Avian influenza (Bird flu): Questions & answers
This page was last updated on 14 January 2008.
Public safety
- Could it happen here?
- Why is there so much concern about bird flu?
- Are all of the currently reported outbreaks in birds equally dangerous for humans?
- I have heard bird flu will kill millions of people. Is this the same disease?
- Does it affect humans and if so, how?
- Can people get it from other people?
- Which groups of people would be at most risk if we had the disease in poultry in the UK?
- Can we vaccinate people against bird flu?
- Why are not all poultry workers being offered free seasonal flu vaccinations?
- What about the H5N1 vaccine for humans?
- Is it safe to eat poultry meat and eggs?
- Can I get AI from handling wild birds?
- Advice on travelling to countries affected by H5N1
- What measures should we take now or in future to protect those who work with poultry?
- What measures should we take if avian influenza in poultry is suspected or confirmed on a poultry premises?
- During an outbreak of Highly Pathogenic Avian influenza what Personal Protective Equipment (PPE) is recommended for those involved in disease control activities?
N.B. Health concerns are primarily the responsibility of the Health Protection Agency, The Health & Safety Executive and the Department of Health. Answers in this section point to where further advice or information can be obtained. The World Health Organisation also provides information and guidance on health issues. Food safety advice is available from the Food Standards Agency.
Could it happen here?
There is no confirmed evidence of human to human transmission and the European Centre for Disease Prevention and Control (ECDC) have not changed their risk assessment - that the direct risk to the health of people in Europe is very low, but not zero. The risk is almost entirely confined to those who have close contact with infected domestic poultry.
Poultry keepers in the UK should continue to keep a close eye on their birds for health problems and maintain good biosecurity measures as set out in the Defra guidance agreed with the industry.
Why is there so much concern about bird flu?
A. There is concern that the virus may change (reassort or mutate) to emerge as a new virus that is easily transmissible between people and capable of causing disease in people, birds and other animals. Influenza A viruses occur worldwide in man and a wide range of mammals.
The high pathogenic H5N1 AI strain involved in most of the outbreaks during the last 18 months has shown the ability to jump the species barrier occasionally and cause severe disease, with high mortality, in humans. It has not shown the ability to move easily between humans.
Avian and human influenza viruses can exchange genetic material when a person or other animal susceptible to infection with both viruses is simultaneously infected with both viruses. This could create a completely new subtype of the influenza virus to which few, if any, humans would have immunity and which might be able to spread between humans.
More information on the risks of this happening and the implications are held on the Health Protection Agency (HPA), European Centre for Disease Prevention Control (ECDC) and World Health Organisation (WHO) websites.
Are all of the currently reported outbreaks in birds equally dangerous for humans?
A. No. It varies between strains. See the Health Protection Agency website for further details.
I have heard bird flu will kill millions of people. Is this the same disease?
A. No. Avian influenza (bird flu) is primarily a disease of birds. It is caused by influenza viruses closely related to human influenza viruses. Transmission to humans in close contact with poultry or other birds occurs rarely and only with some strains of avian influenza.
There is potential for mutation of avian influenza viruses to new forms of virus that can causes severe disease in humans and spread easily from person to person. That possibility is a great concern for public health. More information is available on the HPA website.
Does it affect humans and if so, how?
A. Humans are usually infected only through close contact with infected poultry.
The severity of disease in humans varies from mild disease to severe respiratory disease. This depends on the strain of virus and characteristics of the person infected. Human deaths have been reported following severe disease.
Since December 2003, AI has resulted in 331 cases in humans in 12 countries (and 203 deaths) - to 17 October 2007. See the WHO website for up to date information.
Can people get it from other people?
A. There has been a limited number of cases in which there has been evidence to suggest person-to-person transmission but to date there is no evidence that the highly pathogenic avian influenza virus has adapted to spread easily in humans.
Examples of these family clusters are described on the Health Protection Agency website.
Which groups of people would be at most risk if we had the disease in poultry in the UK?
A. People in close contact with infected poultry or infective material from poultry are most at risk. This would include poultry farm workers, veterinarians and others involved in disease control.
Can we vaccinate people against bird flu?
A. No. There is currently no vaccine to protect people against AI infection or disease, though one is being developed. There is however good evidence that avian flu viruses respond to antiviral drugs. In the UK oseltamivir or other appropriate antiviral agent would be used for the treatment of avian flu in people exposed to the virus or to protect people, including poultry workers, who might become exposed to the virus during disease control activities. Such people will be supplied with appropriate antiviral drugs, under prescription, as soon as possible after potential exposure and at least within 48 hours of exposure.
The Department of Health is offering flu vaccination this winter to those who work in close contact with poultry. This is being done as a precautionary public health measure and does not mean that workers are at any higher risk of getting flu this winter than usual. Nor does it mean that there is an increased risk of an outbreak of bird flu in the UK as this risk remains low. For further information please see the leaflet and Q&A sheet at the links below.
- Flu vaccination for poultry workers - Leaflets
- Download Flu
immunisation programme for people who work in close contact with poultry
(65 KB)
Back to questions
Why are not all poultry workers being offered free seasonal flu vaccinations?
A. Workers in poultry units that do not require statutory registration (i.e. less than 50 birds) are not considered to be at higher than normal risk of exposure to avian influenza viruses therefore are not being offered seasonal influenza vaccination.
What about the H5N1 vaccine for humans?
A. On 20 July, the Government announced its intention to purchase a limited amount of H5N1 vaccine (for humans) as part of its ongoing preparations for a possible influenza pandemic. This vaccine will be used for further research, and could be used to provide some protection to frontline healthcare workers. These vaccines are currently in development and it is not expected that these vaccines will become available for 12 to 18 months. There is no guarantee that H5N1 vaccine would protect against any new pandemic influenza strain.
The Government is considering how this vaccine, when available could be used during an AI outbreak in birds in this country. Further information can be found on the Department of Health website.
Is it safe to eat poultry meat and eggs?
A. The Food Standards Agency advises that avian flu does not pose a food safety risk for UK consumers. The risk of people getting avian influenza from eating poultry meat and eggs is low. Evidence from countries where people have caught the disease indicates that direct contact with infected birds is the main risk factor. Eating infected chicken or eggs has not been identified as a cause of their illness. Further information is available on the Food Standards Agency website.
Can I get AI from handling wild birds?
A. The ACDP consider that the risk of transmission of either LPAI or HPAI from wild birds to the general public is small. However, to minimise any risk it is advisable to carry out general hygiene precautions when handling wild birds, such as wearing disposable protective gloves when picking up and handling carcases and washing hands, nails and forearms thoroughly with soap and water after handling the carcase.
Advice on travelling to countries affected by H5N1
Advice on travelling to countries affected by H5N1 is available on the
Department
of Health website.
What measures should we take now or in future to protect those who work with poultry?
A. Information and guidance on how to avoid the risk of zoonotic infections, including avian influenza, when working with poultry not suspected of having avian influenza has been produced by a cross Government and industry working group. This guidance has been endorsed by the Advisory Committee on Dangerous Pathogens (ACDP) and is available on the Defra and HSE websites.
What measures should we take if avian influenza in poultry is suspected or confirmed on a poultry premises?
A. Employers must provide their employees who have had, or are likely to have contact with infected birds with information as to how to protect themselves and their families from infection. A hierarchy of control measures is likely to be required that include:
- Limiting exposure to potentially infected poultry
- the wearing of appropriate personal protective equipment
- safe disposal of used personal protective clothing and equipment
- use of an appropriate antiviral agent for the prescribed period by all who are considered to be at risk of infection and for whom antiviral therapy is not contraindicated
- vaccination with seasonal flu vaccine where appropriate of all those considered to be at risk of infection and for whom vaccine is not contraindicated
- monitoring of health status of persons exposed to infected birds; and
- guidance to those at risk of infection on the personal hygiene measures to be taken to protect their health and to prevent the spread of infection
Information and guidance on avoiding the risk of zoonotic infections when working with poultry that is suspected of having highly pathogenic avian influenza (HPAI) has been produced the cross Government and industry working group. The advice has been endorsed by the ACDP and is available on the HSE and Defra websites.
During an outbreak of Highly Pathogenic Avian influenza what Personal Protective Equipment (PPE) is recommended for those involved in disease control activities?
A. The choice of PPE will depend upon the local risk assessment which will need to take account of the nature of the disease, virus strain and the level of human exposure. PPE must be of good quality, properly maintained and issued individually. Where appropriate, a range of sizes should be available. The ‘one size fits all’ principle is not an option as, badly fitting PPE is, at best, inconvenient and, at worst, ineffective and may give a false sense of protection.
Current advice is that a FFP31 respirator with exhalation valve in conjunction with close fitting goggles or other equipment which gives similar levels of protection is necessary where protection against airborne transmission is required. Where a good seal cannot be achieved with other respirators e.g. because of facial hair, a full hood powered respirator should be considered. Lightweight disposable overalls with hoods should be worn to prevent contamination of personal clothing. Wellington boots, disposable surgical type rubber/vinyl gloves should be worn. Where available, toughened, tear resistant brands are preferred.
1 Respirators are intended to help reduce the wearer’s exposure to airborne particles. Some, including the ones recommended here resemble surgical face masks. They are made to defined national standards, such as European standard EN149:2001 FFP3 respirator the similar (but not identical) United States NIOSH-approved N99 respirator. The standards define the performance required of the respirator, including filtration efficiency. When worn correctly, they seal firmly to the face, thus reducing the risk of leakage.
Guidance on the use of PPE is available on the Health & Safety Executive website.
Page last modified:
14 January, 2008