: https://www.fda.gov/media/80782/download
- The FDA also offers tips in English and Spanish for use of medical devices during disasters: https://www.fda.gov/medical-devices/emergency-situations-medical-devices/fda-offers-tips-about-medical-devices-and-hurricane-disasters
- Learn more about preparing home medical devices for a power outage at https://adata.org/factsheet/emergency-power
Use of medical devices during a power outage
- Some medical devices require safe water in their use, cleaning, and maintenance. Use only bottled, boiled or treated (chlorine tablets, iodine tablets, or diluted unscented household chlorine bleach) water until your local supply is safe.
- Check to be sure your power cord and device is dry before plugging it in. Do not plug in a power cord if the cord or the device is wet.
- Do not reuse a medical device intended for single use.
- When the power is restored, check to make sure the settings on your medical device have not changed (often medical devices reset to a default mode when power is interrupted).
- Consider generator use. Generators can be extremely hazardous and even life-threatening. It’s critical to follow safety guidelines to prevent toxic carbon monoxide in your home. Even if doors and windows are open, don’t run them inside any enclosed structure, such as a basement or garage, or outside near an open window.
Information for CPAP and BiPAP Users (for Sleep Apnea)
For CPAP and BiPAP users, a power outage may impact your ability to use CPAP or BIPAP to treat your sleep apnea.
Remember that regular usage of CPAP/BiPAP has carry over benefits for a night or two, by increasing muscle tone in your mouth and throat. Your sleep apnea may not be as severe on a single night without CPAP/BIPAP as it was before you started treatment.
There are a few things you can do to reduce your sleep apnea severity if you find yourself without CPAP/BiPAP:
- Sleep on your side or stomach, but NOT on your back
- Sleep semi-upright (e.g., in a recliner)
- Sleep semi-upright (e.g., in a recliner)
- Do not drink alcohol
- Do not smoke tobacco or marijuana
- Do not use narcotic pain medicines or other sedatives
- Backup power options in the event of a power outage include:
- A rechargeable CPAP battery. Available options can be found online, e.g. from http://www.cpap.com/.
*If you use CPAP, BiPAP or an oxygen concentrator for chronic respiratory failure and not just CPAP/BiPAP for sleep apnea, please review your emergency plan for power outages with your primary care provider and/or pulmonologist (lung specialist).
Health and Safety
Be Food Safe: Avoid Food Borne Illness
Refrigerated food needs to remain between 0-40 degrees
Try to keep your refrigerator doors closed. Use the most perishable items first.
Items which fully thaw (above 40 degrees) must be used within 4 hours or thrown out.
Food Wise is Food Safe –When in Doubt Throw it Out
Hydrate and Relocate
During a heat event, keep hydrated. If you cannot cool your residence, contact your nearest cooling center to confirm they have power and are open.
If you have relatives or friends in other areas that still have power, take this opportunity to visit them.
Conserving Water
In the event of a power outage, most of Marin County’s water and sewer systems are supported by back-up power. In the event of an outage that lasts 24 hours or longer, residents are encouraged to conserve water indoors and outdoors, this includes using water efficiently, eliminating outdoor watering, and turning off irrigation systems.
Emergency Planning Resources (Links to printable PDFs)
General Preparedness Plans
- Red Cross Family Preparedness Plan
- Emergency Preparedness for Older Adults and People with Disabilities
- Important Medical Information
- Medical Information Wallet Card - Rx
- Ready Marin Checklists
- Print-ready Marin HHS Extended Power Outage Information
Medical Condition Specific Preparedness Plans
- Emergency Information: AFN Communication
- How to Prepare for and Handle Power Outages
- Emergency Power Planning for People Who Use Electricity and Battery-Dependent Assistive Technology and Medical Devices
- Diabetes Disaster Response Plan
- How to Prepare for an Emergency or Disaster When You Have Lung Disease
- Oxygen Users Disaster Evacuation Planning Guide
- Ventilator Respiratory Disaster Planning Guide
- A Guide for People on Dialysis
Additional Resources
- BC Association for Individualized Technology and Supports for People with Disabilities (BCITS). Self-Help Guide • Back-up Power for Ventilators.
- California Office of Emergency Services (OES). Office of Access & Functional Needs Library.
- Centers for Disease Control and Prevention (CDC). Power Outages.
- Centers for Medicare and Medicaid Services. Medicare coverage in disasters and emergencies.
- FEMA. https://www.ready.gov/disability
- Marin Center for Independent Living
Preparing for Extended Power Outages in Marin County
What is a Public Safety Power Shutoff (PSPS)?
Most Marin County residents live in elevated (Tier 2) or extreme (Tier 3) fire threat areas. Pacific Gas and Electric Company (PG&E) is expanding its Community Wildfire Safety Program. This includes turning off electric power for safety (Public Safety Power Shutoff) when extreme fire danger conditions are forecasted. Learn more about Public Safety Power Shutoffs at prepareforpowerdown.com.
When will PG&E shut off power? For how long?
PG&E may shutoff power if extreme fire danger conditions are forecasted to help reduce the likelihood of an ignition. These include, but are not limited to:
- A Red Flag Warning declared by the National Weather Service
- Low humidity levels, generally below 20 percent
- Forecasted sustained winds generally above 25 mph
Marin County residents need to prepare for up to a week and possibly longer without electricity.
If PG&E issues a power shutoff warning, residents and business owners can review PG&E’s Fire Threat, PSPS Event Maps and Service Impact Map webpages to see if a property is in an area where power may be shutoff. If a power shutoff does occur, residents can access updated information from PG&E on the PSPS Updates webpage.
What should I do to prepare?
Ask yourself these 4 questions:
- How will I receive emergency alerts and warnings? When possible, PG&E will notify customers of a possible Power Shutoff. Register for PG&E’s Wildfire Safety Shutoff Alerts so PG&E can contact you when the power needs to be shut off for safety. Also, register for emergency alerts at both Alert Marin and Nixle to receive notifications about other emergencies that may effect your safety.
- What is my shelter plan? Collect items you’ll need to evacuate using Ready Marin’s Grab & Go Checklist and prepare to shelter-in-place for at least 5 days using Ready Marin’s Build a Kit Checklist.
- What is my evacuation route? If you need Electricity and Battery-Dependent Assistive Technology and Medical Devices, especially life support equipment (e.g., ventilators, apnea monitors, dialysis machines), you should consider staying with friends or family during a prolonged power outage.
- What is my family/household communication plan? Build a support team of people who will help you in an emergency if necessary. The real first responders in an emergency are often your neighbors, friends and co-workers. If you complete your Family Emergency Communication Plan online at ready.gov/make-a-plan, you can print it onto a wallet-sized card and share with your support team.
What if I need Electricity and Battery-Dependent Assistive Technology and Medical Devices?
- Update your contact information with PG&E at pge.com/mywildfirealerts or call 1-866-743-6589.
- Follow FEMA’s recommendations in its Power Outage Information Sheet
- Review and update the American with Disabilities Act’s Emergency Power Planning Checklist every 6 months
- Review Marin County Community Development Agency's BACK-UP POWER FACT SHEET and consider solar plus battery storage or solar generators
Emergency Planning Resources (Links to printable PDFs)
General Preparedness Plans
Red Cross Family Preparedness Plan
Emergency Preparedness for Older Adults and People with Disabilities
Important Medical Information
Medical Information Wallet Card - Rx
Ready Marin Checklists
Print-ready Marin HHS Extended Power Outage Information
Medical Condition Specific Preparedness Plans
Emergency Information: AFN Communication
How to Prepare for and Handle Power Outages
Emergency Power Planning for People Who Use Electricity and Battery-Dependent Assistive Technology and Medical Devices
Diabetes Disaster Response Plan
How to Prepare for an Emergency or Disaster When You Have Lung Disease
A Guide for People on Dialysis
Additional Resources
BC Association for Individualized Technology and Supports for People with Disabilities (BCITS). Self-Help Guide • Back-up Power for Ventilators.
California Office of Emergency Services (OES). Office of Access & Functional Needs Library.
Centers for Disease Control and Prevention (CDC). Power Outages.
Centers for Medicare and Medicaid Services. Medicare coverage in disasters and emergencies.
FEMA. https://www.ready.gov/disability
Page last reviewed: October 29, 2025
This month there was an outbreak of influenza A at a local skilled nursing facility. During our investigation, the first influenza-associated fatalities were announced for California, which included an infant, an adult and an elder. These events remind us that influenza can cause serious illness or death across the lifespan. Visit marinflu.org for links to clinical information and surveillance reports. The first of our regular seasonal influenza surveillance reports for 2015-2016 will be released in early December.
Marin County Public Health is monitoring the Ebola Virus Disease outbreak in the Democratic Republic of the Congo's Ituri Province.
There are no cases of Ebola Virus Disease in Marin County.
Marin County is prepared to respond to communicable disease outbreaks, including Ebola. Marin County Health and Human Services (HHS) works closely with local hospitals, emergency medical services, clinics, and healthcare providers to ensure clinicians and healthcare facilities are informed, trained, and prepared to respond safely and effectively.
The risk of Ebola in Marin County remains very low. However, should a suspected case arise, Public Health and healthcare partners are prepared to respond quickly, using established countywide response plans designed to protect the community's health and safety.
Healthcare providers should routinely ask patients with acute infectious symptoms about recent international travel, including travel to areas experiencing an Ebola outbreak. Providers should immediately isolate any patient with compatible symptoms and relevant exposure history, use appropriate infection prevention measures, and contact Marin County Public Health for consultation.
Ebola is reportable immediately. Marin County Public Health will coordinate with CDPH, CDC, healthcare facilities, laboratories, emergency medical services, and other partners to conduct risk assessment, testing, infection control, patient management, and contact monitoring, as needed.
Vaccines and FDA-approved therapeutics are available for Ebola disease caused by Zaire ebolavirus. The current outbreak in Ituri province appears to involve the Bundibugyo strain, for which no approved vaccines or strain-specific therapeutics are currently available. Laboratory sequencing is ongoing to confirm the strain. Marin County Public Health will continue to monitor developments and update guidance as new information becomes available.
Updated: May 15, 2026
Influenza transmission in health care settings presents risk to both health care workers (HCW’s) and their patients, many of whom are vulnerable to severe influenza disease. Influenza vaccination of HCW's protects against influenza infection, illness, and mortality. Marin County health care facilities, in agreement with Health Officer orders, have joined other Bay Area health facilities in adopting policies requiring HCW’s to be vaccinated or to wear a mask in patient care areas. Read more.