Self-Observation Instructions for Demobilizing Bird Flu Responders

Public Health Monitoring Plan for USDA/APHIS Responders to Detections of Avian Influenza Virus in PoultryCdc-pdfExternal

This document provides guidance to local, state, and federal public health authorities on monitoring of persons potentially exposed to avian influenza viruses during official United States Department of Agriculture Animal and Plant Health Inspection Service (APHIS) response activities in the United States.

You are being given this information and these instructions because you participated in the U.S. response to domestic outbreaks of avian influenza.

As part of your work, you may have been around bird flu viruses. Infected birds shed avian influenza virus in their saliva, mucous and feces. Human infections with bird flu viruses can happen when enough virus gets into a person’s eyes, nose or mouth, or is inhaled. This can happen when virus is in the air (in droplets or possibly dust) and a person breathes it in, or when a person touches something that has virus on it then touches their mouth, eyes or nose. Rare human infections with some avian viruses have occurred most often after unprotected contact with infected birds or surfaces contaminated with avian influenza viruses. However, some infections have been identified where direct contact was not known to have occurred.

The Centers for Disease Control and Prevention (CDC) believes the risk of infection with AI viruses is low. Because human infections with these viruses are possible, however, all people participating in avian influenza outbreak response efforts should be monitored for illness for 10 days after their last possible exposure to infected birds or potentially-contaminated environments, even if exposure to the sick birds was minimal or if personal protective equipment (PPE) was worn appropriately. State and local health departments are helping with this monitoring effort and they may contact you while you’re observing your health. By following the instructions below, you can help ensure that you receive prompt medical evaluation, possible testing and appropriate treatment if you become ill with signs and symptoms that could be due to AI virus infection. Thank you for your contribution to the AI domestic response effort.

Please follow these instructions carefully:

1. Monitor your health for symptoms of avian influenza virus infection.
During and then immediately after your last exposure to infected birds or contaminated surfaces, monitor yourself daily for any of these signs and symptoms for 10 days:

  • Fever (Temperature of 100°F [37.8°C] or greater) or feeling feverish/chills
    Cough Nausea
    Sore throat Vomiting
    Runny or stuffy nose Fatigue
    Sneezing Seizures
    Muscle or body aches Rash
    Eye tearing, redness, irritation
    Difficulty breathing/Shortness of breath

You should observe your health daily even if you carefully followed all guidelines and instructions for properly putting on and taking off personal protective equipment (PPE) and maintaining biosecurity precautions.

Re-start your 10-day monitoring period from Day 1 if you are around sick birds again.

2. Call your state/local health department immediately if you develop any illness signs or symptoms during the 10-day observation period.
Your health department will help you determine what to do next.


    • Most of the signs and symptoms of bird flu overlap with those of other respiratory illnesses (like seasonal flu).
    • If you develop any of the signs or symptoms listed in this fact sheet, call the health department of the state you are in immediately. Your health department wants to hear from you, even if it turns out to be a ‘false alarm’.
    • Your health department may contact you by phone, email or text while you are observing your health.
    • If you have symptoms, your health department may give you instructions and ask you to get tested for avian influenza virus infection.
    • If you have symptoms, your health department may ask you to stay home and limit contact with others as much as possible until the results of your test are known.
    • To test for avian influenza virus infection, a doctor or nurse will collect a sample from you by swabbing your nose and/or throat.
    • If you become sick while you are observing your health after demobilization, a doctor may prescribe you an antiviral medication that is used for treatment of influenza. It’s important to take the medication as prescribed. (CDC recommends that clinicians prescribe antiviral medications for treatment of ill persons who had exposure to avian influenza viruses.)


Here’s an example of a log you can keep as a reminder to check your health each day for illness signs and symptoms.
Day Date Temperature Signs and Symptoms Write ‘None’ if you aren’t experiencing any of the signs and symptoms.

Where to Find More Information:

Visit Information on Avian Influenza or Información sobre la influenza aviar.

Call 1-800-CDC-INFO (1-800-232-4636); TTY: 888-232-6348

Avian influenza virus infections in humans are of public health concern, not only because of the illness they may cause, but because of their pandemic potential. Some avian influenza viruses have been associated with greater numbers of human infections and more serious illnesses in people and therefore may pose a greater known public health risk. Avian influenza viruses of particular public health concern include (1) those viruses which are known to have caused severe disease in humans, such as highly-pathogenic avian influenza (HPAI) A(H5N1) virus and low-pathogenic avian influenza (LPAI) A(H7N9) virus. Also, (2) avian influenza viruses that are related to viruses known to cause severe disease in humans are of concern because of their perceived potential to cause severe disease in people. These include HPAI A(H5) and A(H7) viruses identified in birds in the United States during 2015 and 2016. Finally, (3) other avian influenza viruses may be deemed to be of public health concern based on specific circumstances.

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