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Color enhanced transmission electron micrograph (TEM) of avian influenza H5N1 grown in MDCK cells. Although this virus does not typically infect humans, in 1997, the first instance of direct bird-to-human spread of influenza A (H5N1) virus was documented during an outbreak of avian influenza among poultry in Hong Kong. The virus caused severe respiratory illness in 18 people, six of whom died.

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