Avian Influenza (H5N1) or Bird Flu

Current State of Play

There is a tremendous amount of media coverage for the so called bird flu and the possibility of a global pandemic. Indeed, the media have been quoted as describing it as a “Biological Time Bomb”.

As of the time of writing, the situation may be summarized as:

Asia is currently experiencing a second major outbreak of avian flu since 1997
Since December 2003, there have been a total of 60 reported deaths from the disease
All cases of bird flu amongst humans appear to have been transmitted from birds to people. According to the best available information, there have, as yet, been no cases of transmission from person to person
Whilst most reported cases amongst humans have been in Southeast Asia, infected birds have now been identified in European countries. It is believed that some of these infections are the result of importing infected birds and others, which are far more difficult to control, have resulted from migrating birds.
Influenza viruses are capable of mutating and it is believed that the possibility of the virus developing the ability to transmit from human to human is a very real one. Should this occur, the likelihood of a global pandemic is high unless we can do something to halt the spread of infection.

Some influenza viruses have the ability to swap genetic materials and merge with each other. Consequently, in simple terms, it is possible for a strain of bird flue to merge with a strain of human flu to produce a virus that is readily transmissible from person to person. This kind of mutation is most likely to occur in a person who contracts both bird and human forms of flu at the same time.

Although the consequences of bird flu are relatively minor at present (though clearly this is not the case for those 60 or so families who have lost loved ones), it nonetheless represents a high risk, which, if it occurs, could have catastrophic consequences.

Clearly, governments have a major role to play in containing this risk and we look to them to identify each new strain of virus and prepare vaccines in appropriate quantities. However, there are limits to what governments are able or willing to do and employers cannot afford to ignore the threat and hope someone else will find the solution.

Apart from their legal duties under health and safety legislation, employers could also be faced with very severe consequences for their businesses, should their workforce (or that of their suppliers or customers) be severely infected.

Assessing the Risk

So how should an employer approach this particular threat? First it must be recognized that although there is a general underlying risk that affects everyone, there are also significant differences for different organisations.

For example, any organisation where employees come into frequent close contact with birds is at a higher risk as a result of this activity. Poultry farmers are an obvious example, as are vets and those who look after aspects of our natural environment.

It isn’t just poultry farmers who are on the front-line. For example, pigs are susceptible to both bird flu and human forms of flu so that merging of the two strains of virus could also occur in pigs.

Health care professionals are clearly at risk should significant infection break out amongst humans.

Another group of people at particular risk are those who travel to countries where the virus is known to exist. This includes members of the travel industry as well as those who need to travel in order to conduct their business in these countries.

According to the Food Standards Agency, people who are not considered to be at risk are those who handle or eat properly cooked poultry meat. The risk of becoming infected arises from close contact with live poultry that are infected. Of course, this does not negate the advice that has always been around to wash your hands after handling uncooked poultry meat because of the risk from all kinds of bacteria.

All of these are just examples of people who could be at particular risk of infection. It is incumbent on each employer to consider the activities of each group of employees to assess the likelihood that those activities could make them more or less susceptible to infection.

Not only so, but the time to undertake such assessments is as early as possible after the hazard becomes apparent – in other words NOW. Should a pandemic occur, then the best medical advice indicates that the spread could be very rapid indeed, which is not the best time to be starting to think about risks assessments and effective control measures.

Addressing the Risks

Although vaccinations can help, it may not be possible to administer vaccinations on a wide scale against strains of bird flu, but the regular annual vaccinations against human forms of flu are certainly worthwhile. Apart from limiting the risk of becoming infected by two viruses at the same time (double trouble), it reduces the opportunities for the bird flue virus to mutate into something that can be transmitted more readily from human to human.

Antiviral drugs can also be effective both for treatment and prevention of infection. However, some have limitations, can be very expensive and supplies are limited

Keep employees informed

It is worth ensuring that all employees are properly informed about the risks, both in general terms and in specific ways that might affect them in the course of their work.

As well as being aware of the risks, employees also need to know about any precautions you have put in place to minimize the likelihood of infection and what you expect of them should they become infected.

It is a fact that many UK employees believe it is a sign of weakness if they allow an infection to keep them away from work. Much as such a work ethic may be commendable, it is seriously counter productive if other people become infected as a result.

In the case of bird flu, the consequences of spreading infection are on a completely new level – potentially fatal – and this needs to be made very clear to “workaholic” employees.

Consequently, should there be a serious outbreak in our own country, employees need to be aware that they will not be welcome in the workplace if they have reasonable grounds for believing they are infected. Instead, they should seek immediate medical treatment and follow their doctor’s advice.

Common Sense Measures

Some precautions are obvious when pointed out but it is still worth making the point – over and over again if necessary. For example:

Avoid direct contact with any live poultry and keep away from places where poultry is raised or sold
Wash your hands thoroughly and frequently, regardless of whether or not they are visibly soiled
If at all possible, avoid travelling to parts of the world where the infection is already present
Avoid mass gatherings of people anywhere if there is any reason to believe that infected people may be present (including yourself)
Even avoid mass gatherings in the workplace if it is possible to make alternative arrangements
If you have to mix with people (or livestock) that you believe could be infected, ensure you wear appropriate protective clothing, mask etc and that you follow available advice for washing, cleaning and disinfecting
As far as possible, avoid touching the face, particularly around the areas of the mouth, nose and eyes
Avoid eating poultry meat, eggs, etc that are not properly cooked
Seek help and advice at the first signs of any symptoms, particularly fever, coughing, sore throat or difficulty in breathing

Poultry and related industries

If you have anything to do with keeping live birds, then you need to obtain specific advice from DEFRA in regard to preventing infection in the first place and controlling it should any birds show symptoms of infection. The most obvious precautions include:

Restricting movement of animals and litter
Limiting the movement of vehicles between yours and other locations that could be harbouring infection
Cleansing and disinfection of premises and vehicles
Avoid importing live birds if at all possible. If essential, ensure you scrupulously observe strict quarantine procedures
Keeping in touch with your local vet if there is the slightest suspicion of infection

However, such a list should not be treated as exhaustive. It is essential that you seek advice for your specific circumstances.

Travel to infected parts of the world

Before travel

Educate yourself on the current situation in the country you plan to visit
Visit your doctor for advice and ensure you are up to date with all routine vaccinations. Flu of any kind is bad enough by itself without suffering other infections as well
Check out health care resources in the destination country before leaving
Ensure your medical and travel insurance are sufficient to get you home in an emergency

After travel

Monitor your health for at least 10 days after your return
If you need to visit a medical practitioner, be sure to inform them where you have been and when
Avoid unnecessary contact with others to minimise the potential for any infection to spread

In summary, the first thing every employer needs to do is to undertake an assessment as a matter or urgency in order to identify and evaluate the risks to employees of contracting bird flu. The level of risk can vary for different groups of employees, depending on their specific circumstances, and therefore it is important to identify who may be affected by the risks and how.

Next consider what precautions you can put in place; considering preventative measures first and then what needs to be done in the event of significant infection of your workforce.

Finally, you need to ensure all employees are properly briefed as to the true nature of the risks and what they need to do in order to comply with the precautions you have put in place.

For most employers, there is probably little we can do to prevent the bird flu virus from mutating and passing from person to person, but if we act in a timely fashion, we can certainly take a few common sense measures to limit the impact on our employees and our businesses.

Useful links

Dept of Health - http://www.dh.gov.uk/en/Publichealth/Flu/PandemicFlu/index.htm

Health Protection Agency - http://www.hpa.org.uk/infections/topics_az/avianinfluenza/menu.htm

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