Avian influenza (H5N1) also known as bird flu is primarily a disease of birds that is caused by several types of influenza viruses. The highly pathogenic avian influenza is a highly contagious disease affecting wild birds and poultry with occasional infections in human. All human cases have coincided with outbreaks in poultry. Since it was first reported in Vietnam in 2003, the disease has been responsible for human outbreaks and deaths in 15 countries in Asia, Europe, Middle East and Africa resulting in 603 human cases including 356 deaths.

The highly pathogenic H5N1 avian influenza has spread rapidly through the Eastern Mediterranean Region in 2006, with large epizootics reported in Iraq, Egypt, Jordan, occupied Palestine territories, Afghanistan, Pakistan, Djibouti and Sudan. Transmission of H5N1 from infected birds to humans has been confirmed in Iraq, Egypt, Djibouti and Pakistan. Egypt has been the most affected country in the EMR where the disease has remained endemic, with frequent epizootic and 167 human cases that include 60 deaths.

Symptoms of infection in humans include cough, muscle aches, runny nose and sore throat. Severe disease and death may result from a complication of pneumonia.