What precautions and guidelines would help prevent avian influenza transmission?

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Avian influenza is an umbrella term for diseases caused by various strains of influenza A virus known to infect birds that occasionally cause outbreaks of viral illness in humans. The well-known outbreaks of avian influenza include an outbreak of Avian influenza viruses (AIV), such as the H5N1 strain in western and H7N9 in Eastern and Southern countries. Although adapted to birds and often causing only mild illness, avian influenza viruses can be dangerous with successful transmission to humans, with a high percentage of confirmed cases requiring hospitalization and frequent intensive care unit (ICU) care. The most well-known strains to cause infection are H5N1 and H7N9. H7N9 outbreaks have primarily occurred in the same regions. Unsurprisingly, AIV infection is most often found in people who have close contact with poultry. H7N9 infection appears to occur more in older patients and H5N1 in younger patients, and both appear to occur more in men than in women.

Most patients have symptoms similar to a flu-like viral illness, especially in patients with bird contact and uncharacteristically severe viral symptoms (encephalopathy or organ failure), higher suspicion should be had for avian influenza virus (AIV) infection. Patients who work in the poultry or culinary industries have frequent contact with birds and have greater opportunities to contact the active virus. Most patients with AIV infection have had contact with poultry. Because environment-to-human and human-to-human transmission is theoretically possible with all AIVs and has confirmation in cases of H7N9 infection, even patients with no direct contact with birds can still acquire avian influenza. Different strains of the avian influenza virus appear to have different manifestations. H5N1 usually has a fever and lower respiratory tract symptoms and occasionally presymptomatic non-bloody, non-inflammatory diarrhea. Other avian influenza viruses have other characteristic symptoms. H7N9 and other LPAI strains may more commonly be associated with conjunctivitis.

Treatment and prevention:

Treatment usually consists of supportive care and antiviral medications. The majority of care should aim at managing the aftermath of infection, such as volume loss or possible electrolyte imbalances, which require volume resuscitation and treatment to correct imbalances. Patients with persistent fever should receive anti-fever medication. Patients with respiratory compromise should be placed on supplemental oxygen and monitored closely for signs of deterioration, as these patients are at high risk of requiring intubation and mechanical ventilation. As severe disease can cause organ dysfunction and failure, such signs should be closely monitored and aggressively treated to prevent further decompensation.

These recommendations include antiviral medicines such as neuraminidase inhibitors (especially Oseltamivir) for strongly suspected or confirmed cases of H5N1. The WHO also made recommendations for the prevention of those with possible viral exposure in the above guidelines. These include antiviral medicines such as Oseltamivir 75 mg daily for seven to ten days after the last known potential exposure for high-risk groups (household and close family contacts). Moderate and low-risk groups are not as strongly advised to receive medicines but may require individual assessment.

Protective action (CDC recommendations):

As a general precaution, whenever possible, people should avoid direct contact with wild birds and observe them only from a distance. Wild birds can be infected with avian (bird) influenza (flu) viruses even if they do not look sick. Avoid unprotected contact with domestic birds (poultry) that look sick or have died. Do not touch surfaces that may be contaminated with saliva, mucous, or feces from wild or domestic birds. The best way to prevent avian (bird) influenza (flu) is to avoid sources of exposure whenever possible. Infected birds shed bird flu virus in their saliva, mucous, and feces. Human infections with bird flu viruses can happen when enough virus gets into a person’s eyes, nose, or mouth or is inhaled. This can happen when a virus is in the air (in droplets or possibly dust), and a person breathes it in, or when a person touches something that has the virus on it and then touches their mouth, eyes, or nose. Bird flu virus infections in people happen most often after close, prolonged, and unprotected (no gloves or other protective wear) contact with infected birds, and then the person touches their mouth, eyes, or nose.

Protective measures also include:

Use protective equipment like gloves, an N95 respirator if available, or, if not available, a well-fitting facemask (e.g., a surgical mask) and eye protection. Avoid touching mouth, nose, or eyes after contact with birds or surfaces that may be contaminated with saliva, mucous, or stool droppings from wild or domestic birds. Wash hands with soap and water after touching birds, and change clothes before contact with healthy domestic poultry and after handling wild birds. Then, throw away the gloves and facemask, and wash your hands with soap and water.

Vaccination

CDC (Centers for Disease Control and Prevention) recommends that people who may have exposure to sick birds get a seasonal flu vaccine, ideally, two weeks before their potential exposure, if possible. Seasonal flu vaccination will not prevent infection with bird flu viruses but can reduce the risk of getting sick with human and bird flu viruses at the same time.

Seal Avian Influenza

Various outbreaks of H3N8, H7N7, and H4N6 low pathogenicity avian influenza (LPAI) viruses have occurred in harbor seals along the New England coast of the United States. Yet, the exact route of viral transmission from bird to seal remains unclear. Avian (not human) influenza viruses have been reported to attach to cells of the respiratory tract of seals.

As per the fisheries department, testing of samples of some recent outbreaks has found some harbor seals positive for highly pathogenic avian influenza H5N1. It is a zoonotic disease that has the potential to spread between animals and people. However, the health risk posed to the general public is deemed to be low, at this time. Full or partial necropsy examinations were conducted on several seals. Based on recent research, the virus is most likely transmitted from wild birds to seals. It is unlikely that multiple seals acquired the viruses through predation or scavenging of an infected source (such as an infected bird) at this scale, as birds are not a typical food source for harbor seals. There is an ongoing highly pathogenic avian influenza H5N1 event. The spread of Avian influenza began in domestic birds and wild birds and some species of terrestrial mammals across the United States (e.g., red fox, striped skunk, opossum, raccoon, bobcat, American mink, coyote, fisher cat, bear, river otter).

Recommended protective Measures

As per the government fisheries department, the following measures are recommended:

People and their pets must maintain a safe distance of 150 feet so as not to disturb the animal, which may be just resting on the beach, and to avoid injury to themselves, their pets, or the seals. Seals, like other marine mammals (dolphins, whales, and sea lions), are protected under the Marine Mammal Protection Act. Seals are wild animals and can transmit disease. Some safe viewing tips in a zoo: Stay at least 100 yards away from seals or other marine mammals. Keep dogs on a leash and do not allow them to approach seals. Seals and dogs can easily infect each other with diseases since they are closely related species

Take care.

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Regards.