Avian (H5N1) influenza has been responsible for millions of wild bird and poultry deaths throughout the world. Sporadic human cases with a high mortality have occurred, almost exclusively in association with very close contact with sick, dying or dead birds. Appropriate management of suspected cases requires their prompt recognition via attention to travel and bird-exposure history. The early isolation, diagnosis and treatment of suspected cases as well as prompt involvement of the health protection unit should enable patients to be optimally managed with minimum risk to health care staff.