AVIAN INFLUENZA IN WILD BIRDS IN PUBLIC PARKS AND AQUATIC AMENITY AREAS IN IRELAND: A RISK ASSESSMENT. October 2006 1. Background: Avian influenza is a disease of birds caused by an avian influenza A virus of which about 16 different types have been identified based on the structure of their surface attachment protein. Most of these viruses cause either no clinical disease, or only mild symptoms in the infected birds and are called Low Pathogenic Avian Influenza (LPAI). These LPAI strains are not unusual in waterfowl (ducks, swans and geese) around the world. However, a characteristic of the influenza virus family is their ability to mutate rapidly and for new strains to appear. Some of the mutants have the ability to cause more severe disease and they are then called Highly Pathogenic Avian Influenza (HPAI). In this manner the highly pathogenic H5N1 strain arose in Southeast Asia and has resulted in the current (2003-2006) epidemic affecting poultry, wild birds and rarely people or other mammals such as cats, dogs, and various wild carnivores. The role of wild birds, and particularly waterfowl, in maintaining LPAI is well documented and once introduced into domestic poultry the LPAI strains can also mutate into HPAI. The question now is what role migratory waterfowl play in the spread of HPAI H5N1 in the current epidemic? The recent emergence of the Asian lineage of H5N1 in western Europe shows that long distance spread has occurred but further research is needed to determine how this has occurred. Migration of waterfowl from Asia and eastern Europe during a period of unusually cold winter weather in early 2006 was undoubtedly a significant risk factor. HPAI H5N1 first appeared in the EU in February 2006 when the virus was found in over-wintering waterfowl including ducks and mute swans (Cygnus olor). The closest known occurrence of HPAI H5N1 to Ireland was the discovery of a dead whooper swan (Cygnus cygnus) found on the Fifeshire coast in Scotland in March. A previous risk assessment exercise conducted by DAF in collaboration with NPWS and BirdWatch Ireland has identified 24 species of water birds that pose the greatest risk of introducing avian influenza into Ireland, or spreading it once it has arrived. These include two species of swan, two species of geese, 10 species of ducks, two of rails, three of waders, and five of gulls (Table 1 & Fig. 1). A further four species of water birds (two grebes, brent geese, and the cormorant) pose a lesser risk. The risk assessment was based on the following criteria: Migration from areas known to have HPAI H5N1. Previously known to have been infected by H5N1 in other countries. Known use of farmland as well as wetland habitats. Species that are gregarious and have the potential to spread viruses. Proximity of their natural habitat to areas of poultry farming. Should HPAI H5N1 arrive in Ireland with migratory waterfowl during the coming winter season (2006/07) it could appear at any wintering site used by these birds. The distribution of wetland habitat in Ireland encompasses the coastal estuaries and bays and also inland lakes, callows, rivers, and bogs (Fig. 2). Because of the pattern of demographic settlement and land use in Ireland, none of these areas are remote from human settlement, farming, or amenity areas used for boating, fishing, hunting, swimming, or other pursuits that could bring people or domestic animals into contact with birds, bird droppings, carcases or other potential sources of influenza virus. 2. Issues The purpose of this risk assessment is to describe the qualitative risk from avian influenza from water birds posed to members of the public using aquatic/wetland amenity areas or parkland also used by water birds. It also describes the risk to park workers, to staff of the NPWS, DAF, Local Authorities, Civil Defence, and to members of volunteer organizations such as BirdWatch Ireland who may be exposed to wild waterfowl, given: The current distribution of avian influenza in Europe. The epidemiology of virus spread and potential pathways that may present a risk to humans. Our understanding of the environmental survival of the virus once excreted from an infected host. The zoonotic potential and virulence of the virus. 3. Risk Assessment In the six month period from May to October 2006 there have been 20 occurrences of HPAI H5N1 in wild birds in EU member states and 18 of those were in May at the tail end of the Winter / Spring incursion of the virus from the east. Since then there was one case of infection in a free-living great crested grebe in northern Spain in June and a single case in a captive swan in Dresden Zoo in August. Further afield the incidence of infection in wild birds has been equally unremarkable with a limited number of outbreaks in waterfowl in Siberia between June and September. The most recent outbreak occurred in the Omsk region of Russia in early September. At the present time in mid-October the autumn migration is well underway and peak numbers of wintering water birds should arrive in Ireland in the coming weeks. The current risk of HPAI H5N1 incursion is minimal but this situation could change with the arrival of birds from the east. It would be unlikely that avian influenza would appear in Ireland without first being detected in another EU member state. Should HPAI H5N1 arrive in Ireland with returning migratory water birds, the main mechanism by which it could spread to other birds would be by faecal or respiratory excretion. For transmission to other animals and humans, ingestion of faeces or food contaminated by infected bird faeces is a more likely route. Thus, for a person to be infected, they must ingest food or water contaminated by the faeces of an infected bird, or have such material come in close contact with sensitive areas such as the conjunctivae of the eye in sufficient quantity. When water birds defecate, the faeces are semi-liquid and any viral particles are bound to the organic matter in the faeces. This is not particularly hazardous unless foodstuff is contaminated. The infective dose of virus will also decrease rapidly as the faeces dries out and is exposed to UV rays in sunlight, rain, wind and other environmental elements. In addition, viruses cannot multiply outside a host animal - further reducing the quantity that could infect a new host. Therefore in a situation where water birds are living in natural habitat, it is highly unlikely that humans would be exposed to an infective dose by ingestion or by dried viral particles blowing into eyes, mouth or airways. Such mechanisms of transmission are only likely under circumstances of intensive poultry production where large numbers of infected birds are housed indoors generating large quantities of infected aerosol. Infected waterfowl excreting large quantities of virus into water bodies such as ponds, lakes, canals, reservoirs, or outdoor swimming pools could pose a theoretical risk to humans using these amenities. The risk is less where dilution results from greater water volumes or higher flow rates. The avian influenza virus is also sensitive to the elements and its survival is dependant on water temperature, water chemistry (pH, salinity), and exposure to the sterilizing effects of UV light all of which will deactivate the virus. Increasing temperature increases the rate of deactivation, with the virus being most stable between 4oC and 10oC. It can remain infectious for at least a month at 0oC but only six days at 37oC. So under Irish winter conditions it could survive in the environment for periods of hours to several weeks. It can also remain infectious for longer in fresh water habitats than in brackish estuarine or marine habitats. The H5N1 strain of avian influenza is transmissible to people but it is poorly adapted to human hosts with only 256 people confirmed with infection worldwide since 2003. Approximately half of these have died as a result. Most of those who were infected had very close contact with infected poultry and were involved in slaughtering infected birds, plucking or dressing carcasses, had infected birds in their dwelling or allowed children to play with sick or dead birds. There is only one example of human infection from wild birds and that occurred in Azerbaijan when people plucked swans that had died from H5N1 infection. No cases have been found in people involved in any of the following activities: Culling infected poultry in commercial units throughout SE Asia. Conducting survey work on poultry or wild birds. Ornithological research such as bird banding or ringing. Husbandry of birds in zoos or parks. Refuse collectors including those involved in clean up after culling of flocks. Veterinary work and poultry farm workers. Wildlife rehabilitation. 4. Conclusions Based on current scientific research and thinking with regard to avian influenza it may be concluded that: The risk of infection in people, and particularly from wild birds, is very low for the circulating H5N1 strain of HPAI. The most likely means of introduction of this virus to areas of public use such as parks and recreational waterways (rivers, lakes and beaches) is through faeces of infected waterfowl. In respect to public use of parks and parklands, direct contact with fresh bird faeces should be avoided. Contamination of skin or clothing should be washed off with soap and water. Disinfectants are not required as the influenza virus is sensitive to detergents alone. Likewise, the virus is sensitive to UV light, and degradation will occur with exposure to the elements such as wind, rain, and sunlight. Dogs and cats are also unlikely to be infected in parks or parklands barring scavenging of dead birds or consumption of large quantities of recentlyexcreted infected faeces. Recreational activities such as boating, fishing, canoeing, water skiing or swimming would entail minimal risk of people contracting avian influenza. Wild waterfowl are unlikely to be present in significant numbers where many of these activities occur, and persons involved are not likely to ingest any or sufficient quantities of infected material. The dilution capacity of the water body is also likely to dilute any infected material rapidly to a level where it is no longer infectious. As mentioned above, exposure to sunlight and other adverse environmental conditions will also inactivate the virus. Small water bodies such as ponds or small shallow lakes with a high density of water birds and heavy faecal contamination of the water should be avoided for the recreational activities mentioned if that use entails a risk of ingesting contaminated water. 5. Recommendations With the current distribution of HPAI H5N1 globally and current understanding of the epidemiology of infection it is recommended there is minimal risk to the public or their pets in normal use of parks, parklands for recreational purposes. Therefore: 1) There should be no restrictions on use of these areas. 2) Aquatic activities such as swimming, canoeing, boating, skiing etc in water bodies where there is ample dilution of faeces from birds entails minimal or no risk to the public. Such activities are only a risk in small water bodies heavily contaminated by faecal matter from infected birds. Such areas should not be used for these activities regardless of whether avian influenza is present or not. 3) The advice on the Department of Agriculture and Food website: http://www.agriculture.gov.ie on the handling of dead birds and their safe disposal is appropriate and current. 4) The advice to staff who may be exposed to wild birds through their occupation in regards to personal hygiene, proper use of personal protective equipment (PPE), and categorization of risk is also in concurrence with scientific thinking: http://www.agriculture.gov.ie. 5.1. These conclusions may be validated by assessment of risk in the following scenarios: Scenario 1: There is no evidence of HPAI H5H1 in Ireland. Scenario 2: HPAI H5N1 infection confirmed in a single migratory water bird in a park used for recreational purposes in Ireland. Scenario 3: HPAI H5N1 detected in an endemic wild bird in a park in Ireland. Scenario 4: A local die-off of endemic wild birds has occurred in a park and HPAI H5N1 is suspected. Scenario 5: A local die-off of endemic wild birds has occurred in a park and HPAI H5N1 is confirmed. 5.1a. Scenario 1, HPAI H5N1 is not in Ireland: There is no risk to the public using parks or waterways for recreational purposes. Likewise, there is no risk to employees of the parks and wildlife service or local authorities who may come in contact with wild birds inhabiting these areas. General hygiene standards should still be maintained to protect against any zoonoses that could be contracted from contact with wild bird faeces. Dead birds should be handled as per the DAF guidelines. Areas with hard surfaces where waterfowl may aggregate and be fed by the public should be kept as clean as possible by regular washing down to decrease the faecal load. Detergents or viricides are not necessary. Normal public use of aquatic recreational areas should not be restricted. 5.1b. Scenario 2, HPAI H5N1 found in a single migratory bird in Ireland: DAF may place restrictions around the area in which the bird was found as per Commission Decision 2006/563/EC. Restricted areas will be demarcated by an Avian Influenza Infected Zone notice (Fig. 3). Risk analysis will also be conducted by DAF, assisted by NPWS, to determine the size of the restricted areas, or the need for such restricted areas, and whether infection has spread to other birds. While restrictions are in place, certain recreational activities such as game hunting will be prohibited. Parks and aquatic recreational areas should remain open for normal use by the public but parks should have signage for public toilets or washrooms where soap and running water is available for hand washing. Dead birds should be handled as per the DAF guidelines. Areas with hard surfaces where waterfowl may aggregate and be fed by the public should be kept as clean as possible by regular washing down to decrease the faecal load. Detergents or viricides are not necessary. 5.1c. Scenario 3, transmission of HPAI H5N1 has occurred to a native wild bird in a local area such as a park: DAF will impose restrictions as per Commission Decision 2006/563/EC until further investigations have determined the cause of the event. Restricted areas will be demarcated by an Avian Influenza Infected Zone notice (Fig. 3). While restrictions are in place, certain recreational activities such as game hunting will be prohibited. However, parks and aquatic recreational areas should remain open for normal use by the public because the risk of transmission to the public and to their pets would remain unchanged. Parks should have signage for public toilets or washrooms where soap and running water is available for hand washing. There should be increased vigilance by park staff for dead birds and these should be handled as per the DAF guidelines and removed promptly for diagnostic purposes or disposal. DAF should be notified of all sick or dead birds via the Local Disease Control Centre (LDCC) or the Avian Influenza Helpline (1890 252 283). Areas with hard surfaces where waterfowl may aggregate and be fed by the public should be kept as clean as possible by regular washing down to decrease the faecal load. Detergents or viricides are not necessary. 5.1d. Scenario 4, HPAI H5N1 is suspected as the cause of a local die-off of endemic birds. DAF will impose restrictions as above and further risk assessment initiated with the assistance of NPWS. Restricted areas will be demarcated by an Avian Influenza Infected Zone notice (Fig. 3). Increased surveillance should be carried out by DAF and NPWS staff to retrieve all dead birds for analysis or disposal as per DAF guidelines. All sick and dead birds should be reported to the LDCC or to the Avian Influenza Helpline. The public should be warned not to handle dead birds and signage posted showing the Avian Influenza Helpline number. There is no risk to members of the public who witnessed the die off without direct contact with affected birds. The public should be restricted from the immediate area of the die off until dead birds are removed and any hard surfaces washed down with running water. There would not be any need to use detergents or viricides on these areas. Daily cleaning with water and sweeping should be sufficient to maintain these areas subsequently. Regular surveillance for moribund or dead birds should continue after the event to provide public reassurance and to remove any carcasses from the area. Otherwise public access and use of the park should continue as normal. 5.1e. Scenario 5, HPAI H5N1 has been confirmed as the cause of a local die-off of wild birds. In this case all of the measures necessary to control and eradicate infection would have been carried out while infection was suspected. Thus there would be no incremental risk to the public by confirmation of H5N1. Increased surveillance should be carried out by DAF and NPWS staff to retrieve all dead birds for analysis or disposal as per DAF guidelines. All sick and dead birds should be reported to the LDCC or to the Avian Influenza Helpline. The public should be warned not to handle dead birds and signage posted showing the Avian Influenza Helpline number. There is no risk to members of the public who witnessed the die off without direct contact with affected birds. The public should be restricted from the immediate area of the die off until dead birds are removed and any hard surfaces washed down with running water. There would not be any need to use detergents or viricides on these areas. Daily cleaning with water and sweeping should be sufficient to maintain these areas subsequently. If regular cleaning cannot be conducted of areas heavily contaminated by waterfowl faeces, then restricted access to these areas should be considered. Regular surveillance for moribund or dead birds should continue after the event to provide public reassurance and to remove any carcasses from the area. Otherwise public access and use of the park should continue as normal. References 1) DAF website: http://www.agriculture.gov.ie/ (Advice on handling dead birds, Occupational health Guidance for Avian Influenza. 2) Aznar, I., More, S., McGrath, G., Collins, D., Crowe, O. 2006. An assessment of the risk of the introduction and spread of avian influenza in Ireland relating to the activities of migratory waterbirds. CVERA and BirdWatch Ireland. 3) World Health Organization website: http://www.who 4) European Commission, Animal Disease Notification System webpage: http://ec.europa.eu/food/animal/diseases/adns/index_en.htm 5) OIE webpage: http://www.oie.int/eng/en_index.htm 6) ProMed website: http://www.promedmail.org 7) DEFRA website: http://www.defra.gov.uk/ 8) FAO website: http://www.fao.org/. 9) Pfeiffer, D.U. et al., 2006. Scientific Opinion on Migratory Birds and their possible role in the spread of Highly Pathogenic Avian Influenza. The EFSA Journal 357, 1-46. Table 1. WILD BIRDS THAT POSE THE GREATEST RISK FOR AVIAN INFLUENZA IN IRELAND COMMON NAME SPECIES TYPE STATUS IN IRELAND HABITAT AI RISK Mute swan Cygnus olor Swan Resident Freshwater & coast High Whooper swan Cygnus cygnus Swan Winter immigrant Freshwater & coast High Greylag goose Anser anser Goose Resident & winter immigrant Estuaries,freshwater & arable land High Canada goose Branta canadensis Goose Resident Freshwater, estuary, arable land High Shelduck Tadorna tadorna Dabbling duck Resident, moult & winter immigrant Estuaries High Wigeon Anas penelope Dabbling duck Winter immigrant Freshwater & estuaries High Gadwall Anas strepera Dabbling duck Breeding & winter immigrant Freshwater & coast High Teal Anas crecca Dabbling duck Breeding & winter immigrant Freshwater & coast High Mallard Anas platyrhynchos Dabbling duck Resident & winter immigrant Freshwater & coast High Pintail Anas acuta Dabbling duck Winter immigrant Freshwater & coast High Shoveler Anas clypeata Dabbling duck Resident & winter immigrant Freshwater & coast High Pochard Aythya ferina Diving duck Winter immigrant (some resident) Freshwater High Tufted duck Aythya fuligula Diving duck Breeding & winter immigrant Freshwater High Goldeneye Bucephala clangula Diving duck Winter immigrant Freshwater & coast High Coot Fulica atra Rail Breeding & winter immigrant Freshwater & estuaries High Moorhen Gallinula chloropus Rail Resident (some winter immigrants) Freshwater High Golden plover Pluvialis apricaria Wader Breeding & winter immigrant Uplands and coast High Lapwing Vanellus vanellus Wader Breeding & winter immigrant Farmland and coast High Curlew Numenius arquata Wader Breeding Inland and coast High Black-headed gull Larus ridibundus Gull Breeding & winter immigrant Freshwater, farmland and coast High Common gull Larus canus Gull Breeding & winter immigrant Freshwater, farmland and coast High Lesser black-backed gull Larus fuscus Gull Breeding & winter immigrant Larger lakes and coast High Herring gull Larus argentatus Gull Breeding & winter immigrant Larger lakes and coast High Greater black-backed gull Larus marinus Gull Resident Larger lakes and coast High Little grebe Tachybaptus ruficollis Grebe Resident Freshwater and coast Med Great crested grebe Podiceps cristatus Grebe Breeding & winter immigrant Freshwater and coast Med Cormorant Phalacrocorax carbo Cormorant Breeding & winter emigrant Coast and freshwater Med Light-bellied brent goose Branta branta hrota Goose Winter immigrant Estuaries, coast, grassland Med Avian Flu Risk Assessment Wild Birds 27/10/2006 Figure 1: Wild bird species of greatest risk with regard to carrying HPAI H5N1 to Ireland or transmitting the virus within the country. (Pdf file of bird spcies photos to be inserted here) 10 Avian Flu Risk Assessment Wild Birds 27/10/2006 Figure 2: Map of Ireland showing wetland habitats with the greatest densities of waterfowl representing higher risk areas for avian influenza introduction. 11 Avian Flu Risk Assessment Wild Birds 27/10/2006 Figure 3. Avian Influenza restricted zone notice. 12