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Highly Pathogenic H5N1 Avian Influenza

Frequently Asked Questions

April 2023


How can Avian Influenza be transmitted from birds and animals to humans?

The exact mode of transmission from birds to people is not known, but in the few human cases that have been reported worldwide, cases of avian flu have been traced to direct contact with infected poultry or their droppings. High risk activities include caring for diseased birds, dressing birds that died from the disease, consuming duck’s blood or possibly undercooked poultry, and handling birds involved in cockfighting. The handling of dead birds is considered a lower risk activity and has not been implicated in transmission of HPAI H5N1 to date.

It is not known if or how animals infected with HPAI H5N1 can transmit the virus to people, so avoiding contact with sick animals, especially those showing neurological and/or respiratory disease signs, is recommended.

Based on current scientific evidence, the risk of a human contracting avian influenza is low. To date, there have been no reports of mammals infecting people, nor of human-to-human transmission of H5N1. Furthermore, no domestically acquired human cases of HPAI H5N1 have been reported in Canada.

What is the difference between Avian Influenza and an influenza pandemic?

HPAI H5N1, or the “bird flu”, is not the same as an influenza pandemic. An influenza pandemic is a large and severe world-wide epidemic of a human influenza virus.

Although there has been laboratory confirmed human cases of the HPAI H5N1 virus in the world, the virus does not have the attributes necessary for a pandemic. Specifically, the HPAI H5N1 virus does not transmit easily from birds to humans and there has been no sustained human-to-human transmission.

It is possible that the current HPAI H5N1 virus could mutate resulting in sustained human-to-human transmission, so it is important to take steps to prevent human infection from occurring.

How can I protect myself and what precautions should I take?

While the risk of human infection with avian influenza viruses remains low, individuals should be cautious when handling wild birds or potentially infected animals. As a general guideline, members of the public should avoid handling live or dead wild birds or potentially infected animals. If contact with wild birds or potentially infected animals is unavoidable, wear gloves or use a doubled plastic bag and avoid contact with blood, body fluids and feces. You should then wash your hands with soap and warm water.

While the annual human influenza vaccine does not protect against Avian Influenza, it will help prevent you from getting seasonal influenza, which could weaken your immune system or resistance to other infections.

Here are some general guidelines for avoiding seasonal human influenza:

  • Get your flu shot every year
  • Wash your hands with soap and warm running water thoroughly and often
  • An alcohol-based sanitizer (60-90% alcohol) should only be used if no visible dirt is present on the hands
  • Practice proper cough and sneeze etiquette
  • Stay at home when you are sick

Is it safe to eat poultry or game meat?

  • Follow safe food handling practices. The transmission of avian influenza viruses to people from eating uncooked or undercooked eggs or poultry is unlikely. However, proper safe food handling practices such as hand washing and keeping poultry and egg products separate from other food products to avoid cross contamination should be followed as a general practice.
  • Thoroughly clean contaminated surfaces on tools and work surfaces with hot, soapy water and then disinfect the area using a household disinfectant.
  • Always wash your hands for at least 20 seconds before handling food, and after handling raw meat, poultry, or eggs.

Follow these guidelines if you handle poultry or game bird meat:

  • Cook pieces and cuts of game meat to an internal temperature of 71°C (160°F).
  • Whole birds should be cooked to an internal temperature of 82°C (180°F)
  • Do not feed uncooked or undercooked poultry or game bird meat to cats or dogs.

I work with birds. How can I protect myself?

For people with occupational exposure to live birds that are showing signs of respiratory or neurological disease, where splash or aerosols will be generated (e.g., using high pressure hoses or in ponds), or if you are working in an area where H5N1 has been diagnosed in wild birds or poultry, the following additional personal protective equipment (PPE) is recommended:

  • Fit-tested and seal-checked respirators (e.g., N95 or equipment with equivalent protection)
  • Eye protection (e.g., tight-fitting non-vented safety goggles)
  • Wear heavy duty rubber gloves when handling birds that can pierce skin with beak or claws, otherwise it is essential to wear rubber gloves or disposable gloves (e.g., latex or nitrile) for cleaning and sanitation procedures
  • Impervious disposable gown or coveralls
  • Disposable protective shoe/boot covers or rubber or polyurethane boots

You should be properly trained in the proper fit-testing, wearing and use of respirators, safe removal of respirators, proper disposal of disposable respirators or cleaning and disinfection of reusable respirators, and medical contraindications to respirator use. In addition, it is imperative that you be trained in and follow procedures for the donning and doffing of PPE and its cleaning and sanitization or disposal. Hand hygiene must be performed before donning PPE, just prior to removing facial protection and after PPE has been completely doffed. Whenever possible, always work outdoors or in a well-ventilated area.

If you become ill after handling birds, see your health care practitioner. Be sure to mention that you have been in contact with wild birds.

Should I be concerned about traveling outside of Canada or in areas where there is Avian Influenza?

As an important measure before you travel outside of Ontario or Canada, visit Public Health Agency of Canada’s web site to determine if there are any active advisories for the region to which you are travelling.

While traveling there are some important precautions you should take to help safeguard your health, including:

  • Avoid visits to poultry farms or bird markets,
  • Do not eat undercooked eggs or poultry; and
  • Practice proper hand hygiene. Bring along an alcohol-based hand sanitizer.
  • If you have a fever and respiratory illness within 10 days after returning from a region affected by avian influenza, contact your healthcare provider immediately.

What are the human symptoms for Avian Influenza?

Based on the studies of patients with the HPAI H5N1 virus, signs can range from very mild to severe. The most common signs include,

  • Fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle and/or body aches
  • Headaches
  • Fatigue or tiredness
  • Conjunctivitis (red eyes)
  • Shortness of breath or difficulty breathing

Less commonly, diarrhea, nausea, vomiting or seizures can occur. Diarrhea is more common with avian influenza than with influenza due to human viruses.

It is important to tell your doctor if you have any of these signs and if you have been around birds or animals in the past 10 days, and especially important if you have been around sick or dead birds or potentially infected animals and did not wear any personal protective equipment. Specific tests to detect avian influenza in people are available. Anti-viral therapy may be prescribed for you. If you do not have access to a doctor, please call Health Connect Ontario at 811.

Who can be tested for Avian influenza?

In Ontario, people who are symptomatic and have had exposure to an infected bird, animal, or premises can be tested. More information on testing can be found on Public Health Ontario’s website.

Is there a vaccine for humans against Avian Influenza?

Vaccination for seasonal influenza is recommended. There is no vaccine for H5N1 indicated for use in Canada at this time.

What should I do if my pet may have been exposed to avian influenza?

If you think that your pet is sick after being exposed to avian influenza, please call your veterinarian.

How can I protect my backyard poultry?

The Ontario Ministry of Agriculture, Food and Rural Affairs has information on biosecurity principles for small flock owners.

Who do I call to report if my backyard poultry are sick or dying?

If you suspect that your birds could have avian influenza, please call your veterinarian or the Canadian Food Inspection Agency at 226-217-8022, 8 am to 6 pm (EST), or email cfia.ontsurveillanceanddiagnostics-survetdiagnostiques.acia@inspection.gc.ca.

Is it safe to feed or observe backyard birds or wild waterfowl?

Generally people should observe wildlife, including birds, at a safe distance. As always, people should practice proper hand hygiene, especially when handling bird feeders or equipment. Bird feeders should be washed with soap and water frequently to reduce the chance of bacterial or viral contamination. Owners of small flocks and pet birds may want to consider removing wild bird feeders and bird baths to protect their birds from possible exposure to wild birds that may be infected with AI.

What should I do if I find a dead wild bird(s) in my backyard or in a park?

Please call Canadian Cooperative Wildlife Health Centre at 1 800-673-4781 to report the finding of sick or dead wild birds. If they determine that the sample is appropriate for testing, they will advise you as to how to safely collect and store the bird(s) and will provide you with a pre-paid shipping container for submission.

If the dead bird(s) is not being collected by authorities, then avoid handling the bird altogether, or dispose of the bird in the following manner:

  • Use an implement such as a small shovel or large tongs, or by hand only if disposable plastic or rubber gloves are worn. Alternatively, the dead bird(s) may be placed in a puncture-resistant leak-proof plastic bag of appropriate size by inverting the bag over the hand, then grasping the carcass through the bag, and wrapping the bag around the bird without touching it.
  • Bury the dead bird(s) several feet deep where they will not be disturbed.
  • Alternatively, the dead bird(s) may be double-bagged and placed in garbage.
    • Note that some regions do not allow dead birds to be placed in the garbage. If you are unsure, contact your local municipality!
  • Always dispose of dead bird(s) in a manner such that no one could handle it again.
  • People handling birds (live or dead) should wash hands thoroughly with soap and water immediately afterward.

Is it considered safe to hunt, handle, and eat healthy game birds?

Yes, especially if the following precautions are observed:

  • Do not handle or eat sick birds or birds that have died from unknown causes.
  • Avoid direct contact with blood, feces, and respiratory secretions of all wild birds.
  • Do not eat, drink, or smoke while cleaning game.
  • Work outside whenever possible
  • Wear a medical mask, preferably an N-95 or KN-95, when cleaning game.
  • Wear dish gloves or latex gloves when handling or cleaning game. Wash gloves, hands, and clothing with soap and warm water immediately after you have finished. Thoroughly clean contaminated surfaces on tools and work surfaces with hot, soapy water and then disinfect the area using a household disinfectant. Immediately remove and wash clothing that may be contaminated with blood, feces or respiratory secretions.
  • Cook pieces and cuts of game meat to an internal temperature of 71°C (160°F).
  • Whole birds should be cooked to an internal temperature of 82°C (180°F).
  • If you become ill while handling birds or shortly thereafter, see your doctor. Inform your doctor that you have been in contact with wild birds.

For More Information

Ministry of Health
Health System Emergency Management Branch
1075 Bay Street, Suite 810
Toronto, Ontario
Canada M5S 2B1
Fax : 416-212-4466
TTY : 1-800-387-5559
E-mail : emergencymanagement.moh@ontario.ca

 

Health workers and health sector employers can call the Healthcare Provider Hotline for more information
Toll free : 1-866-212-2272

CritiCall Ontario provides a 24 hour call centre for hospitals to contact on-call specialists; arrange for appropriate hospital bed access and facilitate urgent triage for patients
1-800-668-4357

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