Avian Influenza Essential information

Avian Influenza Origins Influenza is a highly contagious acute viral infection caused by influenza viruses. All influenza viruses are part of the orthomyxoviridae family of viruses. Avian influenza refers to those influenza strains that can cause illness in birds through bird to bird transmission, while human influenza refers to strains that affect people, through person to person transmission Transmission of avian influenza to people can occur, but it is rare as the transmission mechanism is inefficient. Thus even when there is an outbreak of avian influenza in birds, the risk of transmission to people is believed to be small. While influenza viruses can be classified generically as belonging to a certain family (influenza type A, B or C viruses), within a species, unique serotypes are identified with letter/ number combinations, such as H1N1, H3N2, etc, which is often how they are referred to in the media. Some important strains that caused previous influenza outbreaks are shown below. • H1N1 – Spanish Flu pandemic in 1918 and Swine Flu pandemic in 2009 • H2N2 – Asian Flu outbreak in 1957 • H3N2 – Hong Kong Flu outbreak in 1968 • H5N1 – Avian Influenza outbreak (Bird Flu) in 2004 • H7N2 – Avian Influenza outbreak in US in 2002 • H7N9 – Avian Influenza outbreak (Bird Flu) in 2013

Influenza A viruses are believed to live in a large number of warm-blooded animals including birds, pigs, horses, and people. All subtypes of Influenza are found in birds, making them the natural carrier for all influenza strains, not just avian influenza. Strains present in one species can interact with a strain from another species, causing a new version or serotype. This type of evolution, called antigenic shift, is responsible for the constant evolution of influenza. One of the main concerns with Influenza is that it is highly contagious between people and between animals. Also, some people and animals can carry influenza viruses without developing symptoms of illness, so not every person or animal carrying the virus develops the disease. Farms that raise animals, especially bird and poultry farms, have a wide range of risks of pathogen transmission, including pathogens such as avian influenza. This risk extends from the farm level, where birds/ poultry are raised prior to processing, to the bird/poultry processing facilities, to the facilities that receive the processed poultry including restaurants, grocery stores, hotels, and other facilities that receive raw birds and poultry

Diagnosis Symptoms of human influenza illness include: • Sudden onset fever/high fever • Headache • Cough • Muscle and joint pain, body aches, and fatigue • Stuffy/runny nose • Sore throat • Watery eyes • Chills • Vomiting and diarrhea can also occur, but are less common Influenza in birds (avian influenza) can present similar symptoms, so birds and other animals that demonstrate respiratory illness are always of high concern as a potential infection risk. In the rare cases that avian influenza is passed to people, people develop the same symptoms shown above for human influenza. The symptoms likely to present early in influenza illness are often seen in patients with more commonly occurring diseases, such as the common cold, and certain coronaviruses, as they generate similar symptoms. Diagnosis and treatment should only be performed by a trained physician who can rule out other potential diseases.

Method of Transmission/ Contagiousness The avian Influenza virus is excreted from infected birds via feces, mucus, nasal, or ocular discharge, which then infects other birds. The virus has also been isolated from contaminated feed, water, and soil as a result of crosscontamination and can live for extended periods of time in the tissues and feces of infected birds. The influenza virus can live on surfaces for up to several days. For animals on a farm, large numbers of animals packed closely together, especially birds and poultry, increases the risk of transmission between animals. Transmission of avian influenza from birds to people is rare, but does occur. The mechanism of transmission between birds and people is believed to be inefficient, which is why even when there are outbreaks of avian influenza in bird and poultry populations, bird to human transmission occurs rarely and when it does occur, very few additional people become ill through secondary infections. Thus the risk of Avian Influenza infecting large number of people is believed to be low according to experts at the CDC and WHO.

Prevention The primary site for preventing the spread of Avian Influenza is on the farm through strict practice of infection prevention and sanitary measures. People working on bird and poultry farms need to be taught proper infection control procedures and provided the necessary protective equipment to practice them. Any business receiving animals from a farm (whether the animals are alive or dead) should assess the risk of avian influenza being transmitted from the farm even when there’s no outbreak and take appropriate precautions in the handling of birds and poultry. Farms that observe good infection prevention practices are generally better prepared to use practices to minimize the risk of transmission of avian influenza and other pathogens. Prevent Transmission from the Farm: There are 2 critical parts to addressing the risk at the farm level – killing of birds on a farm that are infected or exposed to infected animals, and preventing the transmission to other farms through environmental sanitation practices. Crates, cages, containers, and any other objects/surfaces that come in contact with or in close proximity to birds or poultry must be disinfected between uses. Trucks and other transport vehicles used to transport birds and poultry from the farm to processors must be disinfected between farms and on a regular basis to prevent the potential spread of avian influenza and other pathogens.

Other recommended precautions to prevent the transmission of avian influenza from birds to people include: Reduce the Risk of Cross-Contamination in Farm Areas: • Use of boot dips, wheel washes, and gate keeper systems to prevent contamination between areas of the farm. • Limitation of movement of animals is a principal control at the farm level. • Outdoor areas, such as yard enclosures are impossible to disinfect. Allowing land to sit without animals for 42 days (longer in the winter) is recommended on a rotating basis to ensure natural UV light destroys residual influenza virus. • Prevent or minimize contact with wild birds to prevent transmission to farm animals. Wire screens can be placed over open yards and ponds to prevent wild birds from coming in contact with the farm animals. If open water cannot be protected, it should be treated with UV radiation or chlorine on a regular basis. • Use “All-In” “All-Out” rotation of animals rather than multiage poultry practices.

Hand Hygiene: Farm workers should perform frequent handwashing through the day, especially when entering and leaving animal housing areas. Hand hygiene should be performed after sneezing or coughing. They should avoid touching the face, mouth, eyes, and nose, especially when around animals. Surface Disinfection: As the influenza virus is easily killed on environmental surfaces with disinfectants, standard cleaning and disinfection practices are effective and critical in preventing the spread of avian influenza viruses. Environmental hygiene practices should include: • Measures to prevent spreading the virus through spraying surfaces during cleaning. • Use of protective equipment (gloves, face shields, and clothing) for employees during cleaning and during farm operations • Providing opportunities for frequent hand hygiene during cleaning operations.

Reduce Contact: Minimize direct contact and/or prolonged contact with birds – sick, healthy, or dead - and their environment (cages, transport containers, etc.) Avoid or minimize contact with sick people. People who are already sick should stay home for at least 24 hours after their fever subsides.

• Surface decontamination – both food and non-food contact surfaces at the farm. Surfaces need to be cleanable (metal, plastic). Surfaces made from wood or bamboo cannot be disinfected.

Protective Equipment: Farm workers should use protective clothing, gloves, and masks when handling feed, water, feces, or in close contact with birds. They should wash clothing after contact with animals and change clothing each day.

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• Basic steps of cleaning to include: Removal of birds and eggs. Egg shells can become contaminated with feces, which can contaminate chicks with avian influenza when they hatch.

o Dry cleaning – scraping/shoveling feces, litter, feathers, and feed

o Cleaning with a detergent to remove dried on soil



o Rinsing of surfaces

o Disinfection with an appropriate disinfectant. Surfaces that cannot be disinfected, such as wood, should be discarded. o After the contact time of the disinfectant, rinsing for food contact surfaces. Note in some geographies, these surfaces will additionally be sanitized after rinsing. • The influenza virus can be cross-contaminated to common environmental surfaces not in contact with animals and can remain viable for several days. Commonly touched surfaces (door handles, light switches, keyboards, counter tops, phones, etc.) should be disinfected regularly or when visible soiled.

Good Health Practices: Practicing good health is also helpful in preventing the development of many illnesses. The strength of a person’s immune system is often related to their overall health. Get plenty of sleep, eat healthy, be physically active, manage stress, and drink plenty of fluids to keep your immune system strong. Protocol for Sick Staff Members: Farm workers who lose pay for staying home when sick may be tempted to come to work sick, creating risk for other staff and customers. Facility policy should address how to resolve this issue.

Proper Raw Food Handling: Handle and prepare (cook) raw birds and poultry correctly to prevent the risk of transmission through food. Respiratory Hygiene: Anytime farm workers cough or sneeze, they should cover their mouth with a tissue or use their elbow. They should dispose of the tissue once used and wash their hands or use alcohol hand gel after sneezing or coughing.

References and useful websites Much of the information used in the development of this brochure was taken from the sites listed below. http://www.cdc.gov/flu/avian/ http://www.cdc.gov/flu http://www.who.int/influenza/human_animal_interface/en/ http://www.who.int/influenza/surveillance_monitoring/updates/en

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