Pandemic Influenza Plan - Questar III

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Section 12: H5N1 in Non-Human Animals The Erasmus Medical Center in the Netherlands has published some research showing that: 1) domestic cats that are inoculated intra-tracheally with an H5N1 strain isolated from a Vietnamese man who died of the disease become symptomatic, show gross lesions characteristic of H5N1 infection and the virus can be re-isolated from their tissues, 2) horizontal transmission of the same virus can occur between domestic cats in the laboratory setting, and 3) feeding infected chicks to domestic cats can produce clinical symptoms in the animals with subsequent viral shedding. Ferrets are often used as a research model in influenza studies. Laboratory work has demonstrated that infection of ferrets with human derived H5N1 virus strains is fatal. However, infection of ferrets with avian derived strains of H5N1 did not result in fatal disease. The possibility of natural infection in other species of mustelids has not been documented. Without additional evidence of HPAI risk to domestic or free-ranging mammals in the U.S., mammals will not be prioritized at this time for early detection and disease surveillance. Testing for HPAI in mammals is available, when indicated, through the NYSVDL at Cornell University. Specific guidelines for surveillance are under development. E. Importation All legally imported birds are tested before they leave their country of origin according to country-specific requirements. Once they arrive in New York State, they are immediately quarantined at a federal facility in Newburgh, New York for one month. AI testing of these birds is routine, and any bird testing positive for AI is euthanized and appropriately disposed of. For more information on importation requirements, contact the USDA Animal and <strong>Plan</strong>t Health Inspection Service Veterinary Services New York office at 518-869-9007. The federal Department of Homeland Security, Customs and Border Protection, Department of Interior, U.S. Fish and Wildlife Service and the U.S. Department of Agriculture jointly handle the investigation and control of illegally imported or smuggled animals and animal products. Based on known patterns for smuggling, agents inspect for smuggled birds or poultry products. If any birds are found, they are sampled with testing conducted at the NVSL for AI and other foreign animal diseases. Illegally imported poultry products are either returned to the country of origin, or destroyed according to APHIS policy. IV. Laboratory Diagnosis for Non-Human Animal Infection Laboratory testing for all strains of AI, including H5N1, in non-human animals is available from several laboratories. Domestic birds (poultry) are routinely tested by NYSDAM at the NYSVDL, part of Cornell University’s Animal Health Diagnostic Center. A sample of wild birds submitted to the WPU for WNV or other evaluation will be submitted for testing to Cornell, in accordance with guidelines to be developed. The February 7, 2006 12-6
Section 12: H5N1 in Non-Human Animals National Wildlife Health Center (NWHC) laboratory in Madison, Wisconsin may also be considered as a testing resource by the WPU. Additional bird flu research is underway at the NYSDOH Wadsworth Center. V. Response to HPAI in the United States Any HPAI virus is considered a Foreign Animal Disease (FAD) and as such the discovery of any HPAI in poultry, wild birds, or captive exotic birds in the United States would result in an immediate state and federal response to control and eradicate the virus. The USDA Animal and <strong>Plan</strong>t Health Inspection Service (USDA-APHIS-VS) has primary authority over all FADs found in the U.S. NYSDAM would work in conjunction with USDA-APHIS to quarantine and take all necessary measures as needed to eradicate HPAI. Such measures may include culling of potentially exposed or infected animals, and vaccination of animals in adjacent areas. In NYS, NYSDEC has the legal responsibility for wild birds and game bird breeders, and the U.S. Fish and Wildlife Service (USDOI) has responsibility for migratory birds, including migratory waterfowl. Thus, these agencies are involved in cooperative efforts for avian influenza surveillance and control. In the event such a response is needed for any HPAI strain, WHO and CDC have advised that workers responding to such an outbreak take certain precautions to prevent human infection with HPAI. It is recommended that poultry workers and workers who will respond to a potential outbreak of HPAI receive the currently available human seasonal flu vaccine (to reduce the possibility of a worker being co-infected with a human and avian flu virus) and to receive prophylactic antiviral medications in the event of an exposure. These workers would also be prioritized for any human HPAI H5N1 vaccines that are developed, if there is an HPAI H5N1 outbreak in poultry. Federal employees will presumably have worked with their own occupational health providers to have vaccine and medications as needed. New York State employees will need to coordinate through NYS occupational health, and this may require assistance through the NYSDOH to acquire and provide vaccine and antiviral medication. Nongovernmental employees with potential exposure will need to work with their private and employment health care providers. LHDs can assist by providing information and triage of questions to appropriate state and federal agencies. Occupational health issues will be of concern not only for those working with potentially infected poultry, but also those in contact with potentially infected wildlife. NYSDOH will work with other federal and state agencies to develop and disseminate guidelines for protection. Within laboratories, guidelines developed by the NYSDOH Wadsworth Center are recommended for those handling non-human as well as human samples potentially infected with HPAI (see Section 2: Surveillance and Laboratory Testing). February 7, 2006 12-7
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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 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 • Pe
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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 • En
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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 o Staf
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Section 4: Infection Control • De
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Section 4: Infection Control • Pr
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Section 4: Infection Control The ma
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Section 4: Infection Control • Up
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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 1) N
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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 diabetes mellitus), re
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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-B a The drug package ins
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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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Section 9: Communications I. Overvi
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Section 9: Communications and commu
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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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