Avian Influenza

Quick Reference Guide

for Responders

2011 1
Disclaimer:
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purposes only; it does not imply recommendation or
endorsement by the Extension Disaster Education Network
(EDEN) or the University of Maryland (UMD). This material
may be copied and distributed freely by any emergency
response organization.

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 Table of Contents
Avian Influenza Facts Recovery:
- Source and Transmission……………………………………………Pg 4 - Quarantine release………………………………………………….…Pg 50
- Virus Survival…………………………………………………………….Pg 5 - Indemnification……………………………………………………….…Pg 51
- Agent Characteristics…………………………………………………Pg 6
Resources……………………….………………………………………………………..…Pg 52
- Clinical Signs in Birds………………………………………………….Pg 7
Acronyms……………………………………….………………………………………..…Pg 53
- Human Concerns……………………………………………………….Pg 8 Glossary.............................................................................................Pg 54
- HPAI H5N1 – Bird Flu…………………………………………………Pg 9 References……………………………………………..…………………………………..Pg 55

Prevention:
- Preparedness……………………………………………………………Pg 10
- Biosecurity……………………………………………….………………Pg 11
- Surveillance and Monitoring……………………….……………Pg 12
- Response Plan……………………………………………….……..….Pg 13

Response:
- Reporting Cases………………………………………………………….Pg 14
- Incident Command System…………………………………………Pg 15
- Personal Protective Equipment…………………………………..Pg 17
- Site Setup……………………………………………………………………Pg 23
- Sampling and Diagnosis………………………………………………Pg 25
- Quarantine and Surveillance Zones…………………………….Pg 29
- Vaccination…………………………………………………………………Pg 33
- Depopulation……………………………………………………………..Pg 34
- Disposal………………………………………………………………………Pg 36
- Transport……………………………………………………………………Pg 38
- Decontamination………………………………………………………..Pg 44
- Hazards………………………………………………………………………Pg 48
- Exposures or Emergencies………………………………………….Pg 49

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 Avian Influenza

Source and Transmission

- Avian influenza (AI) is an infectious disease caused by type A influenza

virus.1

- AI virus is carried in the intestines of wild migratory waterfowl such as

geese, ducks, and shorebirds. They are a natural reservoir for type A
influenza because it generally does not cause disease in these species.

- Domesticated poultry like chickens, ducks, quails, pheasants, and turkeys

are highly susceptible to infection and death.

- AI is transmitted by contact with saliva, nasal secretions, and feces of

infected birds or contaminated surfaces. 4
 Avian Influenza

Virus Survival

- AI virus can survive outside a host for prolonged periods depending on temperature
and humidity of the environment.19

- The virus can live for up to one month in a poultry house setting at 40⁰F.

- AI virus has also been found to survive in lakes (where waterfowl usually congregate)
for over 30 days at freezing temperatures.

It is therefore important to undergo proper disposal and decontamination of

carcasses, litter, manure and other contaminated products as the virus can linger
on surfaces and in water.

- AI is inactivated when heated to 158⁰F for 1 hour or by exposure to disinfectants

or extreme pH levels.23
5
 Avian Influenza
Agent Characteristics

AI virus is characterized into subtypes based on surface proteins called hemagglutinin (H)
and neuraminidase (N).
Hemagglutinin (H) proteins are responsible for binding the virus to the cell that is being infected.
There are 16 hemagglutinin subtypes. (H1 to H16)
Neuraminidase (N) proteins help the virus get into a host cell. There are 9 neuraminidase subtypes.
(N1 to N9)

*Birds can potentially carry 144 possible combinations of influenza A subtypes. 1

AI can also be classified into two categories, Low Pathogenic Avian Influenza (LPAI) and
Highly Pathogenic Avian Influenza (HPAI) based on virulence.
LPAI – Is the most common form of AI. Signs of disease range from none, to ruffled feathers and a
decrease in egg production.
HPAI – Is less common, but spreads rapidly in poultry flocks, causing severe illness, and can kill 90 -
100% of infected birds within 48 hours of exposure.

*Subtypes LPAI H5 and H7 are carefully monitored as they have been known to mutate into HPAI. 6
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 Avian Influenza (Inactivity)

Clinical Signs in Birds

- Inactivity, ruffled feathers, poor

appetite, diarrhea3
(Swollen Wattles)
- Decreased egg production,

soft-shells or misshapen eggs

- Swelling of the head, eyelids, comb,
wattles and hocks
(Comb Cyanosis)
- Cyanosis (dark blue color) of wattles,
combs, and legs
- Coughing, sneezing, nasal discharge
- Sudden death 7
 Avian Influenza
Human Concerns

- AI viruses generally do not cause disease in humans; however, cases of human infection
have been reported. Bird to human transmission can sometimes occur when people come
in contact with infected poultry. Most infections result from direct contact of mucus
membranes (e.g. eyes, nose, and mouth) with feces and body fluids of infected poultry. 2

- Transmission of AI virus from person to person is rare.

- Clinical signs in people include conjunctivitis, influenza-like symptoms (e.g., fever, cough,
sore throat, muscle aches), severe respiratory illness (e.g. pneumonia, acute respiratory
distress) and sometimes nausea, diarrhea, vomiting and neurologic changes.

- Responders should get seasonal influenza vaccination and take prophylactic antiviral
medications throughout a response. Note that seasonal influenza vaccination is used to
prevent mutant variants from forming and will not prevent AI infections.

- The Centers for Disease Control and Prevention (CDC) and the World Health Organization
(WHO) recommend oseltamivir (Tamiflu), a prescription antiviral medication, for treatment
8
and prevention of human infection with avian influenza A viruses.
 Avian Influenza
HPAI H5N1 – Bird Flu
- HPAI H5N1 has killed millions of birds and is one of the few avian influenza viruses that have
crossed the species barrier and infected humans. Emerging from Hong Kong in 1997, it has caused
the largest number of confirmed cases of severe disease and death in humans from an AI virus. 1

- As of February 2011, HPAI H5N1 has been confirmed in 15 countries mainly throughout Asia,
Africa, Middle East and Europe. There have been 520 confirmed human cases and 307 deaths,
with an overall mortality of 60%.4

- While HPAI H5N1 has not been reported in the U.S. as of February 2011, outbreaks of other HPAI
subtypes have occurred in poultry.2

World Health Organization - Confirmed Human Cases of HPAI H5N1 (2003-2010)

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 Avian Influenza
Mutations

All influenza (flu) viruses have a relatively high mutation rate, however, scientists are
particularly concerned over the avian influenza subtype HPAI H5N1. Avian influenza, in
the presence of "human" or seasonal flu, has the potential to mutate and develop into
a new subtype of virus. Globally, there would be little immunity to this new strain.

Influenza viruses mutate in two ways:

1.Antigenic Drift refers to the process of small genetic changes in the virus that happen
gradually over time. Antigenic drift produces new virus strains that may not be
recognized by the body's immune system. The seasonal flu vaccine is different each
year due to these subtle changes.

2.Antigenic Shift refers to an abrupt and substantial change that produces a new
influenza A virus subtype in humans. Antigenic shift can occur either through direct
animal (poultry)-to-human transmission or through genetic reassortment of the
viruses. Genetic reassortment results from the genetic material of two different viruses
mixing to create a new influenza A subtype.
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 Prevention
Preparedness

Throughout history there have been multiple influenza pandemics.

The most infamous is the "Spanish Flu“ of 1918 which killed between
20-40 million people worldwide, targeting healthy young adults.20

At this point, there is no evidence of genetic reassortment between

avian H5N1 viruses and humans; however, if H5N1 continues to
circulate widely among poultry, the potential for emergence of a
reassorted pandemic strain remains a concern.

A global influenza pandemic (worldwide spread) may occur if three Phase of Pandemic Alert
conditions are met:
1. A new subtype of influenza A virus is
introduced into the human population.
2. The virus causes serious illness in
humans. (Pandemic Severity Index)
3. The virus can spread easily from person
to person in a sustained manner. (Phase of
Pandemic Alert)

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 Prevention
Biosecurity

- Biosecurity is one of the key steps to preventing AI in the U.S. as there is no practical treatment
for infected poultry.

-CDC defines biosecurity as “the cumulative measures that can or should be taken to keep
disease from a farm and to prevent the transmission of disease within an infected farm to
neighboring farms.”5

-Practicing biosecurity is important for decreasing the risk of acquiring any disease, which can
result in financial losses.

-As a responder, following biosecurity measures will help prevent viral transmission. More
information on biosecurity practices will be provided in the following topics.

For biosecurity “Dos and Don’ts” see NAHEMS

Quarantine and Movement Control:Highly Contagious Diseases, Appendix I
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 Prevention
Surveillance and Monitoring

Surveillance and monitoring are key factors in early detection which lead to better
response times and lower risk of disease transmission.

- The U.S. Department of Agriculture (USDA) conducts avian influenza

surveillance programs including the National Poultry Improvement Plan
(NPIP) and the Smuggling Interdiction and Trade Compliance (SITC). 3

- Under the National Center of Import Export (NCIE) all imported live birds,
except from Canada, undergo a minimum 30-day quarantine period and
are tested for avian influenza.

- Poultry and eggs from countries with HPAI H5N1 are not imported into the
U.S.
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 Prevention
Response Plan

- Having a prepared response plan to an avian influenza outbreak

can help prevent an isolated event from turning into an epidemic.

- The plan should address how to quickly detect the disease,

confirm a diagnosis, respond, and recover from an outbreak.

View the USDA’s Summary of the National Highly

Pathogenic Avian Influenza Response Plan for a
detailed description on how to manage an
outbreak.
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 Response
Reporting Disease
- Avian influenza is a World Organization for Animal Health (OIE) reportable disease. OIE tracks
global outbreaks of potentially detrimental animal diseases. HPAI is considered to be a List A
disease, which can result in major trade disruptions, such as export bans on poultry products
from infected countries.

- If animal handlers notice signs of infectious disease, they should notify the state veterinarian
or contact the USDA through their free hotline (1-866-536-7593).

- A team of Federal and State advisors will be deployed to the incident site, evaluate the
situation, and provide an epidemiological assessment to the Deputy Administrator of
Veterinary Services within 24 hours of arrival. 3

15
Adapted From: Incident
FEMA - Course: IS-100
Commander
Response
Incident Command System (ICS)
Operations Planning Logistics Finance
Section Section Section Section

Depopulation
- In an AI outbreak, the ICS would be used.7
Disease
Disposal - ICS utilizes a chain of command structure.
Control
Branch Decontamination - ICS can be easily incorporated into a larger, federal
multi-agency response if necessary.
Traffic - All incident officers and section leaders should be easy
Monitoring
to identify by wearing labeled vests.
Traffic Traffic
Operations
Control Enforcement
Section Branch Key leadership roles include:
Detour
Planning
1. The incident commander manages emergency
response operations in the field.
Surveillance 2. The National Incident Coordinator, at the APHIS
Quarantine
Branch
Vehicle
Inspection
Emergency Operations Center in Riverdale, MD,
Adapted From
AGPREPARDNESS provides national support to the incident commander.
Animal Disease Movement
Response checkpoints

Responders may be organized into branches within the Operation Section. 16

 Response
ICS - Operations Section Tasks
As a responder, it is important to understand the procedures involved within these
branches as you may be called upon to assist state and/or federal agencies in
carrying them out.

Disease Control Branch:7

- Depopulation (Euthanasia)
- Disposal
- Decontamination

Traffic Control Branch:

- Route planning
- Traffic monitoring
- Traffic enforcement (setting up signs, lights,
barricades, etc. )

Quarantine Enforcement Branch:

- Surveillance teams
- Inspection of vehicles
17
- Movement of animals (transporting / receiving)
 Response
Personal Protective Equipment (PPE)

Depending on the magnitude of the outbreak, assistance may be requested.

The National Veterinary Stockpile (NVS) can deploy “push packages” within
24 hours, each containing critical response equipment.3
- For a list of recommended equipment click here.

PPE is designated into 4 different levels A-D, with A being the highest level of
protection. An avian influenza outbreak requires Level C PPE. Level C PPE is
to be used when airborne substances are identified, air purifying respirators
are necessary, and skin and eye exposure is unlikely.7

All responders should be medically cleared, respirator fit-tested, and trained

with PPE before potential exposure to infected materials. Questions about
PPE should be directed to the safety officer.8
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 Response

Personal Protective Equipment (PPE)

Personal Protective Equipment:8,16

- Nitrile disposable gloves or thick rubber work gloves that can be disinfected
- Disposable shoe covers/ cleanable Polyurethane boots
- Coveralls with hood* and outer impermeable apron
- Safety goggles or face shields
- Disposable head covers
- Duct tape (cover wrist/ankles)
- Particulate mask (N-95 or higher) or
powered air purifying respirator (PAPR)
( N-95 mask) (PAPR)
(Never enter a facility if a proper mask fit cannot be achieved)

*If there is no attached hood, a disposable head cover must be worn 19

 Response
Personal Protective Equipment (PPE)

Coveralls: Use of disposable (cotton) or reusable (nylon) coveralls may depend

on the type of work being done.16

Gloves: Avoid latex to prevent allergic reactions. Must be changed if torn. May
need inner and outer gloves.

Goggles: Goggles must prevent particles from entering the eye (no vented
goggles). Prescription glasses alone are not appropriate.

Respirator – If a disposable mask becomes wet, it must be replaced. If

responder has facial hair or unusual facial features, a PAPR must be worn
instead.12

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 Response
Personal Protective Equipment (PPE)

Fit Testing for Disposable Masks (N-95 or higher)11

Step 1: Place hood over head without mask while

Bitrex (bitter smell) or Saccharin (sweet smell)
aerosol is sprayed.

Step 2: Don mask and adjust to fit face.

Aerosol is sprayed.

Step 3: If you can taste or smell the agent, then

try a different mask and/or size. If you can
not taste nor smell the agent, then you pass
the fit test.

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 Response
Personal Protective Equipment (PPE)

When should PPE be worn?7

- When AI is suspected.
- On the infected premise.
- On the contact premise.
- When in close proximity to contaminated materials or
infected animals.
- During movement of animals or equipment.
- During Depopulation, Disposal, and Decontamination.
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 Response
Personal Protective Equipment

It is important to understand the order of donning (putting on) and doffing (taking off)
PPE so you don’t contaminate yourself. This may be done by a two person team.
Donning PPE12 Doffing PPE12
1. Inspect PPE for tears 1. Disinfect gloves and open bag
2. Step into coveralls 2. Remove apron and place in bag,
3. Put on foot covers disinfect gloves
4. Don respirator, adjust fit, and test for 3. Remove foot covers and place in bag,
proper seal disinfect gloves
5. Don goggles, adjust to a snug fit 4. Remove outer gloves, place in bag
6. Don apron 5. Remove coveralls, place in bag
7. Put on inner gloves then outer gloves 6. Remove goggles, place in bag
8. Seal glove and coverall edges with 7. Remove respirator, place in bag
tape 8. Remove inner gloves and seal bag
9. Wash or disinfect hands

Watch these videos for proper donning and doffing of PPE. 23

 Response
Site Setup
Control zones should be determined and set up prior to response activity in order to prevent
viral exposure and contamination.

The site should be divided into four major zones:13

1. Hot Zone: The potentially contaminated area where infected birds and equipment are
located.
2. Decon Corridor: Area between Hot and Warm Zone where decontamination of personnel
and equipment occurs.
3. Warm Zone: The contamination reduction area , where decon and removal of PPE takes
place.
4. Cold Zone: The uncontaminated area where staging occurs (Incident Command Post) and
PPE is donned.

Considerations:
- Warm Zone access point should be uphill and upwind of Hot Zone to avoid aerosol or
runoff contamination.
- Zone boundaries should be clearly marked off and labeled.
- Security gates should be established at access points between each zone.
- Keep log of personnel, hours worked, and equipment that enter and exit the zones.
24
Response
Site Setup

25
 Response
Sample Collection

Antigen Capture kits may be used to sample potentially infected

poultry.14

- Detects Influenza Type A virus

- May be performed in the field
- Results in 15 minutes

Tracheal swabs (domestic poultry) and cloacal swabs (waterfowl)

are the preferred methods of sampling for virus detection tests.3
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 Response
Sample Collection

Samples must be packaged and shipped to USDA-approved

laboratories where diagnostic tests will verify disease status.3

Samples that may be required:14

- Tracheal swabs
- Cloacal swabs
- Blood
- Tissues (deceased birds)
(Cloacal Swab) (Tracheal Swab)

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 Response
Sample Collection

Collecting and shipping samples:14

1. Appropriate PPE must be worn when handling birds and vials.
2. Unwrap the swab, avoiding contamination of the tip.
3. For waterfowl gently secure the bird and swab the cloaca in a circular motion.
4. For domestic poultry secure the bird and wait for the protective cartilage to open
when air is passing, then lightly swab the back and sides of the trachea.
5. Open the vial and place the swab tip in the transport media.
6. Snap off the swab stem while keeping the swab in the vial and secure the cap.
7. Label vial with date, species, sample type, location, and ID number in sample
database.

The transport media used will determine storage temperatures and times of samples.

WHO has shipping procedures for Safe Transport of Infectious Substances that should
be followed.
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 Response
Diagnosis

- Swab samples are submitted to USDA-approved laboratories where

diagnostic tests (RT-PCR and virus isolation) detect disease.3
- If results come back positive, they are sent to the
National Veterinary Services Laboratory (NVSL) for confirmation.

- The NVSL can verify the presence of avian influenza, the specific
viral subtype, and the pathogenicity.

For information on diagnostic testing see

USDA APHIS Summary of the National Highly Pathogenic Avian Infl
uenza (HPAI) Response Plan,
Diagnosis and Reporting. 29
 Response
Quarantine

- Quarantine is a movement restriction (on animals, people, vehicles,

and equipment) placed on a potentially infected area where culling
of infected or exposed birds occur to prevent the spread of virus.3

- In the event of an AI outbreak, a quarantine will be placed on the

premise.

- Premises and Zones are established to monitor and survey virus

location.

- When creating quarantine areas, insect and rodent control plans

should be considered in an effort to prevent further transmission
of AI. (e.g. insecticides and mouse traps)
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 Response
Quarantine, Premises and Surveillance Zones

Premises Classifications:3
 
Infected premises: Area where HPAI is presumed or confirmed in birds and susceptible animals.
- Depopulation and disposal (destroy remaining live birds; dispose all birds)
 
Contact premises: Area with birds or other susceptible animals or products that have been exposed
directly or indirectly to birds and other animals, products, materials, people, or aerosol from an infected premises.
- Depopulation and disposal (sick birds)
 
Suspect premises: Area with birds or other susceptible animals that are under investigation , but with no apparent exposure.
- Quarantine at least 42 days
- Movement by permit only
 
At-risk premises: Area in a buffer surveillance zone with birds or other susceptible animals that do not have
clinical illness.
- Movement of animals by permit only with At-Risk Premise
 
Free premises: Area with birds or other susceptible animals that do not have clinical illness. (Outside surveillance zones)
 
Vaccinated premises: Area within a buffer vaccination zone, where vaccination is to be used.

For more information on animal health incidents visit NAHEMS guidelines. (Note that registration is required for access.)
 
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 Response
Quarantine, Premises and Surveillance Zones

Surveillance Zone Designations:3

 
Infected zone: A perimeter of all presumptive or confirmed
positive cases. (May contain infected and contact premise) Once
Surveillance Zones
set, zone shall extend at least 2 miles beyond initial perimeter. No
birds should enter infected zone unless going to slaughter.

Buffer surveillance zone: The zone immediately surrounding

the infected zone. Size depends upon situation.
 
Buffer vaccination zone: If vaccination is used this zone will be
within the buffer surveillance zone.

Control area: Includes infected zone, buffer vaccination zone

and buffer surveillance zone.
 
Surveillance zone: Zone that separates the buffer surveillance
zone from the free zone and extends into free zone.
 
Free zone: Area determined free of HPAI. (Boundaries may change over time)

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 Response
Quarantine, Premises and Surveillance Zones

Premises and Zones

33
 Response
Vaccinations

Currently, there are two main types of poultry vaccines for avian influenza. 21
1. Inactivated, whole-virus vaccine (most common)
2. Fowl pox vectored AI vaccine for H5 subtypes

Advantages of Vaccination:
1. Protects birds from developing signs
2. Reduces viral shedding in infected vaccinated birds
3. Lowers chance of spreading virus to uninfected birds
4. Protects against virus mutations

Vaccination during an AI outbreak requires serious thought. If the vaccine is not used appropriately, it
could result in the infection becoming endemic. Also, the virus still replicates in healthy vaccinated birds
but the signs are masked thus removing the most significant warning signal for HPAI. 22

- Vaccination of birds in the U.S. is determined by USDA-APHIS. 3

-
Generally not used in the U.S., however, exceptions are occasionally made for commercial turkey flocks
and isolated poultry farms.
- Should cease as soon as possible to allow the region or State to quickly return to a favorable trade
status.

HPAI Vaccine Decision Tree see Summary of the National HPAI Response Plan, Appendix F 34
 Response
Depopulation

Within 24 hours of a premise being classified as infected with AI, the infected and susceptible birds
will be depopulated to prevent further spread of the virus. 3

- Procedures vary by state and will be determined by officials from the affected
jurisdiction.
- Procedures are only carried out by qualified persons to assure methods are performed
in a quick, safe, and humane manner.

Common Methods7
Physical:
- Cervical dislocation

Chemical:
- Carbon dioxide gas
- Water based foam (Water Based Foam)

35
 Response
Depopulation

Cervical dislocation – Uses mechanical pressure (usually manual) to separate

the spinal cord from the skull. An inexpensive method, but only used on
small numbers of small birds.15

Carbon dioxide gas – Results in hypoxia. Can be used in all species. This
method can be done by whole house, partial house, or containerized
approach.

Water based foam – Causes airway occlusion and hypoxia. Recommended

for birds housed in unsound complexes that would be dangerous to enter,
houses that would be impractical to seal, or in outbreaks that pose an
imminent threat to human health (e.g. HPAI H5N1). Used mostly in floor-
reared birds such as broiler chickens and turkeys; requires a foam delivery
system, foam concentrate, and a large supply of water.17

Poultry Depopulation Methods 36

 Response
Disposal
All infected/contaminated carcasses, eggs, litter, manure, and waste should be effectively disposed of.3
Disposal methods are determined on a case by case basis. (See USDA-APHIS Flowchart)

Common Disposal Methods3,9

Composting: Decomposition of organic waste by microorganisms

- In-house composting is the preferred method of disposal as it limits risks of groundwater and air pollution
and is relatively inexpensive.
- On-site composting (i.e. on the same premise but outside the poultry house) is the next best method. It is not as biosecure but no
transport is required.

Incineration: Complete combustion of organic compounds

- One of the biologically safest ways to eliminate disease, but may be expensive and cause air pollution. This is
different than burning, which may not reach total combustion.

Burial: Carcasses are placed in ground and back-filled with soil

- Quick and inexpensive but creates potential for groundwater pollution.

Rendering: High temperatures and pressure break down animal remains

- Requires transportation off site but recycles carcasses into protein by product meal.
- Disposal of limited number of carcasses only; regular rendering facilities and equipment are not designed to
handle catastrophic (high volume) mortalities

Alkaline Hydrolysis Digestion : Uses hydroxides to break down carcasses

- Disposal of limited numbers, expensive, but very effective way of destroying pathogens.

Poultry Carcass Disposal Options

37
 Response
Disposal
Handling Materials:3
To prevent self-contamination, materials should be handled
using the following techniques:

- Spray carcasses and materials with disinfectant prior to

handling them.
- Use tools (shovels, pitchforks, wheelbarrows, etc.) to avoid
direct contact.
- Avoid creating dust particles.

38
 Response
Transport

- There may be times when infected materials must be transported off site for
disposal (Rendering/Landfill).16

- This process must be performed properly as road transport has been implicated
in the spread of virus in previous outbreaks.

- State and/or Federal authorities must authorize the movement of HPAI materials.
This includes permission from the Department of Transportation (DOT),
Environmental Protection Agency (EPA), and Centers for Disease Control and
Prevention (CDC).

- Vehicles transporting infected materials may need to be escorted by a

government official.

39
 Response
Transport
Vehicles that may be used to transport infected materials include
roll-off dumpster trucks, tractor trailers, or custom built trucks.16

40
 Response
Transport
It is important to have a planned route of transport, which
should consider the following:16

- Be direct as possible with as few stops as possible

- Pass through the least populated area
- Pass through roads that will allow for truck maneuverability
- Avoid roads that are close to other poultry farms

41
 Response
Transport

Preloading:
- Inspect containers for holes or cracks. (Don’t use if any large
openings are found)16
- Seal any small openings with several layers of duct tape and
plastic liner or with caulk or silicone.
- After sealing holes, double line the container with
polyethylene sheets.
- Once the containers are ready, the infected materials should
be sprayed with disinfectant to kill the virus and decrease the
potential for creating aerosols. However, avoid fully
saturating the material to prevent dripping.
42
 Response
Transport
Loading:
- Using a skid steer loader, transfer the materials evenly into the
container/trailer.16
- When fully loaded, fold the inner plastic lining over itself and
secure with duct tape. Then fold the outer lining over itself and
tape.
- Seal container with lid or with 2 tarps separated by a polyethylene
sheet.
- To secure tarps, use duct tape or tie down.
- Conduct final inspection of truck for leaks or tears. Clean and
disinfect the outside of the vehicle and container.
- If loading material into fixed trailer trucks the driver should remain
in the truck donned in PPE. 43
 Response
Transport
Unloading:
- Unloading must be done as close as possible to disposal site.16

- After all materials are unloaded, remove the liners and clean
and disinfect the inside.
- Then clean and disinfect the exterior and undercarriage of the
truck.
- Any equipment used during the loading/unloading process
should be cleaned and disinfected.
- After completing delivery, drivers should undergo
decontamination procedures like discarding PPE and
showering. 44
 Response
Decontamination
It takes only 1 gram of contaminated manure to infect a million birds! 12

Decontamination involves two processes:16

Cleaning – the physical removal of materials, such as dirt, manure, feed, and blood.
Disinfecting – destroying the virus by direct exposure to disinfectants.

Steps to clean and disinfect:7

1. Remove all visible materials from surfaces, as it may prevent disinfectant from reaching
the site of contamination
2. Wash with hot water and detergent
3. Scrub with brushes
4. Rinse with hose or pressure washer
5. Apply approved EPA disinfectants
6. Rinse

Decontamination of the infected premises begins as soon as infected birds, other

45
susceptible animals, and products have been properly disposed of. 3
 Response
Decontamination
Decon Area:
- Located in the warm zone perimeter starting at the “hotline.”18
- Decon set up must prevent ground contamination. This is done through the use of pools,
pads, and tarps.
- Reusable equipment should be dropped in marked bins or tarps within the corridor for
decontamination.
- A glove and boot wash/rinse pool should be placed at the “hotline” of the decon area where
they will be sprayed with disinfectant and rinsed. If using disposable boot covers and gloves
this step may not be necessary.
- Apron, coveralls, and outer boot covers should be removed, while avoiding the outer
contaminated surfaces, and placed in bags or disinfectant if reusable.
- While moving through the decon corridor into the warm zone, eye protection and respirators
should be removed and placed in proper receptacles.
- Boots should be dipped in footbaths for a final decontamination.
- Hands and face should be washed and personnel should shower after leaving the infected
premise and change into clean clothes.
- Clothing worn during infected premise decontamination is not to be worn home, even
underwear.
46
 Response
Decontamination

- All reusable PPE must remain at the decon station for reuse until all
decontamination is complete. Upon completion of decon, PPE must
be placed in bags and properly disposed of.18

- All disposable PPE must be placed in bags after each use and properly
disposed of.

- All bags for disposal must be disinfected on the outside when sealed.

- The Decontamination Group is required to decontaminate themselves

and their equipment.

47
Response
Decontamination

48
 Response
Hazards

Response personnel should be aware of potential on site hazards

Pathogenic:
- Exposure to HPAI
- Tetanus

Environmental: Chemical:
-Temperature -Carbon dioxide
- Dehydration -Carbon monoxide
- Uneven grounds - Disinfectants
- Trench or structural
Machinery:
collapse - Physical
- Electrical
- Carbon Monoxide

49
 Response
Emergencies and Exposures

Despite having a response plan, there is always the potential for emergency situations to
occur. Having a good contingency plan will help maintain biosecurity procedures during
unforeseen events.

Medical Emergencies:20
- In the event of a medical emergency, notify immediate supervisor.
- Trained medical personnel with appropriate PPE may respond to patient.
- Medical facility should be notified of a potential avian influenza exposure.
- A decon team member should be sent with cleaning and disinfecting supplies to meet the emergency vehicle
at the medical facility.
- Responder and patient clothing that may be contaminated should be removed and properly disposed of or
laundered.
- Any equipment and surfaces that may have been contaminated should be thoroughly cleaned and disinfected.

Exposure:10
- In the event of an exposure notify immediate supervisor.
- Observe for signs or symptoms of avian influenza for 7 days after last exposure.
- If signs or symptoms develop, seek medical attention and notify health care facility of potential exposure to
avian influenza prior to arrival.

50
 Recovery
Quarantine Release

Continuous monitoring and testing for avian influenza are required before a
farm or premise can be released from quarantine. 3

Releasing Federal Quarantines

- Once decontamination is complete, the infected premises must have a

downtime of 42 days or until sampling shows negative results for AI virus.

- Eligibility for infected premises release requires that all infected and contact
premises within a set portion of the control area are also eligible for release.

- Notification of other agencies, states, slaughter plants, and public should be

made upon quarantine release.
51
 Recovery
Indemnification

Indemnity is part of the USDA disease control program that provides fair
compensation for the owner’s financial losses, thereby promoting prompt
and complete cooperation of the owner in eradicating the avian influenza
virus in affected poultry.

- Appraisal of the fair market value of birds is estimated using several factors that consider
the purpose for which the animal is being reared as well as its age, breed, physical
condition, and potential production.

- USDA compensates 100% of losses from a highly pathogenic avian influenza outbreaks. The
standard rate for low pathogenic avian influenza is 50% of fair market value.

- The Code of Federal Regulations and the 2008 Farm Bill regulate the indemnity process.

Avian Influenza Indemnity Program

52
Additional Sources of Avian Influenza Information

Centers for Disease Control and Prevention

Avian Influenza (Bird Flu)

U.S. Department of Agriculture, Animal and Plant Health Inspection Service

Summary of the National Highly Pathogenic Avian Influenza Response Plan
Avian Influenza (AI)

U.S. Department of Agriculture

Biosecurity Guide for Poultry and Bird Owners

The Food and Agriculture Organization of the United Nations (FAO)

Manual on Procedures for Disease Eradication by Stamping Out

World Health Organization (WHO)

AI Global Alert and Response
Rapid Operations to Contain the Initial Emergence of Pandemic Influenza

Animal and Plant Health Inspection Service (APHIS)

Foreign Animal Disease Preparedness and Response Plan (FAD PReP)

53
 List of Acronyms
AI Avian Influenza NVS Nati
APHIS Animal and Plant Health Inspection Service NVSL Nati
EPA Environmental Protection Agency OIE Wor
HA Hemagglutinin RT-PCR Rea
HPAI Highly Pathogenic Avian Influenza PPE Per
ICS Incident Command System SITC Smu
ICT Incident Command Team USDA U.S
LPAI Low Pathogenic Avian Influenza VI Virus
NA Neuraminidase WHO Wo
NAHEMS National Animal Health Emergency Management System
NCIE National Center for Import Export
NPIP National Poultry Improvement Plan

54
 Glossary
Antigen - any substance that can stimulate the production of antibodies and combine specifically with them.

Cloaca - the common cavity into which the intestinal, urinary, and reproductive canals open in birds.

Conjunctivitis – inflammation of the mucous membrane that lines the exposed portion of the eyeball and inner
surface of the eyelids.

Cyanosis- blueness of the skin, as from imperfectly oxygenated blood.

Epidemic – a widespread occurrence of a disease attacking or affecting many persons simultaneously in a

community or area.  

Indemnification – the act of compensation.

Pathogenicity - the disease-producing capacity of a pathogen.

Polymerase Chain Reaction - a technique for rapidly synthesizing large quantities of a given DNA segment.

Prophylactic – preventive or protective.

Virulence - the relative ability of a microorganism to cause disease .

• Definitions from Dictionary.com 55

 References
1. “Key Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus.” (May 2007) http://www.cdc.gov/flu/avian/gen-info/facts.htm Center for Disease
Control.

2. “Avian Influenza A Virus Infections of Humans.” (May 2008) http://www.cdc.gov/flu/avian/gen-info/avian-flu-humans.htm Center for Disease Control.

3. “Summary of the National Highly Pathogenic Avian Influenza (HPAI) Response Plan.” (Aug. 2007).
http://www.aphis.usda.gov/newsroom/hot_issues/avian_influenza/contents/printable_version/SummaryHPAI-Response092007Draft.pdf. United States Department
of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services, Emergency Management and Diagnostics.

4. “Cumulative Number of Confirmed Human Cases of Avian Influenza A / (H5N1) Reported to WHO”
http://www.who.int/csr/disease/avian_influenza/country/cases_table_2010_10_18/en/index.html World Health Organization.

5. Hegngi, Fidelis N. “Overview of Biosecurity and Avian Influenza.” (Nov 2004). http://www.cdc.gov/flu/pp/biosecurity_on_farm_11_2004.pdf Center for Disease Control.

6. “Avian Influenza Homepage.” (2008) http://www.extension.org/pages/Avian_Influenza_Homepage University of Maryland Extension. University of Maryland.

7. United States Department of Homeland Security Ag Terrorism Preparedness Center. “Animal Disease Response: Field Notes.”2009

8. “Interim APHIS Plan on Personal Protective Equipment (PPE) in Preparation for Highly Pathogenic Avian Influenza (HPAI)” (2006)
http://www.docstoc.com/docs/46347548/Policy-on-Personal-Protective-Equipment-%28PPE%29-in-Response-to United States Department of Agriculture, Animal and
Plant Health Inspection Service.

9. Blake, J., Carey, J., Haque, A., Malone, G., Patterson, P., Tablante, N., Zimmerman, N. “Poultry Carcass Disposal Options for Routine and Catastrophic Mortality.” CAST.
40 (2008) : 1-9 .

10. “Interim Guidance for Protections of Persons Involved in U.S. Avian Influenza Outbreak Disease Control and Eradication activities.” (Jan 2006)
http://www.cdc.gov/flu/avian/professional/protect-guid.htm Center for Disease Control.

11. “Fit Testing Procedures (Mandatory).” (Aug 2004) http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9780

United States Department of Labor

12. “Avian Influenza Commodities Training Guide, Module 1.” (Aug 2007) http://avianflu.aed.org/docs/mod1Handouts.pdf United States Agency,
International Development

56
 References
13. “Site Control Measures, Work Zones.” (Sept 2008) http://www.aphis.usda.gov/emergency_response/hasp/health_safety_site_control.shtmlUnited
States Department of Agriculture, Animal and Plant Health Inspection Service

14. “Avian Influenza Commodities Training Guide , Module 3.” http://influenzatraining.org/documents/s17609en/s17609en.pdfUnited States Agency,
International Development

15. “AVMA Guidelines on Euthanasia.” (June 2007) www.avma.org/issues/animal_welfare/euthanasia.pdf American Veterinary Medical Association

16. “Emergency Response Tools, Secure Transportation.”

http://www.aphis.usda.gov/emergency_response/downloads/tools/Secure%20Transportation%20Job%20Aid.pdf United States Department of Agriculture, Animal
and Plant Health Inspection Service

17. “Use of Water Based-Foam for Depopulation of Poultry.” (Nov 2006) www.avma.org/issues/policy/poultry_depopulation.asp American Veterinary
Medical Association

18. “Decontamination Procedures.” (Sept 2008) http://www.aphis.usda.gov/emergency_response/hasp/health_safety_decontamination_procedures.shtml

United States Department of Agriculture, Animal and Plant Health Inspection Service

19. “Preparing for a Highly Pathogenic Avian Influenza.” (2006) ftp://ftp.fao.org/docrep/fao/010/a0632e/a0632e.pdf Food and Agriculture Organization of
the United Nations

20. “Quarantine and Movement Control:Highly Contagious Diseases.” (May 2003)

http://www.dem.ri.gov/topics/erp/nahems_quarantine_and_movement_control.pdf United States Department of Agriculture, Animal and Plant Health Inspection
Service

21. The Johns Hopkins University and Rashid Chotani. "The Impact of Pandemic Influenza on Public Health." (2006)

22. Grogan, K., Halvorson, D., Slemons, R. "Avian Influenza Vaccines: Focusing on H5N1 HPAI" http://www.ncfar.org/AI_Vaccine_KGrogan_CAST.pdf CAST

23. Breytenbach, J.H. "Vaccination as Part of an Avian Influenza Control Strategy" (Jan 2004)
http://www.thepoultrysite.com/articles/268/vaccination-as-part-of-an-avian-influenza-control-strategy

23. Wanaratana S, et al. The inactivation of avian influenza virus subtype H5N1 isolated from chickens in Thailand by chemical and physical treatments. Veterinary
Microbiology Volume 140, Issues 1-2, 6 January 2010, Pages 43-48 57