SLIDE #1
Objectives:
1. Describe the most likely scenario regarding H5N1 Avian Influenza in the
Midwest this year.
2. List the most likely questions that you can anticipate being presented to the health
care providers in your community should H5 N1 avian influenza infect birds in
the Midwest this season.
3. Identify the role that health care providers play in each hospital beginning with
the most likely scenario to the worst case scenario.
SLIDE #2
Influenza is a virus that we see in the world every year. A new strain often gets started in
environments that are a perfect mixing ground for these viruses that infect animals and
then eventually move to people.
Usually the animals and people spend a great deal of their waking hours in very close
proximity…unlike what we might see in our country.
SLIDE #3
Lets try a pop quiz to see what is generally known about influenza
SLIDE #4
Every year there are strains present that mix in animals and eventually a strain will get to
humans
SLIDE #5
Question from the caller: Why is everyone so worried about this H5N1? I have
heard of influenza before. but I don’t remember memorizing a certain number like
we have been doing this year.
Actually most of the annual influenza is caused by a low pathogenic subtype .---most
people recover and we vaccinate those at highest risk of spreading to others or having a
bad outcome
Throughout history there have been occasional highly pathogenic strains that we did not
have vaccine for that had a sudden onset of severe illness and proceeding onto rapid
death…..such as H5 N1 that is associated with a 55-60% mortality rate
This type of highly pathogenic virus has only been found in H5 and H7 subtypes
This does not mean that all H5 and H7 subtypes are highly pathogenic
SLIDE #6
Question from caller: So it is not likely to be a pandemic this summer, just birds
with avian flu?
1. No – the H5N1 bird flu strain is still almost entirely a disease of birds. Right now,
this is still a “bird pandemic” – not a human pandemic.
2. In rare cases, the H5N1 virus has caused human illness – but for the most part,
only in people who have had extensive, close contact with infected domestic
poultry or their droppings.
3. No one has been infected through contact with wild birds
4. Person-to-person spread of H5N1 has been extremely rare
5. Unless the H5N1 bird flu virus changes dramatically, so it can pass easily from
person to person, we are unlikely to see widespread human disease.
SLIDE #7
1. Public health officials remain concerned about the possibility of a future
pandemic. We need to be prepared for that possibility.
2. Three worldwide pandemics occurred in the last century – and scientists believe
that another pandemic will occur some day.
Question from Caller: So right now –we are not sure what may happen except
some birds will probably get avian flu?
1. If the H5N1 bird flu strain changes, so it can pass easily from person to person, it
could cause a pandemic. That may or may not ever happen.
2. A pandemic could be also be caused by a completely different flu virus – one that
we haven’t seen yet.
3. Public health officials at all levels of government are watching closely for
changes in the H5N1 bird flu virus – and any other potential pandemic threats.
1. Surveillance for H5N1 bird flu is already underway on major bird migration
routes leading into the U.S.
2. In the coming weeks, the U.S. Geological Survey and the U.S. Fish and Wildlife
Service will be working with state officials – primarily in Alaska – to test
thousands of wild birds.
3. Initially, Minnesota will not be directly involved in the federal testing effort.
However, the Minnesota Department of Natural Resources will be supporting
these efforts, and will be preparing a plan for wild bird surveillance in Minnesota.
SLIDE #8
Question from caller…what is being done in MN?
1. Anticipated surveillance efforts in Minnesota include investigation of waterfowl
die-offs, and sampling of birds in connection with bird-banding and hunter bagchecks.
2. The University of Minnesota and others will be doing some limited testing of
birds, and DNR will also be assisting with those efforts.
3. There are many strains of bird flu besides the “H5N1” strain – and it’s not
uncommon to find them in wild birds. None of them are known to pose a threat to
human health.
4. Other bird flu strains are around all the time. We have experience looking for
them and responding to them.
SLIDE #9
Question from caller: Can you explain exactly how I know that Minnesota is on top
of this situation? I am a little nervous?
1. “Avian influenza” includes a whole family of viruses. It’s been around for a long
time. Every year, we have garden-variety forms of avian flu, and this year is no
different.
2. We have a monitoring system in place to help us quickly identify commercial
poultry flocks infected with avian influenza, contain the infection and work with
the industry to eliminate it.
3. The forms of bird flu we’ve seen have not been “highly-pathogenic” strains like
H5N1.
4. In fact, Minnesota’s poultry industry has never had a case of the more serious
“high-pathogenic” form of avian flu in nearly 30 years of surveillance.
5. Modern poultry production practices effectively shield poultry from contact with
wild birds. That makes spread of these diseases less likely here than in other parts
of the world.
SLIDE #10
1. When poultry producers see disease warning signs in their flocks, they contact
their veterinarian. If the veterinarian suspects a form of avian influenza, he or she
is required to contact the Minnesota Board of Animal Health.
2. Minnesota was among the first states to work with turkey growers to establish a
voluntary monitoring network, beginning in 1986.
3. The Board of Animal Health is creating a similar monitoring network for the
state’s commercial egg and broiler producers.
4. A turkey processing plant surveillance program was created several years ago to
identify infected flocks.
5. BAH is working with small backyard flocks to diagnose, control and prevent
influenza using biosecurity, sanitation and disease control measures.
6. The state is working to bring veterinarians, poultry producers and others up to
speed about the warning signs of highly pathogenic H5N1 avian influenza.
SLIDE #11
1. Commercial poultry is monitored carefully for illness – including different strains
of bird flu – by state and federal authorities.
2. In Minnesota, chickens and turkeys are monitored for disease by the state
Department of Agriculture and the Board of Animal Health.
Question from caller: And what if something is found in poultry?
1. Even if the H5N1 bird flu virus were present in poultry, it is extremely unlikely
that you would ever be infected by handling, cooking or consuming it.
2. Normal precautions for handling and cooking poultry should make it safe to
prepare and eat. These precautions include
a. Cleaning all utensils and food preparation services thoroughly after
working with raw poultry.
b. Washing your hands thoroughly after handling raw poultry.
c. Cooking poultry thoroughly – to an internal temperature of 165 degrees or
higher – before eating it.
d. You should be following these precautions anyway, to prevent routine
food-related diseases like salmonella.
SLIDE #12
1. Wild birds can carry the H5N1 bird flu virus, but it usually doesn’t make them
sick. If you find a dead bird, it’s unlikely that it died from H5N1 bird flu.
2. If you find a dead bird, simply put it in a plastic bag and put it in the garbage –
and then wash your hands thoroughly.
Question from caller; MDH does not want any dead birds?
1. Neither the Minnesota Department of Health nor the Minnesota Department of
Natural Resources has plans to test wild birds for H5N1 bird flu or accept dead
birds for testing.
2. You may remember that MDH tested dead birds for West Nile Virus as a way to
track the presence of the virus in mosquitoes. That isn’t an issue with H5N1 bird
flu.
SLIDE #13
1. To date, there have been no reported cases where people have gotten H5N1 bird
flu from wild birds.
2. In general, people should try to avoid contact with wild birds or their droppings –
not necessarily because of bird flu, but as a general health precaution.
Question from caller: But sometimes I like to go biking and I may get bird
droppings on me.
1. If you can’t avoid contact with wild birds or their droppings, wash your hands,
and avoid bringing feces into your home on shoes or clothing.
2. Clean your shoes or clothing as necessary. A bleach solution and exposure to
sunlight may be helpful for disinfecting shoes.
SLIDE #14
1. To date, there have been no reported cases where people have gotten H5N1 bird
flu from wild birds.
2. Regardless of any potential threat from H5N1 bird flu, routine precautions should
always be followed when handling or cooking wild game:
a. Do not eat or handle any game birds that appear to be sick.
b. Wear rubber or disposable latex gloves when handling or cleaning game
birds.
c. After handling game, thoroughly wash your hands, as well any knives,
equipment or surfaces that came in contact with game.
d. Do not eat, drink, smoke, or rub your eyes or mouth while handling game.
e. Thoroughly cook all game to an internal temperature of 165 degrees or
higher.
Question from caller: Where can I get more information?
You can get all of the information that you need on the MDH web site.
http://www.health.state.mn.us/
SLIDE #15
1. Even if the H5N1 bird flu virus were present in poultry, it is extremely unlikely
that you would ever be infected by handling, cooking or consuming it.
Question from Caller: You know this bird flu could affect my business. What is
being done to monitor the illness?
1. In Minnesota, chickens and turkeys are monitored for disease by the state
Department of Agriculture and the Board of Animal Health.
Question from the caller: are there special precautions I should tell my staff when
preparing chicken?
1. Normal precautions for handling and cooking poultry should make it safe to
prepare and eat. These precautions include
a. Cleaning all utensils and food preparation services thoroughly after
working with raw poultry.
b. Washing your hands thoroughly after handling raw poultry.
c. Cooking poultry thoroughly – to an internal temperature of 165 degrees or
higher – before eating it.
Question from the caller: Well I should be doing that anyway, shouldn’t I?
You should be following these precautions anyway, to prevent routine food-related
diseases like salmonella.
SLIDE #16
1. There are no known cases in which people have gotten H5N1 bird flu from eating
eggs.
2. Proper cooking kills bacteria or viruses that may be present in eggs.
3. Eggs should be cooked thoroughly – so the yolks are not runny or liquid.
SLIDE #17
Question from caller: Some of my family like to eat eggs sunny side up—can I
prepare them this way?
1. The best way for consumers to protect themselves and their families is by
thoroughly cooking meat and poultry products, including eggs.
2. Eggs prepared “sunny-side up” are typically not heated to a temperature that kills
potentially dangerous bacteria like salmonella, or viruses like avian flu.
3. Eggs intended for human consumption are typically washed and sanitized before
being sold, so any virus on the shell would be inactivated.
SLIDE #18
If you own birds, a few simple precautions can help you reduce any potential risk to your
birds – or to your own health.
1. Monitor your birds daily for any signs of disease. In birds, flu causes
swelling around the head and discharge from the eyes, nose and mouth.
The H5N1 strain causes severe illness and death in chickens and turkeys.
2. Keep wild birds – especially waterfowl – away from your domestic birds.
Avoid exposing your birds to feed, water or bedding that may have been
contaminated by wild birds.
3. Avoid exposing your birds to sick birds. If your birds become severely ill
– or die – consult a veterinarian promptly.
4. Wash your hands thoroughly after working with your birds to minimize
your any potential exposure to bird flu.
If you have questions about safe handling of your birds, go to the U.S Department of
Agriculture website at http://www.aphis.usda.gov/vs/birdbiosecurity or call 1–866–536–
7593.
SLIDE #19
1. To date, there have been no reported cases where people have gotten H5N1 bird
flu from wild birds.
2. Bird flu is primarily a disease of waterfowl and shorebirds, and is not typically
seen in the “back yard” bird species that visit bird feeders.
Question from caller: Jumping catfish, that is a relief
1. Because wild birds can also carry other diseases – such as salmonella – a number
of precautions are recommended for people who keep bird feeders:
a. Wear rubber or disposal latex gloves while cleaning bird feeders or bird
baths.
b. Use a plastic bag to pick up any dead birds, and dispose of them in the
garbage.
c. Do not eat, drink, smoke, or rub your eyes or mouth after handling birds,
until you can thoroughly wash your hands.
SLIDE #20
1. The risk of being infected by swimming in the same water with infected
waterfowl is extremely remote.
2. There is no evidence that anyone has ever been infected in this way.
Question from caller: I don’t know how to swim and usually stay near the shore.
That should be okay, shouldn’t it?
1. As a general health precaution, bathers may want to avoid shallow areas were
waterfowl may be present – and especially avoid swallowing any water
SLIDE #21
1. There are no known cases where people have gotten H5N1 bird flu from animals
other than chickens.
2. A few cases of H5N1 bird flu have been reported in large cats or domestic cats, in
Europe and Asia. In all cases, these animals were infected by eating raw, infected
poultry.
3. Regardless of any potential risk from H5N1 bird flu, pet cats should always be
kept indoors to minimize possible health risks.
Question from caller: But what about pet birds?
1. Pet birds should not be at any risk as long as they have no contact with wild birds.
SLIDE #22
• All birds are subject to inspection at the slaughter plant. Birds that do not pass
inspection are withheld from the food supply.
• The more dangerous forms of avian flu typically kill birds quickly, making it
unlikely they would ever even reach the poultry processing facility.
• Fortunately, proper cooking destroys avian flu viruses and other potentially
harmful disease-causing microbes. There is no danger of getting avian influenza
from properly cooked poultry.
SLIDE #23
1. Staff will not show up for work if they are occupied with the safety of their
family, pets, or livelihood…..It is important for all families to have a Emergency
Plan that could be used for any hazard and adjusted for a new threat such as avian
influenza in migratory birds
2. Staff in health care agencies will be overwhelmed with phone calls and walk in
visits from the worried well…..paralyzing the normal operations
3. Patients may suffer from a delay in important interventions and from errors
resulting from exhaustion in the workers who have reported for duty.
4. It is critical for HR to get involved now with your hospital planning to anticipate
how these might impact the work force and work with your agency and
community resources to anticipate, plan and practice mobilizing for such events.
5. We need to strengthen our infrastructure in every community and practice
mobilizing with speed and accuracy for different events in order to be ready for
the unforeseen.
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