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Surveillance of Avian Influenza The H5 subtype of the avian influenza A virus is highly pathogenic to chickens in France1. In light of the spread of avian influenza outbreaks among poultry farms in the Southwest and the potential for transmission to humans, a surveillance strategy is being implemented, based on a case definition. This definition has been updated to refocus surveillance solely on severe cases of any origin (return from Asia and exposure to poultry farms in France). Based on the definition proposed in the opinion of the High Council for Public Health (HCSP) of April 24, 2013, any person presenting clinical signs of severe acute lower respiratory infection (requiring hospitalization) with no other identified etiology capable of explaining the condition and who, within 10 days prior to the onset of symptoms: - has traveled to or stayed in exposed areas outside France - or has had close, unprotected contact with poultry (farm, slaughterhouse, force-feeding…), particularly feathers, droppings, and animal residues during cleaning and disinfection processes, in French departments where the highly pathogenic H5 virus has been detected, must report to SAMU-Centre 15, which coordinates classification as a “possible case” by the relevant ARS and the Cire/InVS. Furthermore, the patient must be treated at the regional university hospital (a healthcare facility identified by the ARS with an infectious diseases department and appropriate isolation capabilities), and the quality of the specimens is essential for enabling the biological diagnosis.The case definition² is updated on the InVS website as exposure zones outside France and French departments where the H5 virus has been detected² evolve.As of January 13, 2016, 70 outbreaks of highly pathogenic avian influenza in poultry have been detected in 8 departments in southwestern France (Dordogne, Landes, Pyrénées-Atlantiques, Hautes-Pyrénées, Gers, Haute-Vienne, and more recently in Lot and Haute-Garonne). Since December 18, 41 additional outbreaks have been detected.