PROTOCOLS & ADVICE TO PERSONS HANDLING HPAI AFFECTED POULTRY IN CASE OF OUTBREAK OF BIRD FLU IN INDIA

This Action Plan for the State Governments consists

of three parts. Part I gives the Action Plan in case of any suspicion of

occurrence of avian flu at any place. Part II describes the Action Plan in

the unlikely event of the outbreak of the disease being confirmed by

laboratory tests. Part III provides advice to persons who may be

required to handle HPAI affected poultry. It is clarified that poultry covers not only chickens, but other

domesticated birds like ducks, geese, turkeys, guinea fowls, quails etc.

III. Advice to persons handling HPAI affected poultry

3.1. To evolve a public health policy in respect of influenza in

humans due to involvement of HPAI virus is beyond the scope of this

document and will be done by the Public Health authorities. It is,

however, pointed out here that the health of farm hands, attending

veterinary offic er, and other staff engaged in culling and disinfection of

an infected premises should be under strict observation for a period of

at least three weeks. All the persons entering a suspected farm should

wear protective clothing. Sero-conversion in these in-contact persons

should be monitored. Close contact with live infected poultry could be a

source of human infection. Rapid destruction of affected poultry would

reduce opportunities for further direct transmission to humans.

Recommendations for protection of persons involved in the mass slaughtering of birds potentially infected with highly pathogenic avian influenza viruses

3.2. Exposure to infected poultry and their faeces or dust/soil contaminated with faeces could result in human infection and therefore the following precautions should be taken by all those involved in the slaughtering of affected birds :

(i) Cullers and transporters should be provided with

appropriate personal protective equipment consisting of (a)

protective clothing, preferably overalls plus an impermeable

apron or surgical gowns with long cuffed sleeves plus an

impermeable apron; (b) disposable examination gloves; (c) well-

fitted surgical masks (d) goggles or face masks; (e) cap and (f)

disposable shoe covers that can be disinfected

(ii) All persons who have been in close contact with the

infected animals should wash their hands frequently. Cullers and

transporters should disinfect their hands after the operation.

(iii) Environmental clean up should be carried out in areas of culling, using the same protective measures as above.

(iv) All persons exposed to infected chickens or to farms

under suspicion should be under close monitoring by local health

authorities. It is recommended that persons at specific risk of

inhaling possible infected material (e.g. cullers and farmers

involved in mass culling at commercial farms) receive

prophylaxis in consultation with health authorities. Health

monitoring of chicken cullers, others involved in the process and

their family members should be carried out. These individuals

should report any relevant health problems (respiratory

complaints, flu-like illnesses or eye infections) to a health care

facility.

(v)Serological surveillance of exposed animal workers and

veterinarians is encouraged.

(vi) In liaison with designated laboratories, full blood and post mortem specimens (intestinal contents, anal and oro-nasal swabs, trachea, lung, intestine, spleen, kidney, brain, liver and heart) of animals (including pigs) should be collected for investigation of new viral isolates.

Advice about contact with poultry in an area with HPAI

3.3.People in areas with confirmed HPAI should strictly follow the

following instructions :

(i) People should avoid contact with chickens, ducks or other

poultry as much as possible. Children should not have contact with poultry or any other affected birds.

(ii) Avoid handling (live or dead) chickens, ducks or any

other poultry while visiting friends or family, even if the birds are thought to be healthy.

(iii) Avoid contact with chicken farms, duck farms or any farm

where birds have been sick, killed or are thought to have bird flu.

(iv) If a person comes into contact with an environment that has had sick/dead chickens, ducks and other poultry, he/she must wash hands well and monitor temperature for 4 days. If he/she develops a high temperature, consult doctor to see whether treatment is needed.

(v) If a person has had contact with any dead birds that

have died from avian flu or had contact with the droppings of

these birds, consult a doctor to see whether treatment is needed.

Raising poultry at home in an area affected with HPAI

3.4. It is necessary that the poultry farmers, particularly those who are engaged in backyard poultry, in areas affected with HP AI follow certain basic precautionary steps. These are described below :

(i) If someone has any chickens, ducks or any other poultry

at home, it is important that he/she knows what to do if and

when they are killed or die. He/she should know how to dispose of them and clean up the yard/pen, etc.

(ii) Whenever a person has contact with poultry, the chicken

shed/pen or anything with faeces on it, he/she must make sure

he/she is protected by a mask, goggles, gown, rubber boots and

gloves. If these items are not available, try to improvise as much

as possible; for example use a cloth around the mouth and nose,

plastic bags to cover the hands and shoes, overalls that can be

washed etc. Wear this protective apparel to slaughter the

poultry, dispose of the bodies, clean up the area (see below for

advice on how to clean up the area). Make sure that children are

not involved.

(iii) After the area has been cleaned, remove all the

protective apparel and wash hands, clothes and if possible the

body. A shower is the best option. If possible wash clothes in hot

or warm soapy water, hang them in the sun to dry. Discard

gloves, plastic bags and any other disposable materials. Clean all

reusable items such as rubber boots and glasses/goggles.

Always wash hands after handling these items.

Advice on how to decontaminate the yard/chicken pen

3.5. The following advice should be followed in respect of

decontamination of the yard/chicken pen.

(i) After the culling of the poultry, the area must be cleaned.

(ii) Wear all the protective apparel outlined above before

starting the cleaning process.

(iii) Collect any faeces scattered around the yard into a pile

to be buried. The faeces should be buried at a depth of at least

1 metre.

(iv) Try to move droppings without raising too much dust causing dried droppings to possibly blow into the person’s face/eyes/mouth.

(v) Remove as much of the droppings as possible from the

chicken coup/shed and bury as above.

(vi) Clean all areas very well with detergent and water.

(vii) Discard all disposable items used to protect the person

such as gloves, plastic bags, masks, etc. Place reusable items

into a bowl with detergent and water for washing.

(viii) Wash hands very well in soap and water.

(ix) Shower/wash body using soap and water and wash hair.

(x) Taking care not to recontaminate the body, wash clothes

worn during the cull/clean up; use detergent and hot or warm

water.

(xi) Dry clothes in the sun.

(xii) Any item that may be used again -bsuch as rubber gloves

or boots – should be washed very well in soap/detergent and

water. To ensue the items are clean, wash twice.

(xiii) Always wash hands after handling contaminated items.

Reference-on request