#18,406
On Friday - on the heels of Thursday's announcement of the discovery of asymptomatic H5N1 infections in some farmworkers - the CDC released Multiple revised H5N1 Guidance Documents, geared to farm workers, their employers, clinicians, public health officials, and the general public.
While the risk from HPAI H5 is currently greatest for farm workers and those who have occupational exposure to livestock, the unexplained case in Missouri last August - and potentially last night's announced case from British Columbia - remind us that the risks to the public are not zero.
For that reason I've excerpted the CDC's advice for the general public from their latest guidance.
Highly Pathogenic Avian Influenza A(H5N1) Virus: Interim Recommendations for Prevention, Monitoring, and Public Health Investigations
(Excerpt)Recommendations for the Public
Avoid exposure to sick or dead animals. If you are unable to avoid exposure, avoid unprotected (not using respiratory and eye protection) exposures to sick or dead animals including wild birds, poultry, other domesticated birds, and other wild or domesticated animals, as well as with animal feces, litter, or materials contaminated by birds or other animals with suspected or confirmed HPAI A(H5N1) virus infection.
Personal protective equipment (PPE) should be worn when in direct or close contact (within about six feet) with sick or dead animals including poultry, wild birds, backyard bird flocks, or other animals, animal feces, litter, or materials potentially contaminated with HPAI A(H5N1) viruses. PPE includes properly fitted unvented or indirectly vented safety goggles, disposable gloves, boots or boot covers, a NIOSH-Approved particulate respirator (e.g., N95® filtering facepiece respirator, ideally fit-tested), disposable fluid-resistant coveralls, and disposable head cover or hair cover. Adding a face shield over the top of goggles and a fluid resistant apron can enhance protection. Additional information on PPE recommendations for workers can be found online.
Cook poultry, eggs, and beef to a safe internal temperature to kill bacteria and viruses. Refer to CDC's safer foods table for a complete list of safe internal temperatures. Choosing pasteurized milk and products made with pasteurized milk is the best way to keep you and your family safe. Unpasteurized (raw) milk and products made from raw milk, including soft cheese, ice cream, and yogurt, can be contaminated with germs that can cause serious illness, hospitalization, or death. Pasteurization kills bacteria and viruses, like avian influenza A viruses, in milk.
People exposed to HPAI A(H5N1)-virus infected birds or other animals (including people wearing recommended PPE) should monitor themselves for new respiratory illness symptoms, and/or conjunctivitis (eye redness), beginning after their first exposure and for 10 days after their last exposure.Influenza antiviral post-exposure prophylaxis can be considered to prevent infection, particularly in those who had unprotected exposure to HPAI A(H5N1)-virus infected birds or other animals (more information below). Persons who develop any illness symptoms after exposure to HPAI A(H5N1) virus infected birds or other animals should seek prompt medical evaluation for possible influenza testing and antiviral treatment by their clinician or public health department.
Symptomatic persons should isolate away from others, including household members, except for seeking medical evaluation until it is determined that they do not have HPAI A(H5N1) virus infection.
Obviously, these are `best practices', and may not always be practical or even possible. One may be exposed to infected but healthy-looking birds or animals, or unknowingly to contaminated environments. And not everyone will have the proper PPEs, or will be skilled in using them.
But these are worthy targets to aim for, and some compliance is undoubtedly better than none.
Links to all 5 updated guidance documents follow. They are lengthy and detailed, so plan to stay awhile.
Information for Employers Providing Personal Protective Equipment to Reduce Exposure to Novel Influenza NOV 8, 2024
Interim Guidance for Employers to Reduce Exposure to Novel Influenza A (Such as H5N1 Bird Flu) for People Working with or Exposed to Animals NOV 8, 2024
Information for Workers Exposed to H5N1 Bird FluH5N1 bird flu is a virus that has recently been detected for the first time in cows. NOV 8, 2024
Highly Pathogenic Avian Influenza A(H5N1) Virus: Interim Recommendations for Prevention, Monitoring, and Public Health Investigations Nov 8, 2024
Previously, the CDC also published guidance for pet owners, which includes:
Pet Owners
If your domestic animals (e.g., cats or dogs) go outside and could potentially eat or be exposed to sick or dead birds infected with bird flu viruses, or an environment contaminated with bird flu virus, they could become infected with bird flu.
While it's unlikely that you would get sick with bird flu through direct contact with your infected pet, it is possible. For example, in 2016, the spread of bird flu from a cat to a person was reported in NYC. The person who was infected [2.29 MB, 4 pages] was a veterinarian who had mild flu symptoms after prolonged exposure to sick cats without using personal protective equipment.
If your pet is showing signs of illness compatible with bird flu virus infection and has been exposed to infected (sick or dead) wild birds/poultry, you should monitor your health for signs of fever or infection.
How to prevent spread
As a general precaution, people should avoid direct contact with wild birds and observe wild birds only from a distance, whenever possible. People should also avoid contact between their pets (e.g., pet birds, dogs and cats) with wild birds. Don't touch sick or dead birds, their feces or litter, or any surface or water source (e.g., ponds, waterers, buckets, pans, troughs) that might be contaminated with their saliva, feces, or any other bodily fluids without wearing personal protective equipment (PPE).
More information about specific precautions to take for preventing the spread of bird flu viruses between animals and people is available at Prevention and Antiviral Treatment of Bird Flu Viruses in People. Additional information about the appropriate PPE to wear is available at Backyard Flock Owners: Take Steps to Protect Yourself from Avian Influenza.(Continue . . . )
While we await further information on the British Columbia H5 case, it should be noted that all of this guidance was written and released before that case came to light.
While I hesitate to call this the `new normal', it is rapidly becoming our `new reality'.One to which we'll need to adapt and adjust, if we hope to keep HPAI H5 from becoming an even bigger threat.
