H1N1, BIRD FLU & COVID-19: NAVIGATING THE TRIPLE THREAT OUTBREAKS IN THE UAE

As summer unfolds in the UAE, many associate this season with travel, gatherings, and outdoor activity. But behind the scenes, healthcare experts are closely monitoring an unusual trio of viral threats making waves—despite the warmer weather. Shifting immunity patterns post-pandemic, global travel, and indoor air-conditioned environments continue to facilitate the spread of respiratory infections, making vigilance essential even outside the traditional flu season.

In this blog, we explore a triple viral threat currently unfolding across the UAE—each posing unique challenges to public health. First, H1N1 (Swine Flu) continues its unusual off-season activity, with spikes in cases still being recorded. Second, H5 bird flu (avian influenza) is spreading globally among birds and mammals, though no human cases have been confirmed in the UAE. Third, COVID-19, powered by the emerging NB.1.8.1 variant, is resurging, with test positivity rates climbing across the region. This evolving situation calls for renewed attention to prevention, early detection, and timely vaccination.

H1N1 Resurgence in the UAE

What Is H1N1?

H1N1, often referred to as “swine flu,” is a type of Influenza A virus that behaves much like the seasonal flu—but with a few differences. It spreads through tiny droplets released when an infected person coughs, sneezes, or even talks. You can also catch it by touching surfaces where those droplets have landed and then touching your face, especially your mouth, nose, or eyes.

While H1N1 usually causes typical flu symptoms—like fever, sore throat, cough, body aches, and fatigue—it sometimes includes stomach issues like diarrhea or vomiting, especially in children. It can also hit harder for high-risk individuals, including pregnant women, the elderly, young children, and people with ongoing health conditions such as asthma, diabetes, or heart problems.

H1N1 Trends in the UAE

• Peak Activity in November: H1N1 was the most common flu strain this past winter, with about 200 confirmed cases reported weekly. Many of these also involved co-infections, meaning people were sick with H1N1 and another illness, often a bacterial infection like Mycoplasma pneumoniae, which can cause pneumonia-like symptoms.
• December to February: After the November peak, the number of weekly H1N1 cases dropped but didn’t disappear, hovering around 10–20 per week. That may sound like a big drop, but it’s still higher than what’s typical for the tail end of flu season.

Just because H1N1 cases went down after December doesn’t mean the virus vanished. It’s still around, still spreading, and still causing illness—even into spring and summer. That’s why staying alert, practicing good hygiene, and considering vaccination remain important, even outside the traditional flu months.

What Is Bird Flu (H5N1)?

Bird flu, or H5N1, is a virus that primarily affects birds but can sometimes infect other animals, and in rare cases, even humans. The most recent strain causing global concern is called H5N1 clade 2.3.4.4b. It’s highly contagious among birds, especially in wild populations, and has now been detected in a variety of animals, including cats, cows, goats, and even sea mammals like seals.

So, can people catch it? Yes, but it’s very rare. Most human cases have involved close contact with infected birds or contaminated environments, like bird markets or farms. There’s no clear evidence that this virus spreads easily from person to person, which is reassuring, but it’s still something global health experts are watching very closely.

Bird Flu in the UAE: What’s Happening Now?

As of now, there are no confirmed human cases of bird flu in the UAE, and that’s good news. However, authorities are staying cautious. Poultry farms are being closely monitored, and imports of birds are under strict surveillance. The country is taking all necessary steps to prevent the virus from entering or spreading within its borders.

A Quick Look at the Global Picture

• Widespread among birds: Tens of millions of birds around the world have either died from the virus or been culled to prevent its spread.
• Jump to mammals: In a concerning twist, more animals than ever, including cats, dogs, cows, and wild sea creatures, have tested positive over the last year.
• Occasional human infections: There have been a few cases where people got very sick, and even died, after close exposure. These cases remain rare but serious.
• Vaccine status: There are bird flu vaccines available for poultry, and a few human vaccines exist too. However, these human versions are not in widespread use, unless a higher threat level emerges.

Why It Matters

Even though bird flu hasn’t caused any human outbreaks in the UAE, the way it’s spreading in animals worldwide keeps health officials on high alert. The goal is to stay one step ahead, monitor the situation closely, and act quickly if needed.

Common Symptoms of Bird Flu (H5N1) in Humans:

While bird flu infections in humans are rare, when they do occur, they can be serious and often start like a regular flu but escalate quickly. Here are the typical symptoms:

Early Symptoms (Within 2–8 Days of Exposure):

• High fever (38°C or higher)
• Cough
• Sore throat
• Runny or stuffy nose
• Muscle aches and fatigue
• Headache

Gastrointestinal Symptoms:

• Diarrhea
• Nausea or vomiting
• Abdominal pain
  (These are more common in bird flu than in regular seasonal flu.)

Progressing or Severe Symptoms:

• Shortness of breath or difficulty breathing
• Chest pain
• Severe respiratory illness (e.g., pneumonia)
• Seizures or altered mental state (in very severe cases)
• Bleeding from the nose or gums (rare but possible in critical infections)

COVID-19 Rebound & the New NB.1.8.1 Variant in the UAE

As summer brings changes in virus patterns, COVID-19 is reemerging globally—and the UAE is part of this trend.

What Is NB.1.8.1?

• A Variant Under Monitoring (VUM), NB.1.8.1, was first detected in January 2025
• By mid-May, it represented about 10.7% of all COVID-19 cases analyzed worldwide—a sharp increase from just 2.5% in early April 
• This subvariant includes several spike protein mutations thought to enhance how well the virus can attach to human cells and partially escape antibodies

What You Should Know About Vaccination

• Updated vaccines, like the LP.8.1 monovalent versions, are still effective at preventing serious illness from NB.1.8.1. Especially for older adults, people with chronic illness, or immunocompromised individuals, staying current with COVID boosters is crucial.

What This Means for the UAE

• The UAE has seen test positivity reach 15–17%, showing COVID is on the rise alongside flu viruses in summer.

Symptoms of the NB.1.8.1 Variant of COVID-19 Virus 2025

Common Respiratory Symptoms

• Fever or chills
• Cough (often mild)
• Sore throat (sometimes intense, described as a “razorblade” feel in the throat) 
• Nasal congestion or runny nose
• Fatigue and body/muscle aches
• Headache

Additional or Mild Symptoms

• Hoarseness of voice—emerging symptoms across multiple variants including NB.1.8.1, XFG, and LF.7 
• Loss of taste or smell—less common but still reported 
• Shortness of breath in some cases

Gastrointestinal Involvement

• Diarrhea
• Nausea and vomiting
• Stomach pains

These GI symptoms are more frequent in NB.1.8.1 than in previous COVID variants, affecting about 30% of patients in some regions 

Elderly individuals, immunocompromised people, and those with chronic conditions remain at higher risk, especially if unvaccinated

What You Can Do

• Treat it like other COVID variants: rest, stay hydrated, and use over-the-counter remedies.
• Monitor symptoms closely: if GI issues or shortness of breath persist, consult a doctor.
• Stay protected: masks, hand hygiene, and updated vaccines (including boosters) are still effective.
• Get tested: early identification helps prevent spread and ensures timely care.

Combined Protection Strategy

In the face of three concurrent threats, here’s how you can stay safe:

1. Lead With Hygiene
   • Wash hands for 20 seconds or use a 70%+ alcohol sanitizer.
   • Avoid touching your face, especially after touching public surfaces.
2. Mask & Distance
   • Wear masks in indoor crowds.
   • Keep distance (~1–2m) from anyone with symptoms.
3. Cough & Sneeze Ethically
   • Cover coughs/sneezes with your elbow or tissue.
   • Dispose of tissues immediately.
4. Stay Home If Sick
   • Self-isolation at first symptoms (fever, cough, body ache).
   • Avoid school or work if you have flu symptoms.
5. Clean & Disinfect
   • Sanitize frequently used surfaces: phones, remotes, door handles.
   • Do not share personal items like towels or toothbrushes.
6. Know the Red Flags
   Seek immediate medical attention for:
   • Difficulty breathing
   • Chest/abdominal pain
   • Sudden dizziness/confusion
   • Severe diarrhea or vomiting
7. Vaccinate Without Delay
   • Flu shots offer protection against H1N1 and other strains.
   • COVID boosters (LP.8.1-targeting) remain vital for vulnerable populations.
   • Bird flu: Not yet available for the public—animal vaccine only.

First Response Healthcare: Close-to-Home Support

Partnering with DHA & DOH, First Response offers:

• At-home flu and COVID vaccinations
• PCR and rapid diagnostic tests
• Telehealth consultations, including antiviral prescriptions
• In-home care guidance, especially for children, pregnant women and elderly patients

Diagnosis and Treatment Approaches

Virus	Diagnosis	Treatment
H1N1	Rapid test (RIDT) or PCR; clinical symptoms (fever, cough, diarrhea)	Rest, fluids, OTC meds; oseltamivir for high-risk cases
COVID-19	PCR or antigen test; gene sequencing confirms variant presence	Symptomatic care; antivirals for severe cases; home monitoring
Bird Flu H5N1	Exposure history + PCR; serological tests	Oseltamivir/Zanamivir; hospitalization if serious; supportive & respiratory care

Conclusion

While winter may have passed, respiratory threats haven’t. In the UAE, H1N1 cases still linger, bird flu risks persist globally, and a resurgence of COVID-19 requires ongoing awareness. As we head into the warmer months:

1. Don’t drop your guard, practice hand hygiene, and avoid contact if feeling unwell.
2. Vaccinate year-round, especially if traveling or in high-risk groups.
3. Stay alert to symptoms and don’t hesitate to test or isolate.
4. Leverage at-home care: telehealth, mobile testing, and in-home vaccination can simplify your safety.

First Response Healthcare continues to support your well-being all year with expert at-home medical care, flu shots, COVID testing, and bilingual consultations.