To date, there is a paucity of detailed clinical data and available
information on optimal evidence-based clinical management
of patients with H5N1 virus infection, and much more clinical
research is needed. The systematic collection, analysis, and publication
of detailed clinical data are needed to standardize and
improve clinical care of H5N1 virus–infected patients worldwide
and especially to guide intensive care management. Given
that sporadic human infections with H5N1 virus are expected
to continue among exposed persons, many challenges remain,
including the ability to detect and treat H5N1 virus infection
early. The development and availability of highly accurate, specific,
simple, rapid, and inexpensive point-of-care H5N1 diagnostic
tests are needed. Comprehensive data on clinically
mild cases and additional autopsy data will help further understanding
of the pathogenesis of H5N1 virus infection.
Although the pathogenesis of human H5N1 virus infection
is not completely understood, data suggest that controlling viral
replication and cytokine dysregulation should be targeted.
Given the high mortality for patients with H5N1 virus infection
and lack of definitive treatment to date, there is an urgency to
consider and assess new treatment strategies, including combination
antiviral treatment (oral, inhaled, or parenteral administration
and higher dosing) with anti-inflammatory agents
and immunotherapy, and to make any effective therapies widely
available.