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Highly Pathogenic Avian Influenza A(H5N1) Virus in Animals: Interim Recommendations for Prevention, Monitoring, and Public Health Investigations

Summary

Background

Recommendations for the Public

Recommendations for Protecting Farmers and Poultry, Backyard Bird Flock, and Livestock Owners

  • Sick birds, livestock, or other animals
  • Carcasses of birds, livestock, or other animals
  • Feces or litter
  • Raw milk
  • Surfaces and water (e.g., ponds, waterers, buckets, pans, troughs) that might be contaminated with animal excretions.

Recommendations for Clinicians

Recommendations for State Health Departments

Recommendations for Surveillance and Testing

Epidemiological Criteria

  • Exposure to HPAI A(H5N1) virus infected birds or other animals defined as follows:
    • Close exposure (within six feet) to birds or other animals, with confirmed avian influenza A(H5N1) virus infection. Bird or other animal exposures can include, but are not limited to handling, slaughtering, defeathering, butchering, culling, or preparing birds or other animals for consumption, or consuming uncooked or undercooked food or related uncooked food products, including unpasteurized (raw) milk, OR
    • Direct contact with surfaces contaminated with feces, unpasteurized (raw) milk or other unpasteurized dairy products, or bird or animal parts (e.g., carcasses, internal organs) from infected birds or other animals, OR
    • Visiting a live bird market with confirmed bird infections or associated with a case of human infection with HPAI A(H5N1) virus.
  • Exposure to an infected person – Close (within six feet) unprotected (without use of respiratory and eye protection) exposure to a person who is a confirmed, probable, or symptomatic suspected case of human infection with HPAI A(H5N1) virus (e.g., in a household or healthcare facility).
  • Laboratory exposure (unprotected exposure to HPAI A(H5N1) virus in a laboratory)

Clinical Criteria

  • Mild illness (e.g., cough, sore throat, eye redness or eye discharge such as conjunctivitis, fever or feeling feverish, rhinorrhea, fatigue, myalgia, arthralgia, headache)
  • Moderate to severe illness: (e.g., shortness of breath or difficulty breathing, altered mental status, seizures)
  • Complications: pneumonia, respiratory failure, acute respiratory distress syndrome, multi-organ failure (respiratory and kidney failure), sepsis, meningoencephalitis

Public Health Response Criteria

Preferred Clinical Specimens

Recommendations for Infection Prevention and Control

Recommendations for Influenza Antiviral Treatment and Chemoprophylaxis

Treating Symptomatic Persons with Bird or Other Animal Exposures

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