Friday, August 11, 2023

WHO Guidance: Public Health Resource Pack for Countries Experiencing Outbreaks of Influenza in Animals


#17,611

In many respects we've entered new territory with H5 avian influenza in recent years years, between its dramatic move into the Americas in late 2021 and its enhanced ability to spill over into mammals.

Along the way the virus has diversified into dozens of different genotypes, and occasionally new subtypes (e.g. H5N5). While while human infections remain rare, the virus keeps honing its abilities. 

Reports of H5Nx spillover into mammalian wildlife species have increased markedly over the past few  years (see Avian influenza overview April-June 2023). Surveillance and reporting from many regions of the world being quite limited, these likely represent only a fraction of the actual number of spillover events.


Somewhat ominously, H5N1 appears to be becoming increasingly neurotropic in mammals. A few (of many) studies we've seen on this changing aspect of H5N1 infection include:
PLoS Pathogens: Evolution of Highly Pathogenic H5N1 Influenza A Virus in the Central Nervous System of Ferrets

Long chains of infection in mammals favors the development of mammalian adaptations that could bring the virus closer to becoming a pandemic strain.


While many spillovers are isolated events, we've seen huge die-offs of marine mammals around the world see Chile: SERNAPESCA Reports > 3500 Marine Animal Deaths In July), and a number of large outbreaks on fur farms (see Finland Orders All Mink On H5N1 Affected Farms To Be Culled).

In July, in PNAS: Mink Farming Poses Risks for Future Viral Pandemics, we looked at an excellent opinion piece penned by two well known virologists from the UK (Professor Wendy Barclay & Tom Peacock) on why fur farms - and mink farms in particular - are high risk venues for flu.

Along the way we've seen a wide range of government responses to HPAI H5; some being highly proactive, while others seemingly far less so.  

While no two outbreaks are the same, and resources may differ from country to country, the WHO has put together a set of guidance documents for countries finding themselves (many for the first time) dealing with H5N1 spillover into animals. 

I've posted the summary below, followed by the table of contents, but you'll want to download the full document and read it in its entirety. 

Public health resource pack for countries experiencing outbreaks of influenza in animals: revised guidance
9 August 2023
Guideline

Overview

This resource pack was developed for the country offices of the World Health Organization and national Public Health institutions, as an overview of the key information needed for advising their Member States in response to questions raised on human health due to influenza outbreaks or detections in animals. It assembles the available information from WHO, FAO and WOAH, on recommendations and guidelines on influenza that might be relevant to a country experiencing detections or outbreaks of influenza in animals or facing suspicion of human infections with animal-origin influenza viruses.
This resource pack updates the information provided in the Summary of Key Information Practical to Countries Experiencing Outbreaks of A(H5N1) and Other Subtypes of Avian Influenza, published in 2016. Additionally, the scope of this current document was broadened to address the risks to public health from all animal influenza viruses, not only avian influenza. Links to existing resources were updated and new resources were added where available.

This guidance is an update and replaces a previous document:
Summary of Key Information Practical to Countries Experiencing Outbreaks of A(H5N1) and Other Subtypes of Avian Influenza 


DEVELOPMENT HISTORY
ACKNOWLEDGEMENTS
ABBREVIATIONS AND ACRONYMS
INTRODUCTION
1. General information on animal influenza
KEY ISSUES
Information sources
Avian influenza
Swine influenza
In humans
Prevention
2. Role of the animal health sector
KEY ISSUES
Information sources
The Food and Agriculture Organization (FAO) of the United Nations
The World Organisation for Animal Health (WOAH)
The Joint WOAH-FAO Scientific Network on Animal Influenza (OFFLU)
National veterinary services
3. Risk communication, community engagement, infodemic management
and science and knowledge translation
KEY ISSUES
Information sources
Risk communication and community engagement (RCCE)
Science and knowledge translation
Infodemic management
Social listening and infodemic insights analysis
Preparedness activities
Response activities
4. Reduce human exposure to animal influenza: basic messages
for the general public and at-risk groups
KEY ISSUES
Information sources
Identify at-risk groups
Minimize exposure
Practise good hygiene
Seek assistance
5. Reduce human exposure to avian influenza: specific messages
for poultry culling activities
KEY ISSUES
Information sources
Personal protective equipment
Personal hygiene
Monitoring of individuals
Preventive measures
6. Food safety
KEY ISSUES
Information sources
Separate raw meat from cooked or ready-to-eat foods
Keep clean and wash hands
Cook food thoroughly
Handle and store meat properly
Biosecurity at traditional food markets
Hazard management for producers
7. Drinking-water and the environment
KEY ISSUES
Information sources
Water treatment
Wastewater
Recreational water
Animal faeces
Burial of dead animals and solid waste
8. Surveillance and investigation of zoonotic influenza cases
KEY ISSUES
Information sources
Case investigation
Enhanced surveillance
Monitoring of individuals
9. Collecting diagnostic samples from humans
KEY ISSUES
Information sources
Specimen collection
Laboratory testing
Virus sharing
10. Clinical management of suspected and confirmed zoonotic influenza patients
KEY ISSUES
Information sources
Infection control and prevention
Case management
Report cases
11. Vaccinations for humans
KEY ISSUES
Information sources
Seasonal influenza vaccine
Zoonotic influenza vaccines
Pandemic vaccines
Summary of information sources
Posted by at