Avian Influenza: Physicians FAQ

November 6, 2006

Special interest to our physician colleagues

For additional information, please refer to the CDC's Avian Influenza: Resources for Health Professionals.

Q: Can poultry H5N1 avian influenza vaccines be used to protect people against avian influenza?

A: Avian influenza (AI) vaccines used in poultry are developed, tested, and licensed for poultry only. AI vaccines for poultry should not be administered to people.

Q: My apparently healthy patient has requested Tamiflu for prophylaxis. Should I provide it? Should I provide antivirals prophylactically for hunters?

A: Because H5N1 highly pathogenic avian influenza (HPAI) virus has not yet been identified in the United States, we are not aware of any valid reason for prescribing antiviral prophylaxis at this time, even for those in potentially higher risk groups (including hunters). Doing so may be in conflict with recommendations issued by a number of public health experts.

In 2005, the World Health Organization (WHO), Food and Agriculture Organization (FAO), and Office International des Epizooties (OIE) issued a joint statement (see http://www.who.int/foodsafety/micro/avian_antiviral/en/print.html) urging Member States not to use antiviral drugs in animals so that the efficacy of these drugs can be preserved for treatment of influenza infections in humans and strongly requested Member States to ban the use of antiviral drugs in animals. On March 22, 2006, the FDA published a final rule prohibiting the extralabel use of adamantine and neuraminidase inhibitor classes of antiviral drugs in chickens, turkeys, and ducks.

Q: My patient thinks their dog or cat died from H5N1 highly pathogenic avian influenza virus infection. What do I do? Whom do I call?

A: The pet's veterinarian should be contacted immediately so the diagnosis can be confirmed or appropriate confirmatory testing can be recommended to the owner. If confirmed, appropriate authorities will likely already be aware of the case as a result of the laboratory confirmation process. If infection is not confirmed, and the patient is stating their companion animal had an actual infection and/or has not agreed to seek the assistance of their veterinarian, the physician should contact local public health authorities.

Q: My patient has an animal diagnosed with or suspected of having H5N1 highly pathogenic avian influenza virus infection. Should the family be quarantined? Should the children be allowed to go to school?

A: If the animal is any form of poultry or livestock, then the state's department of agriculture or the USDA [1-866-536-7593] likely would have already been notified so that follow up and a possible investigation could be conducted. If warranted by the initial findings of the animal health investigation, public health officials will be notified and will work with animal health officials to make appropriate recommendations for protection of human health, as well as control and elimination of the disease. Whether quarantine is or is not appropriate for that particular situation will be included in those recommendations.

Q: Where do I look for additional information and resources?

A: Links to Information about Avian Influenza

Association of Avian Veterinarians (AAV)
National Association of State Public Health Veterinarians (NASPHV)
Department of Health and Human Services Information on Pandemic Flu and Avian Influenza
Centers for Disease Control and Prevention (CDC) Avian Influenza (Bird Flu)
Human Infection with Avian Influenza A (H5N1) Virus: Advice for Travelers
USDA Avian Influenza (Bird Flu)
Guidance for Protecting Workers Against Avian Flu
EPA: Registered Antimicrobial Products with Label Claims for Avian (Bird) Flu
US Poultry & Egg Association
World Health Organization (WHO) Avian Influenza Resource