Bird Flu Alarm

Understanding Avian Influenza



Avian influenza is a highly contagious disease of birds which is currently epidemic amongst poultry in Asia. Despite the uncertainties, poultry experts agree that immediate culling of infected and exposed birds is the first line of defense for both the protection of human health and the reduction of further losses in the agricultural sector. However, culling must be carried out in a way that protects workers from exposures to avian influenza virus and therefore reduces the likelihood of illness or gene swapping or mutation.

Exposure to infected poultry and their feces or dust contaminated with feces has been associated with human infection; however this is a rare occurrence. The following summarizes the recommendations that have been developed by the CDC and the World Health Organization (WHO) because human infections have occurred in Asia during the current poultry epidemic. They will be updated as more information becomes available.4

  1. All persons who have been in close contact with the infected animals, contact with contaminated surfaces, or after removing gloves, should wash their hands frequently. Hand hygiene should consist of washing with soap and water for 15-20 seconds or the use of other standard hand-disinfection procedures as specified by state government, industry, or USDA outbreak-response guidelines.
  2. All workers involved in the culling, transport, or disposal of avian influenza-infected poultry should be provided with appropriate personal protective equipment:

Protective clothing capable of being disinfected or disposed, preferably coveralls plus an impermeable apron or surgical gowns with long cuffed sleeves plus an impermeable apron;

Gloves capable of being disinfected or disposed; gloves should be carefully removed and discarded or disinfected and hands should be cleaned;

Respirators: the minimum recommendation is a disposable particulate respirator (e.g. N95, N99 or N100) used as part of a comprehensive respiratory protection program. The elements of such a program are described in 29 CFR 1910.134. Workers should be fit tested for the model and size respirator they wear and be trained to fit-check for facepiece to face seal;


Boots or protective foot covers that can be disinfected or disposed.

  1. Environmental clean up should be carried out in areas of culling, using the same protective measures as above.
  2. Unvaccinated workers should receive the current season's influenza vaccine to reduce the possibility of dual infection with avian and human influenza viruses.
  3. Workers should receive an influenza antiviral drug daily for the duration of time during which direct contact with infected poultry or contaminated surfaces occurs. The choice of antiviral drug should be based on sensitivity testing when possible. In the absence of sensitivity testing, a neuramindase inhibitor (oseltamavir) is the first choice since the likelihood is smaller that the virus will be resistant to this class of antiviral drugs than to amantadine or rimantadine.

6. Potentially exposed workers should monitor their health for the development of fever, respiratory symptoms, and/or conjunctivitis (i.e., eye infections) for 1 week after last exposure to avian influenza-infected or exposed birds or to potentially avian influenza-contaminated environmental surfaces. Individuals who become ill should seek medical care and, prior to arrival, notify their health care provider that they may have been exposed to avian influenza.