Information Packages

The U.S. Government is concerned that the ongoing outbreaks of avian influenza in birds have the potential to turn into a human influenza pandemic that would have significant global health, economic, and social consequences. The President's November 2005 National Strategy for Pandemic Influenza assigned the lead role for the U.S. Government's international efforts in dealing with avian and pandemic influenza to the Department of State.

The Under Secretary for Democracy and Global Affairs has developed the Avian Influenza Action Group to be headed by the Special Representative for Avian and Pandemic Influenza. The Avian Influenza Action Group, in close collaboration with the Departments of Health and Human Services, Agriculture, Homeland Security, Defense, the U.S. Agency for International Development, and other agencies, leads the Department's work on developing an international engagement strategy based on preparedness, prevention, and containment.

The Avian Influenza Action Group is involved in efforts to:  engage political leadership in affected nations through bilateral interactions and multilateral forums; strengthen transparency and international cooperation; improve surveillance and laboratory capacity; strengthen coordination between human and animal health sectors; and develop coordination of concerned countries.

All involved agencies throughout the U.S. Government are coordinating to maintain up-to-date U.S. information on pandemic flu and avian influenza at pandemicflu.gov.  The State Department's Bureau of Consular Affairs will keep international travelers up to date through their travel fact sheet.

Latest Techical Information (WHO):

• Cumulative number of confirmed human cases - 4 April 2006
  
• WHO pandemic influenza draft protocol for rapid response and containment - 17 March 2006
• Advice on use of oseltamivir - 17 March 2006

Avian Influenza - Situation in Turkey

To date, there have been 21 confirmed cases of avian influenza in Turkey. The majority of these cases have been in the district of Dogubeyazit in Agri Province in the eastern part of the country. Four of these cases have been fatal: All four were residents of Dogubeyazit. The Turkish government has launched an intensive public education campaign and rapid surveys conducted in the most severely affected eastern part of the country have shown that there is an almost universal awareness of the disease and of the risk factors for infection. This awareness has been accompanied by behavioral changes that are expected to reduce opportunities for human infections to occur. As the virus is now known to be present in many parts of the country, some additional human cases should be anticipated in the immediate future. The number of cases is, however, expected to decline as high-risk behaviors become less common and culling operations, which are presently under way, reduce the number of infected birds.

HOW DO PEOPLE BECOME INFECTED?

Direct contact with infected poultry, or surfaces and objects contaminated by their feces, is presently considered the main route of human infection. To date, most human cases have occurred in rural areas where many households keep small poultry flocks, which often roam freely, sometimes entering homes or sharing outdoor areas where children play. As infected birds shed large quantities of virus in their feces, opportunities for exposure to infected droppings or to environments contaminated by the virus are abundant under such conditions. To date, there have been no known cases of human-to-human transmission in Turkey.

IS IT SAFE TO EAT POULTRY AND POULTRY PRODUCTS?

Yes, though certain precautions should be followed. Poultry and poultry products can be safely consumed provided these items are properly cooked and properly handled during food preparation. The H5N1 (avian influenza) virus is sensitive to heat. Normal temperatures used for cooking (140 degrees F in all parts of the food) will kill the virus. Consumers need to make sure that all parts of the poultry are fully cooked (no ‘pink’ parts) and that eggs, too, are properly cooked (no ‘runny’ yolks). Juices from raw poultry and poultry products should never be allowed, during food preparation, to touch or mix with items eaten raw. When handling raw poultry or raw poultry products, persons involved in food preparation should wash their hands thoroughly and clean and disinfect surfaces in contact with the poultry products. Soap and hot water are sufficient for this purpose.

Avian influenza is not transmitted through cooked food. To date, no evidence indicates that anyone has become infected following the consumption of properly cooked poultry or poultry products, even when these foods were contaminated with the H5N1 virus.

Adapted from the World Health Organization.
Naomi Uludamar, Health Unit, Ankara, January 2006

• Facts on Avian Influenza

Avian Influenza - Controlling Risks from Bird Droppings, Bird Carcasses, and House Cats

BIRD DROPPINGS

1. Birds infected with AI excrete the virus in their droppings, where the virus can survive for long periods, especially when temperatures are near or below freezing.  Although there is minimal risk of humans becoming infected by AI from bird droppings (the majority of human cases have resulted from extensive contact with live poultry), as a precautionary measure the following guidelines should be followed when removing bird droppings, even in regions where there has been no documented case of AI.  Bird droppings can contain infectious agents other than AI, and so these guidelines represent good practice in any case.  (Note: These guidelines apply to the removal of thin coatings of droppings.  Thick amounts of droppings -- i.e., those that would require removal using a shovel -- should be removed only by trained staff in consultation with the Post Occupational Safety and Health Officer (POSHO) or other applicable post official.  POSHOs and others needing guidance on removal of thick amounts of droppings should

-- Wear gloves that are either disposable or easily cleanable (for example, light-weight vinyl or nitrile gloves, or heavy duty dishwashing rubber gloves).

-- Gently spray the droppings with water or preferably a disinfecting solution made from 3 tablespoons of household bleach per gallon of water.  Allow time for the bird droppings to soften.

-- Surgical masks should be worn if removal will aerosolize the droppings; i.e., cause the droppings to turn to airborne dust.

-- Remove the droppings with a disposable or cleanable utensil.

-- If dust is observed as the droppings are disturbed, stop and wet the droppings again before continuing the clean up.

-- Place the droppings, tainted debris, and tools into a plastic bag and seal the bag.

-- Clean re-usable utensils with water and detergent or preferably a disinfectant solution as described above.

-- Clean the exterior of footwear with detergent and water or the disinfectant solution.

-- Rinse reusable gloves with detergent and water or disinfectant solution prior to removing. Disposable

contaminated gloves should be placed in a sealed bag for appropriate trash disposal.

-- Place reusable gloves in a clean plastic bag and wash them in water containing detergent or disinfectant.

-- Thoroughly wash your hands with soap and water for 15-20 seconds.

2. Individuals with the greatest potential for occupational exposure to bird droppings are likely those performing building and security equipment maintenance (e.g., cleaning the roof, mechanical penthouses, ledges where birds roost or rest, or CCTV equipment and lighting) or landscaping (e.g., pruning, digging, spreading mulch).  Supervisors should review work activities and consider the likelihood of disturbing bird droppings.  Questions should be referred to POSHO, and POSHOs can request technical assistance from OBO/OM/SHEM.

DEAD BIRDS

3. The AI virus remains in the tissues of infected dead birds for some time.  Therefore, contact with dead birds should be avoided and local veterinary or agricultural authorities should be notified to collect the bird carcass for disposal or testing.  If contact with a bird carcass is unavoidable (for example, a cat brings a dead bird into the house), follow the guidance below:

-- Wear gloves and, if possible, remove the carcass with a shovel or other disposable or cleanable utensil.  Under no circumstances should the bird be touched with bare hands.

-- Place the carcass in a plastic bag and seal it.  Place this bag in another bag or a cardboard box.

-- If disposing of the carcass in the absence of other instructions, bury it in a location where it is unlikely to be disturbed by other animals.

-- Thoroughly wash your hands with soap and water for 15-20 seconds.

HOUSE CATS

4. A few domestic cats, in addition to pigs, tigers, leopards, ferrets, and stone martens (a weasel-like mammal), have been infected with AI.  The cats are believed to have been infected by eating uncooked diseased birds.  Although no human cases of AI have been associated with contact with AI-infected cats, the following measures are recommended if there has been a verified AI infection in birds within the region:

-- Keep domestic cats inside the house to avoid exposure to potentially infected birds.

-- Avoid all contact with stray cats and keep them outside the house.

-- Inform local veterinary authorities if your cat is sick and has possibly been in contact with birds.

-- Strictly follow normal cat care hygiene rules.  When cleaning cat litter boxes, wear gloves and thoroughly wash your hands with soap and water immediately afterward.

Fact Sheets