Pandemic Influenza Plan - Questar III

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Section 12: H5N1 in Non-Human Animals I. Overview Avian influenza (AI) type A viruses have been found in over 40 species of wild and domestic birds and cases occur every year throughout the world. Low pathogenicity (based on in vivo mortality assay and sequencing of the hemagglutinin cleavage site) AI occurs periodically in the U.S. including New York. The virus is shed in the fecal droppings, saliva and nasal discharges of some avian wildlife species, and infected domestic poultry. Contaminated water is a common source of infection for birds. Many different subtypes of type A AI have been identified. The H5 and H7 subtypes are those most often associated with morbidity/mortality in birds. Highly Pathogenic Avian <strong>Influenza</strong> (HPAI) is considered to be a disease primarily of domestic poultry, and as such, the United States Department of Agriculture (USDA), in conjunction with the New York State Department of Agriculture and Markets (NYSDAM), will have the lead for non-human disease surveillance and control if and when HPAI is detected in New York State. H5N1 is a HPAI subtype circulating in Southeast Asia since 1997, and according to the World Health Organization, since 2003 is responsible for the largest epizootic of HPAI ever recorded. It is of concern to public health because it can spread from birds to people. However, H5N1 has accounted for only a relatively small number of human illnesses. Person to person spread has been documented only very rarely. H5N1 is considered to have the potential to become pandemic because it is a novel strain for the human population (no human immunity), and it has resulted in severe morbidity and mortality in the diagnosed human cases. To cause a human pandemic, the subtype would need to become capable of spreading easily from person to person, a capacity not yet demonstrated. Wild birds may have contributed to the rapid spread of the most recent H5N1 outbreaks in eastern Asia. Infection has been documented primarily, but not exclusively, in waterfowl and shore bird species. Recent data suggest that HPAI H5N1 is being spread by migrating waterfowl, some of which may be asymptomatic. There are also continuing reports of the transport of domestic fowl for food and sport (such as cock fighting) from affected areas to adjacent regions. This HPAI H5N1 strain has recently been confirmed in domestic and wild birds in Europe. There is no evidence that this strain exists in birds or humans at this time in the Western Hemisphere. Experts advise that historically AI has not been carried by migratory birds from Europe or Asia to the Americas. Many strains of low pathogenicity AI, including H5 and H7 types, are known to routinely occur in migratory waterfowl and shorebirds in the U.S. Information about AI worldwide is available from the World Health Organization at http://www.who.int/csr/disease/avian_influenza/avian_faqs/en/index.html . Additional AI information from a public health perspective is available from the Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/flu/avian/ . A summary of initial human cases is available in World Health Organization. Current concepts: Avian influenza (H5N1) infection in humans. New England Journal of Medicine 2005;353:1374-1385. Findings of HPAI H5N1 in Asian waterfowl are available in Li KS, Guan Y, Wang J, et al. Genesis of a highly pathogenic and potentially pandemic H5N1 influenza virus in eastern February 7, 2006 12-2
Section 12: H5N1 in Non-Human Animals Asia. Nature 2004;430:209-213 and Liu J, Xiao H, Lei F, et al. Highly pathogenic H5N1 influenza virus infection in migratory birds. Science 2005;309:1206. This section describes, from a NYS public health perspective, the surveillance system, availability of laboratory diagnostic procedures, and activities by pandemic period in preparation for, and during, an outbreak in the U.S. of HPAI with human risk. A separate interagency AI plan is under development providing more specific details for each NYS state agency’s responsibilities. II. Objectives • Summarize current capacity and responsibilities for non-human animal surveillance and laboratory testing for HPAI. • Summarize anticipated non-human animal disease control activities. <strong>III</strong>. Surveillance for Non-Human Animal Infection AI surveillance may be instituted in domestic birds (e.g., poultry), wild free-ranging birds, captive birds, and mammals during different pandemic influenza and/or AI plan periods. The types of surveillance and areas of responsibility are outlined below. In addition, special situations such as importation (legal and illegal) are described. Confidentiality of animal owners, those reporting disease, and certain detailed address information must be maintained with all non-human animal surveillance systems while still allowing for communication and control activities. A. Surveillance in Domestic Birds (e.g., poultry) State and federal programs currently conduct surveillance for AI among selected domestic poultry, including testing for H5N1. See http://www.aphis.usda.gov/lpa/issues/avian_influenza/. Specific types of poultry surveillance are determined at the state level. In New York, NYSDAM is responsible for domestic bird (e.g., poultry) AI surveillance and control. Periodic sampling is done at live bird markets. In addition, all poultry farms either within or outside New York that have permits to provide poultry to live markets in New York must document that they are free of AI. NYS domestic flocks, regardless of whether they are associated with live bird markets, have ill or dead birds tested by veterinarians for AI when there is any clinical, epidemiologic, or pathologic suspicion of AI. See http://www.agmkt.state.ny.us/AI/AvianFlu.html . Testing is conducted by the New York State Veterinary Diagnostic Laboratory (NYSVDL) at Cornell University’s Animal Health Diagnostic Center with results reported to NYSDAM and the sample submitter. Any domestic bird owners or their veterinarian with concerns about AI in their birds should contact NYSDAM at 518-457-3502 to discuss the need for testing. In New York City, the New York City Department of Health and Mental Hygiene should also be contacted at 212-788-4160. February 7, 2006 12-3
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February206 Pandemic Plan NewYorkSt
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Introduction Pandemic influenza occ
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example, at this time, it is realis
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Acronyms (cont.) IND IHANS IRB ISHS
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Section 1: Command and Control I. O
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Section 1: Command and Control pers
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February 7, 2006 Appendix 1-A
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Appendix 1-B The Public Health Law
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Appendix 1-B communicable diseases
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Appendix 1-C Management Office or t
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Appendix 1-E Suspension of Public M
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Appendix 1-G A Guide to New York St
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Appendix 1-G health commissioner. P
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Appendix 1-G 8. State Institutions
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Appendix 1-G b. Governor May Invoke
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Appendix 1-G may direct, pursuant t
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Appendix 1-G c. Commissioner of Gen
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Appendix 1-G Designation of emergen
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Appendix 1-G physician’s assistan
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Appendix 1-H Summary of Public Offi
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Section 2: Surveillance and Laborat
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Appendix 2-A • Surveillance Crite
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Appendix 2-A • In New York City,
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NYSDOH Novel Influenza Case Report
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Appendix 2-C to health care provide
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Virus Detection History NYS Lab Num
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Section 3: Healthcare Planning and
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Section 4: Infection Control I. Ove
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Section 4: Infection Control A. Bas
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Section 4: Infection Control Drople
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Section 4: Infection Control o Noti
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Section 4: Infection Control E. Coh
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Section 4: Infection Control If wid
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Section 4: Infection Control should
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Section 4: Infection Control Policy
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Section 4: Infection Control The ma
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Section 4: Infection Control Health
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Appendix 4-A Soiled linen and laund
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Appendix 4-B Respiratory Hygiene/Co
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Section 5: Clinical Guidelines I. O
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Section 5: Clinical Guidelines incu
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Section 5: Clinical Guidelines infe
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Section 5: Clinical Guidelines Alth
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Section 5: Clinical Guidelines Infe
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Section 5: Clinical Guidelines •
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Appendix 5-B Clinical Evaluation of
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Appendix 5-C Special Situations and
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Appendix 5-D handling soiled laundr
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DRAFT Appendix 5-E Footnotes to App
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Appendix 5-F February 7, 2006 1
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Appendix 5-F 7. Guidance on the eva
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Appendix 5-H Source: U.S. Departmen
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February 7, 2006 2 Appendix 5-I
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Appendix 5-J Clinical Presentation
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Appendix 5-J resistant S. aureus (M
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Appendix 5-K eight patients—all o
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Appendix 5-L Guidelines for Managem
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Appendix 5-L testing should be perf
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Appendix 5-L February 7, 2006 5
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Section 6: Vaccine Procurement, Dis
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Appendix 6-A Vaccine Priority Group
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Appendix 6-B Mass Clinic Planning O
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Appendix 6-C Vaccine and Antiviral
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Appendix 6-C 1. Request Phase The r
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Appendix 6-C 3. Receipt and Sign-of
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Appendix 6-C • Work with local he
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Section 7: Antiviral Medication Pro
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Appendix 7-A Characteristics of Ant
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Appendix 7-C 7 HCWs in emergency de
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Section 8: Travel-Related Disease C
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Appendix 8-A Home or Community-Base
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Appendix 8-B Contact Identification
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Appendix 8-B • Determine the time
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Appendix 8-C Administrative Data: S
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Appendix 8-D CONTACT DAILY TEMPERAT
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Appendix 8-F Definitions: Intervent
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Appendix 8-F facility. No specific
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Appendix 8-F • Resources Required
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Appendix 8-G Business Pandemic Infl
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Appendix 8-G 4. Allocate resources
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Appendix 8-H CDC guidelines suggest
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Appendix 8-H If I am not masked I
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Appendix 8-H NYSDOH Model Influenza
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Appendix 8-H I understand that if
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Appendix 13-C Overview of the Healt
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Appendix 13-C • Ongoing surveilla
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Table 1. Summary of HERDS Use To da
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Appendix 13-D Commerce Access and A
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Appendix 13-D Table 3. Organization
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