Friday, January 29, 2016

CDC Guidance For People Exposed To Birds Carrying Avian Flu Viruses



With so many new and emerging avian flu viruses popping up in poultry and wild birds, both in the United States and around the world, I suppose it was only a matter of time before a new term would appear describing them:

 Avian Influenza Viruses Of Public Health Concern.

The list, which started off with H5N1, and a couple of H7 viruses, has grown rapidly over the past several years, and now includes H5N1, H7N9, H10N8, H5N6, H7N8, H5N2, H5N8, H5N9, H7N7, H7N2, H7N3, H9N2 . . . among others.

Only a handful of these avian viruses are known to infect humans, and of those, all but a few (H5N1, H5N5, H7N9, H10N8) usually produce mild, self-limiting influenza-like symptoms.  

Unless you work with live poultry, purchase birds from a live market, or are involved in the culling of infected birds, your odds of exposure right now are pretty slim. But, in the words of the CDC:

Avian influenza virus infections in humans are of public health concern, not only because of the illness they may cause, but because of their pandemic potential.
Some avian influenza viruses have been associated with greater numbers of human infections and more serious illnesses in people and therefore may pose a greater known public health risk. Avian influenza viruses of particular public health concern include (1) those viruses which are known to have caused severe disease in humans, such as highly-pathogenic avian influenza (HPAI) A (H5N1) virus and low-pathogenic avian influenza (LPAI) A (H7N9) virus.
Also, (2) avian influenza viruses that are related to viruses known to cause severe disease in humans are of concern because of their perceived potential to cause severe disease in people. These include HPAI A (H5) and A (H7) viruses identified in birds in the United States during 2015 and 2016. Finally, (3) other avian influenza viruses may be deemed to be of public health concern based on specific circumstances.

This week the CDC has published guidance for those who may be exposed to birds that may be carrying avian flu. Again, this is primarily for those who work in the poultry industry who have been exposed to flocks determined to be infected with avian flu.

You are being given this information and these instructions because you were recently around poultry or wild birds found to be infected with avian influenza viruses (“bird flu”) of public health concern. Some avian influenza viruses have caused rare, sporadic infections in people, resulting in human illness ranging from mild to severe. These viruses are of public health concern because of their ability to cause human illness and also because of their potential to cause a pandemic.

Infected birds shed bird flu virus in their saliva, mucous and feces. Human infections with bird flu viruses are rare, but they can happen when enough virus gets into a person’s eyes, nose or mouth, or is inhaled. This can happen when virus is in the air (in droplets or possibly dust) and a person breathes it in, or when a person touches something that has virus on it and then touches their mouth, eyes or nose. Most often these infections have occurred after unprotected contact with infected birds or surfaces contaminated with avian influenza viruses. However, some infections have been identified where direct contact was not known to have occurred.

Because human infections with these viruses are possible, all people with exposure to birds infected with avian influenza viruses of public health concern and people with exposure to surfaces contaminated with these viruses should be monitored for illness for 10 days after their last exposure. State and local health departments are helping to monitor people’s health and you should contact your health department if you get any of the symptoms listed on this fact sheet during the 10 days after your last exposure. By following the instructions below, you can help ensure that you receive prompt medical evaluation, possible testing and appropriate treatment if you become ill with signs and symptoms that could be due to bird flu.

Please follow these instructions carefully:

1. Monitor your health for symptoms of avian influenza virus infection.
During and then immediately after your last exposure to infected birds or contaminated surfaces, monitor yourself daily for any of these signs and symptoms for 10 days:

You should observe your health daily even if you carefully followed all guidelines and instructions for properly putting on and taking off personal protective equipment (PPE) and maintaining biosecurity precautions.  

Re-start your 10-day monitoring period from Day 1 if you are around sick birds again.

2. Call your state/local health department immediately if you develop any illness signs or symptoms during the 10-day observation period.
Your health department will help you determine what to do next.


  • Most of the signs and symptoms of bird flu overlap with those of other respiratory illnesses (like seasonal flu).
  • If you develop any of the signs or symptoms listed on this fact sheet, immediately call the health department of the state you are in at the time. Your health department wants to hear from you, even if it turns out to be a ‘false alarm’.  
  • Your health department may contact you by phone, email or text while you are observing your health.
  • If you have symptoms, your health department may give you instructions and ask you to get tested for avian influenza virus infection.  
  • To test for avian influenza virus, a doctor or nurse will collect a sample from you by swabbing your nose and/or throat.
  • If you become sick while you are observing your health, a doctor may prescribe you an antiviral medication that is used for treatment of influenza.  It is important to follow the directions for taking the medication. (CDC recommends that clinicians prescribe antiviral medications for treatment of ill persons who had exposure to avian influenza viruses of public health concern.)

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