Avian Influenza: Physicians

FAQs for our physician colleagues

April 28, 2015

 

Avian influenza A H5N1 viruses
Colorized transmission electron micrograph of Avian influenza A H5N1 viruses (seen in gold) grown in MDCK cells (seen in green). Photo Credit: CDC/Cynthia Goldsmith

Q: Which subtypes have been identified in the USA?

A: There have been three subtypes recently identified in various locations across the U.S.:

  • H5N2 in commercial turkey flocks, layer flocks and backyard poultry, in several U.S. states; and in wild fowl along the Pacific, Central and Mississippi flyways.
  • H5N8 in wild fowl along the Pacific flyway, as well as backyard poultry in Oregon, and commercial turkeys in California.
  • A new H5N1 in wild fowl along the Pacific flyway. This H5N1 strain differs substantially from the Asian origin strain that has circulated in Asia, Africa, and Europe. This is a mix of North American and Asian genes.

See USDA’s Avian Influenza Fact Sheet and list of National Veterinary Services Laboratory-confirmed HPAI findings in the U.S. for additional information.

Of note, H7N9 which has been circulating in East Asia, affecting people, has not been identified in the USA.

Q: Can 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. However, AI vaccine for people, specifically H5N1 subtype, is maintained in the national stockpile for use by public health authorities, should it be necessary.

Q:  Should I provide antivirals prophylactically for hunters?

A: 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. However, hunting certainly can present risks to various zoonotic diseases. AVMA maintains a Disease Precautions for Hunters resource that may be helpful.

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

A: The pet's veterinarian should be contacted immediately in order to alert state animal health officials, state public health officials, and USDA promptly. Appropriate confirmatory testing can be recommended by authorities to the owner. If confirmed, appropriate authorities will likely have been alerted by the confirming laboratory. If infection is not confirmed, but the patient insists that his companion animal was infected, or the patient will not agree to seek the assistance of his veterinarian, the physician should contact local public health authorities.

Q: My patient has an animal diagnosed with or suspected of having 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, water fowl, 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

Avian Influenza: General FAQ
American Association of Avian Pathologists (AAAP): Avian Influenza Position Statement
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)
Avian Influenza: Advice for Travelers
USDA Avian Influenza (Bird Flu)
Protecting Poultry Workers from Avian Influenza
EPA: Registered Antimicrobial Products with Label Claims for Avian (Bird) Flu
US Poultry & Egg Association
World Health Organization (WHO) Avian Influenza Resource